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Heart Drug May Block Stress of Traumatic Memories

John Roach
National Geographic News
July 29, 2005
 
Memories of wailing sirens, mangled bodies, and smoldering debris in the wake of this month's terrorist attacks in London and Egypt will produce widespread distress in thousands of people.

Can a common drug snuff out the debilitating emotions these memories trigger?

Researchers say the beta-blocker propranolol, commonly prescribed to treat high blood pressure and heart problems, disrupts the way the brain stores memories.

If taken at the right time, the drug may benefit people who suffer post-traumatic stress disorder (PTSD), said Joseph LeDoux, a neuroscientist at New York University.

"We're not erasing memories," he said. "But we think it will reduce the emotional component of the memory."

The science journal Nature reported Wednesday that LeDoux and colleagues are conducting a clinical trial of propranolol in PTSD patients.

Crippling Emotions

Memories of tragic events, such as terrorist attacks, car wrecks, and rape, cause sufferers of PTSD to experience debilitating emotions—ranging from numbness and detachment to extreme anxiety, irritability, and violence.

PTSD can lead to depression, substance abuse, and other anxiety disorders.

If the beta-blockers work as LeDoux and colleagues suggest, the drugs would be a welcome alternative treatment for PTSD, said Barbara Rothbaum, a psychologist at Emory University School of Medicine in Atlanta, Georgia.

"We hope something like this could work," she said.

But Rothbaum added that the preliminary data on propranolol gathered by another research group suggest the drug is only marginally promising as a PTSD treatment.

Today the most effective PTSD treatments are cognitive behavior therapies, also known as exposure therapies.

In such treatments, patients are encouraged to confront their traumatic memories, and therapists help them overcome the associated anxieties.

Richard McNally, a PTSD expert at Harvard University in Cambridge, Massachusetts, compared exposure therapy to watching a scary movie again and again so that over time the movie no longer seems frightening.

However, he said, some people are reluctant to participate in such therapy because they find it too distressing. Others "may enroll in therapy but not participate fully for the same reason and may therefore not benefit," he added.

Trauma Blocker

LeDoux, the NYU researcher, said the idea of using beta-blockers to treat PTSD is based on a recent finding that recalled memories are vulnerable to interference, LeDoux said.

"When you retrieve a memory, you're not retrieving a carbon copy of the experience but some concept of what you think actually happened. And you have to reconstruct that in your mind as a memory," he said.

The reconstruction is based not only on the event but also on things the brain has learned and stored in the meantime. When the memory is re-stored, the new experiences are re-stored with it.

LeDoux and his colleagues believe that propranolol can interfere with this re-storage process.

The drug blocks the effect of stress hormones on the body, relaxing blood vessels and calming nerves. It is effective in curbing high blood pressure and is also used to aid people in stressful situations like public speaking, McNally said.

McNally's Harvard colleague Roger Pitman has shown that propranolol may prevent emotionally vivid memories from taking hold, if it's given to patients immediately after a traumatic event such as a car wreck or an assault.

Previous research conducted by James McGaugh, a psychologist at the University of California, Irvine, found that propranolol weakens the formation of stressful memories in rats exposed to traumatic experiences.

In a follow-up study, LeDoux and colleagues used an electric shock to condition rats to fear a tone. The researchers found that the rats lost their fear of the sound if they were given propranolol after the tone started. Following this finding, the researchers shifted their focus to humans.

Current trial participants are asked to take a dose of the beta-blocker when they feel the onset of PTSD symptoms. In theory "you'd only have to take it once if it works the way animal studies suggest," LeDoux said.

But because human memories are more complicated than those of rats, effective treatment will likely require repeated doses.

Potential Abuse?

Paul McHugh, a mental health professor at Johns Hopkins University in Baltimore, Maryland, told Nature that treatment of PTSD with drugs like propranolol could be abused—for example, to desensitize soldiers to the atrocities of war.

"If soldiers did something that ended up with children getting killed, do you want to give them beta-blockers so that they can do it again?" the journal quoted him as saying.

Rothbaum and McNally told National Geographic News that such fears of abuse are unfounded.

LeDoux acknowledged that the study raises "big ethical and moral issues" but said there is no indication that beta-blockers will erase memories.

"We're altering the emotional impact of the memory," he said.

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