Hydrocortisone Sodium Succinate

Tsai MS, et al. investigated the cardioprotective mechanisms of hydrocortisone administered after return of spontaneous circulation (ROSC) in a rat model of ventricular fibrillation cardiac arrest. Successfully resuscitated animals received either low-dose (2 mg/kg) or high-dose (8 mg/kg) hydrocortisone, or a placebo, immediately after ROSC. Within four hours, both treatment groups demonstrated higher cardiac output compared to controls. Histological and electron microscopy analyses revealed that hydrocortisone treatment mitigated myocardial damage and cardiac mitochondrial injury, including preventing accelerated calcium-induced mitochondrial swelling and preserving complex activity. At 72 hours post-ROSC, a significantly higher proportion of hydrocortisone-treated animals survived with good neurological recovery.

Fig. 1 Histological examinations of heart and troponin‐I at 4 hours. (Tsai MS, et al., 2021)

Steudte-Schmiedgen S, et al. investigated whether hydrocortisone (20 mg) administered one hour prior to single-session exposure-based cognitive-behavioral therapy (CBT) enhances treatment outcomes in 33 individuals with spider phobia. Hydrocortisone augmentation resulted in greater improvement in self-reported fear and increased speed when approaching a spider at follow-up, but did not affect threat processing bias. Neither endogenous glucocorticoid levels nor change in threat bias predicted symptom improvement, although higher baseline hair cortisone was preliminarily associated with greater reduction in threat bias.

Fig. 2 Saliva cortisol and cortisone levels measured at seven time points during the treatment session. (Steudte-Schmiedgen S, et al, 2021)