Introduction. Various interventions, both psychological and pharmacological, have been studied for their efficacy in preventing posttraumatic stress disorder (PTSD) following trauma exposure. However, the preventive effect of pharmacotherapy has not been systematically assessed. Methodology. A systematic review of all clinical trials of drug therapy to prevent PTSD, available through the PubMed and EMBASE databases, was conducted. This included an assessment of each study’s quality. Results. A total of 13 studies were reviewed. The drugs examined in these papers included propranolol, hydrocortisone, serotonin reuptake inhibitors, gabapentin, omega-3 fatty acids, and benzodiazepines. There was marked heterogeneity across studies in terms of quality, study populations, and methodology. Analysis of the outcomes revealed preliminary evidence for the efficacy of hydrocortisone, particularly in critical care settings. There was no consistent evidence to support the use of other drugs to prevent PTSD. Discussion. There may be a limited role for hydrocortisone in preventing the development of PTSD in specific settings. Results with other drugs are inconsistent. Further large-scale studies should assess the efficacy of these approaches in other contexts, such as natural disasters, and the time frame within which they should be used. 1. Introduction Posttraumatic stress disorder (PTSD) is a common psychological consequence of exposure to trauma, particularly situations that threaten the safety or integrity of the self or loved ones. A wide range of traumatic situations has been associated with PTSD: combat situations, natural and man-made disasters, accidental injury, physical or sexual assault, and serious medical illnesses and their treatment [1–3]. PTSD consists of three distinctive groups of symptoms: reexperiencing the traumatic event, avoidance of reminders of the event, and hyperarousal. These symptoms should be present for at least one month and should cause significant impairment in social and occupational functioning [1, 4, 5]. Estimates of prevalence of PTSD in the general population have varied depending on study methodology, but rates as high as 12.3% have been reported, with prevalence in women generally higher than in men [1, 6]. Following exposure to a natural or man-made disaster, prevalences as high as 40% have been reported [2]. The course of PTSD is variable, with some studies finding a favourable outcome and low rates of chronicity [7]; however, long-term studies have found that at least half the patients initially diagnosed with PTSD
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