Recruitment: Insufficient number of patients eligible for enrollment

The aim of this prospective, double-blind, placebo-controlled, cross-over study is to determine the therapeutic efficacy of low-dose cortisol for symptoms of chronic posttraumatic stress disorder.

Inclusion Criteria:

• Female and male patients with chronic PTSD due to adult trauma; PTSD is diagnosed according to the DSM-IV, as measured with the CAPS
• Age between 18 and 60

Exclusion Criteria:

• History of disease states representing contraindications to glucocorticoid therapy (tuberculosis, gastritis, gastric- and duodenal ulcers, Cushing's disease, osteoporosis, hypertension, pregnancy (to exclude with a pregnancy test) and lactation, glaucoma, diabetes mellitus, thrombophilia, acute or chronic infections, hyperthyroidism, cirrhosis)
• Severe or chronic somatic diseases
• Topic glucocorticoid therapy (for large skin parts)
• Inhaled glucocorticoids
• Current psychotic, bipolar, substance-related, or severe personality disorder
• Current severe depressive disorder
• Severe cognitive impairment or a history of organic mental disorder
• Evidence of PTSD or depression immediately prior to the index trauma
• Prominent current suicidal or homicidal ideation
• Asylum seeking status
• Body weight >20% above or below normal range
• Changes in psychopharmacologic or psychotherapeutic management less than 8 weeks before start of the study