TREATMENT OF RECENT TRAUMA SURVIVORS WITH BENZODIAZEPINES - A PROSPECTIVE-STUDY

Background: Most types of psychotropic drugs have been tried in the tr eatment of chronic posttraumatic stress disorder (PTSD), but have yiel ded limited results. Theory and retrospective research predict that ea rly treatment may be more efficacious. Specifically, high-potency benz odiazepines have been recommended for the treatment of acute responses to trauma and for prevention of PTSD. This study prospectively evalua tes the effect of early administration of benzodiazepines on the cours e of PTSD and PTSD symptoms. Method: Thirteen trauma survivors (the be nzodiazepine group) were treated within 6.7 +/- 5.8 days after the tra uma (range, 2-18) with either clonazepam (N = 10, 2.7 +/- 0.8 mg/day) or alprazolam (N = 3, 2.5 mg/day). Thirteen other trauma survivors, pa ir-matched with subjects in the ac tive treatment group for gender and symptom severity in the first week after the trauma, constitute the c ontrol group. Both groups were reevaluated 1 and 6 months after the tr auma for PTSD symptoms (Horowitz Impact of Event Scale; Mississippi Ra ting Scale for Combat-Related PTSD-civilian trauma version), PTSD stat us (Clinician Administered PTSD Scale), state anxiety, depression, and resting heart rate. Results: Subjects in the benzodiazepine group did not differ from controls in 1-month and 6-month PTSD and anxiety scor es. Repeated measures ANOVA showed no group or group-by-time effect on psychometric measures. A trend toward group-by-time interaction in re sting heart rate was noted (progressive decrease in the benzodiazepine group). Nine benzodiazepine subjects and 3 controls met PTSD diagnost ic criteria 6 months after the trauma. Conclusion: Contrary to expecta tions, the early administration of benzodiazepines to trauma survivors with high levels of initial distress did not have a salient beneficia l effect on the course of their illness, while reducing physiologic ex pression of arousal.