"Men In Black III" and Propranolol
May 29, 2012 9:32am
Will Smith and the Memory Eraser
In the real world tormenting and oppressive memories resulting from traumatic events can be hard to forget and in many individuals these cause Post Traumatic Stress Disorder. Our blog at AMHF has a section devoted to identifying and treating PTSD.
An attempt has been made during the last decade to see if administration of Propranolol--a beta blocker medication used to treat hypertension--can be useful in treating Post Traumatic Stress disorder, through a complicated neurophysiological mechanism that would attenuate the strength of past memories that are especially anxiety arousing.
Propranolol is an intriguing medication. It was developed by Scottish scientist Dr. James Black, who was awarded the Nobel Prize Medicine for his achievement in 1988. It can be used for stagefright. Medical students have been known to take it to ease their anxiety before important exams, and some surgeons have taken it prior to surgery to diminish tremors in their hands while performing surgery. It is a banned substance in the Olympics.
At the start of the century there was a certain level of optimism regarding its' possible use in treating the intrusive and debilitating memories evoked in Post Traumatic Stress Disorder. Catherine Dupree, writing in 2004 in Harvard Magazine, said:
"'The more you love a memory,' Vladimir Nabokov once declared, 'the stronger and stranger it is.' Certainly we never forget the details of our beloved moments: first kisses, college graduations, our children's births. 'That kind of thing,' said Nabokov, 'is absolutely permanent, immortal.' But some ineradicable memories are of things we desperately want to forget.
"For those who suffer from post-traumatic stress disorder (PTSD), vivid recollections of the horrific events they survived or witnessed; wars, rapes, accidents, injuries, concentration camp internments, often return relentlessly for years, evoking the same fear, helplessness, horror, and consequent anguish that accompanied the initial experience. This creates a disabling cycle that can be difficult, if not impossible, to break.
"But encouraging new research suggests that the beta-blocker drug Propranolol, by inhibiting the release of certain stress-related hormones, may stop such unwanted memories from being reinforced in our brains. Unlike the creepy device that erases undesirable recalls just like files on a computer in the recent film Eternal Sunshine of the Spotless Mind, Propranolol won't cause PTSD sufferers to forget their ghastly memories, 'but it can take out the sting,' says professor of psychiatry Roger K. Pitman.
"For a double-blind pilot study published in Biological Psychiatry, Pitman recruited 41 emergency-room patients who had just survived a traumatic event (most were car crashes). Eighteen patients received a 10-day course of oral Propranolol; the rest received a placebo. When the patients returned one and three months later for psychometric assessments (like measuring their heart rates while they listened to previously tape-recorded descriptions of the initial event), those who had received Propranolol were less likely to show signs of PTSD."
Despite this enthusiasm 8 years ago, it is uncertain whether or now Propranolol possesses the efficacious quality needed to transform or diminish traumatic memories. In a study published in January, 2012, Elizabeth Hoge and her colleagues ["Effect of Posttraumatic Propalonol on PTSD Outcome and Physiological response during Script-Driven Imagery," CNS Neuroscience & Therapeutics, 18(7), 21-17] administered Propranolol to 41 emergency department patients who experienced acute qualifying psychological trauma.
Their findings were equivocal: "The physiological results provide some limited support for a model of PTSD in which a traumatic conditioned response is reduced by posttraumatic administration of Propranolol. However, the clinical results for this study do not support the preventive use of Propranolol in the aftermath of a traumatic event."
This line of research and intriguing. One also wonders if studies have been conducted using experimental groups that receive both Propranolol and cognitive therapy. Some research has been done with other psychiatric conditions to see if the combination of therapy and medication enhances the overall treatment effect.