Propranolol for PTSD
Blunting Memories and Post-Traumatic Stress Disorder
Could taking propranolol after a frightening or shocking event help prevent PTSD? This article introduces the idea of "therapeutic forgetting".
Propranolol (brand name “Inderel”) is a cheap, effective beta blocker used to treat heart problems and anxiety. It is also thought to prevent the onset of post-traumatic stress, when given after traumatic events. This may seem like a promising find, however, many have expressed strong ethical concerns.
What Is Post-Traumatic Stress Disorder?
Post-traumatic stress disorder (PTSD) occurs following frightening or distressing events. It is both physical and psychological, with symptoms usually appearing immediately after or within three months of the event. Symptoms include nightmares, flashbacks, feelings of isolation and feelings of detachment. These symptoms can be lasting and pervasive, significantly affecting the sufferer’s quality of life. Sufferers may feel as though they are reliving the event over and over.
Propranolol and Post-Traumatic Stress
Propranolol blocks adrenaline, the hormone that surges when people are shocked or frightened. According to BMJ Best Treatments, researchers hypothesized that this action may affect the part of the brain that consolidates emotional memory. The term “amnesia drug” has been used to describe propranolol but is in truth a misnomer, as the drug is not thought to make people literally forget. Instead, it is thought to weaken the emotions attached to memories.
Propranolol and PTSD Research
There is currently little research on this use of propranolol so it is difficult to ascertain if it is truly effective, and why.
A small pilot study published in Biological Psychiatry in 2002 suggested that propranolol, administered following trauma, may be effective in preventing PTSD. Subjects of this double-blind trial began treatment within six hours of experiencing trauma, and were administered either propranolol 40mg or a placebo four times per day for 10 days.
There was little difference between the two groups, with the exception that those on propranolol experienced a drop in body stress response when listening to an account of their trauma. This suggested some effect and that it may be worth studying further.
Some small studies have followed that support propranolol for emotional blunting of memories, including sufferers who have been diagnosed with the disorder for some time. However, further investigations are required to substantially prove and better understand its effects.
Ethical Implications of Propranolol
There are a number of ethical concerns about this use of propranolol. Some researchers are concerned about the possible ill effects of altering memory, particularly as memory is not thoroughly understood. Memories store and retrieve information, and undoubtedly they are an important aspect of what make people who they are. One concern is that the drug will be abused for more trivial purposes, such as getting over a bad night out.
An article published in the American Journal of Bioethics in 2007 highlighted social concerns regarding this treatment. In particular, if bad memories are pathologized, will the pharmaceutical industry then exploit this for lucrative purposes? They suggest further studies be carried out to ascertain the efficacy of propranolol for preventing PTSD, including investigating the possible ill-effects of diminishing memory.
Some researchers in favor of exploring this drug tend to argue that PTSD should be given the same attention as physical injuries. Some also argue that there are other psychoactive drugs available that change people, and that propranolol’s use for PTSD isn’t really any different. Although the positive effects of propranolol appear to be a promising possibility for the treatment of PTSD, further investigation is required to explore the related medical ethics.
Read Surviving Post Traumatic Stress for more information on the signs, complications and history of PTSD. Anyone suffering symptoms of this disorder should seek advice from a qualified medical practitioner.
Sources
Pilot study of secondary prevention of posttraumatic stress disorder with propranolol: Biological Psychiatry, accessed April 5th 2008, authors - Pitman, R.K; Sanders, K.M; Susman, R.M; Healy, A.R; Cheema, F; Lasko, N.B; Cahill, L; Orr, S.P
Propranolol and the prevention of post-traumatic stress disorder: American Journal of Bioethics, accessed April 5th 2008, authors - Henry, M; Fishman, J.R; Youngner S.J
