Propranolol - the memory pill

[WrtngCocaineTutorial]

Heart of America Radio reports on how scientists are developing a pill to reduce the terror of a traumatic event.


Imagine a world where victims of violence or trauma pop a pill to ease their feelings of terror and dim the memory of a car accident, rape, or other assault. That's the hope of scientists at Harvard University who are developing a pill they say will prevent post-traumatic stress disorder in such victims. They are hoping to alter the brain's reaction to traumatic events, lessening the strength of memories and softening the emotions they evoke.

Pitman has been conducting research on PTSD for the past 20 years, and says that scientists have a pretty good idea of how it works. When a person experiences a traumatic event, he says, the body releases adrenaline, a stress hormone that prepares the body to run from or attack an aggressor. When adrenaline and its cousin noradrenaline enter the brain, he says, they act on the amygdala region, which is involved in fear and memory. Basically, Pitman says, "The same adrenaline that's making you run fast has the ability to strengthen your memory."

This system was useful back in prehistoric times, Pitman says, when someone who was chased by a crocodile, for example, would need to remember where that predator lived. But in modern times, Pittman says, "This mechanism goes too far. People who have PTSD, the memories are so strong, they can have trouble living in the present." For example, people involved in car accidents "get to the point where they're having nightmares and can't drive any longer," Pittman says. "If someone is raped in an elevator, they don�t want to ride elevators again."

To counter the harmful effects of stress hormones like adrenaline on memory, Pitman has been experimenting with propranolol, a drug commonly used to treat hypertension. Since propranolol blocks the action of adrenaline and noradrenaline, Pitman thought it might prevent memories from being burned too deeply in the amygdala of the brain. "We figured we could give people this propranolol to affect the memory before it gets laid down," he explains. Pitman is quick to point out that the drug doesn�t cause people to remember things differently, just less strongly. "We would say it would more approximate a normal memory," he says.

Sounds like a win/win situation, but not everyone is convinced that propranolol is such a great idea. Gina Scaramella, executive director of the Boston Area Rape Crisis Center, sees about 400 rape cases a year and says she and her colleagues have concerns about the use of the pill. Scaramella says it's important for women to feel in control when they are recovering from a sexual assault, and taking propranolol means giving up control over their memories. Secondly, she says, "anyone who took that medicine could be in trouble in a legal case," since defense lawyers may say that the victim was so unstable that she needed drugs to cope, or that the propranolol may have altered her memory about the assault. Other ethicists say the pill may erase the rage that victims will need to go on and prosecute their attackers.


From acf new source

Reputation Comments on this post:

	good find, very interesting read
	Fascinating article. Good post.

[wellhelm]

How would it be adminsitered? When the event insighting PTSD happens the adrenaline is immediately released. So they have X amount of time to get to the hospital and take the pill to prevent the memory from developing in to PTSD? Or is it taken when ever one feels the need? Or daily like an ssri,which does not sound like a good idea,because how does this drug pick and choose memories?

[Nagognog2]

I watched this on 60 Minutes the other night. I don't think the doctor proved his results at all. His experiments with a mouse MIGHT show propanolol works for reducing memory imprinting. Or it could also show that his mice were dazed and confused from the drop in blood-pressure.

I'm also wondering if this research isn't being done to keep MDMA off the radar for treating PTSD.

Bongo has taken propanolol for an ulcer. He has reported no loss of memory/emotional response.

Reputation Comments on this post:

swim uses for his ADHD +conserta 3times 40mg day and 1 conserta

[Nicaine]

Originally Posted by Nagognog2

His experiments with a mouse MIGHT show propanolol works for reducing memory imprinting.

SWIM was on propranolol for quite a long time, and ISHO does think it reduces memory imprinting... but probably not enough to end up being used for purposes like this. Subjectively he thinks 'unimportant' memories are affected by propranolol, but meaningful or traumatic crap rolls right over whatever effect it produces.

Is this guy assuming that just because certain imprinting is reduced, ALL imprinting is reduced?

Since propranolol blocks the action of adrenaline and noradrenaline, Pitman thought it might prevent memories from being burned too deeply in the amygdala of the brain.

Yeah, blocks it mostly physiologically (slower heartbeats, less tendency to tremble, etc), i.e. beta-adrenergic receptors. What about alpha-adrenergic effects?

Reputation Comments on this post:

very informative, just as i've come to expect form the user.

[Bajeda]

Originally Posted by Nagognog2

I watched this on 60 Minutes the other night. I don't think the doctor proved his results at all. His experiments with a mouse MIGHT show propanolol works for reducing memory imprinting. Or it could also show that his mice were dazed and confused from the drop in blood-pressure.

I'm also wondering if this research isn't being done to keep MDMA off the radar for treating PTSD.

Bongo has taken propanolol for an ulcer. He has reported no loss of memory/emotional response.

Thats what I was thinking.


Why would you want a drug like this that doesn't even seem to be able to achieve its desired effects and whose effects (which we aren't sure you can actually get) aren't anywhere near as helpful for treating PTSD as MDMA has shown to be?

Doesn't make much sense...

[x cynic x]

Originally Posted by Nagognog2

I'm also wondering if this research isn't being done to keep MDMA off the radar for treating PTSD.

Highly likely; that was the first impression I got from reading the article.

[Micklemouse]

Another thing the 'researcher' is forgetting is that PTSD is not an inevitable after effect of trauma. Not only that but it can take weeks if not months to manifest. Is Dr Pitman wanting to treat with beta-blockers on the off-chance that PTSD might develop? Might it not be better to just stay at home & watch t.v., thereby reducing the risk of directly experiencing a traumatic event?

I'm also wondering if this research isn't being done to keep MDMA off the radar for treating PTSD.

My thoughts exactly.

What about alpha-adrenergic effects?

None that I can find. Propranolol is a beta blocker, working only on the beta-adrenaline.

Anyhoo, a more detailed story from the University of California website...

http://pub.ucsf.edu/newsservices/releases/200310226/

Corinna Kaarlela, News Director
Source: Liese Greensfelder

415-476-2557
22 October 2003
Common drug, administered promptly, reduces incidence of post-traumatic stress disorder (ptsd), small study finds


A common drug administered in the first hours following trauma to patients deemed to be at risk of developing post-traumatic stress disorder (PTSD) reduced the occurrence of PTSD, according to a study led by researchers at the University of Lille, France.
While the study involved a small number of subjects, its results are encouraging, says its senior author, Charles Marmar, MD, associate chief of staff for mental health at the San Francisco VA Medical Center and professor and vice chair of psychiatry at University of California, San Francisco.
"The study is based on the new theory that PTSD is most likely to occur in patients who experience a particularly severe and prolonged response to trauma. If this model proves accurate after five or ten replications of studies like this one, it could have very profound ramifications. From a public health perspective, if you could identify the subgroup of people who are susceptible to PTSD, giving them this course of medication -- which is brief, very well tolerated and inexpensive -- could be very effective prevention [following major trauma] and may have great social relevance." The study appears in the November 1 issue of Biological Psychiatry.
All people confronted by a life-threatening situation, such as a car accident or physical assault, react by releasing a rush of stress hormones, including adrenalin and noradrenalin, which are produced in the adrenal glands, located atop the kidneys. This response, known as "adrenergic activation," initiates the reactions that quicken the heart rate, constrict the vasculature to prevent bleeding to death, and provide energy to the muscles, priming the body to " fight, flee, or freeze." The hormonal flood also strengthens the brain's ability to form and retain emotional memories. The longer the duration of the adrenergic activation, the more vivid and tenacious are the memories of the event. In most people, after minutes to hours the reaction begins to subside.
In some 25 percent of people, however, the hormonal response continues for hours, days, or even a week or longer. The working hypothesis of the new model is that these are the people who are at greatest risk for developing post-traumatic stress disorder, in which a person experiences recurring emotional attacks, for months, years or decades following the inciting event. PTSD patients experience such symptoms as insomnia, difficulty concentrating, persistent reliving of the traumatic event, and reactions of panic or fear when confronted with reminders of the event.
A diagnosis of PTSD is usually made when such symptoms persist at least four weeks following the trauma. For those who suffer from PTSD, memories can be so dogged and intense that they can be triggered years later by details of scenery, smells or sounds associated with the trauma. Some Vietnam veterans with PTSD, for example, feel more anxious on hot and humid days, because these conditions evoke their memories of jungle warfare.
The model now being explored by both basic and clinical researchers predicts that the more quickly a person calms down and regains a sense of safety and composure following trauma, the less vividly the event will be etched in memory, making him or her less likely to develop phobias of objects or actions related to the trauma, and such potent reminders of the trauma will be less likely to trigger panic and fear responses. Recent research involving accident victims in Australia and people exposed to the World Trade Center attacks support this hypothesis.
"Our working model is that if you experience a more intense panic reaction in a life-threatening situation and it takes you a longer period of time to calm down afterwards than most people, you are having a sustained adrenergic reaction and you are more likely to be among those 25 percent of people who are at risk of developing PTSD," Marmar says.
Thus, two important steps in early prevention of PTSD may be to identify the 25 percent of trauma victims who are at greatest risk of developing the disorder and to calm them as quickly as possible in order to block their adrenergic activity.
In the study, doctors in the emergency departments of two hospitals in France evaluated victims of physical assault or auto accidents for symptoms of prolonged panic reactions within two to twenty hours of the traumatic injury. Because one reliable indication of a sustained panic reaction is tachycardia, or elevated heart rate, the doctors chose patients for the study who were medically stable and had heart rates higher than 90 beats per minute measured after they had been lying down for 20 minutes. These patients were offered propranolol, a common drug also known by its brand name, Inderal, which is often prescribed for tachycardia, high blood pressure or anxiety. Those who accepted the drug were given an immediate dose of 40 mg and were then asked to take three daily doses of 40 mg for seven days, followed by a tapering off period of eight to twelve days.
When evaluated with a battery of psychological tests two months following the traumatic event, almost all patients exhibited some degree of symptoms associated with PTSD, but severity of symptoms was twice as high among patients who had not taken propranolol. Only one of 11 propranolol patients had symptoms severe enough to warrant a diagnosis of PTSD, while three of eight patients who declined the drug were diagnosed with the disorder.
Propranolol is one of a class of drugs known as beta-adrenergic antagonists that can control many of the physical symptoms of panic attacks, such as trembling, sweating, tachycardia and heart palpitations. The drug has also been shown to reduce memory for emotional events by blocking adrenergic pathways. For example, when either propranolol or a placebo were given to college students before they were shown disturbing films, the propranolol decreased the students' anxiety both while they watched the film and weeks later when descriptions of the film were read to them.
Treatments for PTSD that have been shown to be beneficial are antidepressant medications and cognitive behavioral therapy -- a form of psychotherapy that works on changing a person's patterns of thinking in order to curb unwanted thoughts and feelings. But the longer PTSD persists, the more difficult it is to treat. Without the benefit of skilled intervention, about a third of those people who have PTSD for a year or longer will suffer from it for many years or even decades. Moreover, many people do not recognize symptoms of the disorder, so they delay seeking treatments. Others are reluctant to ask for treatment for what may be perceived as an emotional disorder, and, in many places, specialized treatment resources are scarce. Given such problems in treating PTSD, many researchers are now looking for ways to prevent or reduce occurrence of the disorder.
Although not a randomized study, the propranolol and control groups did not differ significantly in characteristics such as age (all subjects were 21 to 30 years old), gender, employment, and marital status, degree of exposure, physical injury, or level of terror at the time of the assault or accident. All were medically screened, were free of cardiovascular complications from their exposure, and otherwise in good physical health. No one was enrolled in the study who had lost consciousness during the trauma, sustained serious brain injuries, had injuries compromising cardiovascular function, or who had a history of heart disease, asthma or PTSD.
This is the second study in which propranolol was promptly administered following traumatic injury. The first was conducted by Roger Pitman and colleagues at Harvard and published in 2002. In that investigation, 31 trauma victims who were evaluated in the first hours after traumatic exposure were randomly assigned to take propranolol or a placebo. Pitman's team did not find fewer cases of PTSD in the propranalol group, but propranolol patients experienced lower measures of stress (lower heart rates and skin conductance measurements) than the placebo group when they listened to a vivid narrative of their traumatic event three months after its occurrence.
The first author of the study is Guillaume Vaiva, MD, PhD, at the Clinical School of Psychiatry, University of Lille Medical School, Lille, France. Co-authors are Drs. François Ducrocq, Karine Jezequel, Benoit Averland and Philippe Lestavel, all at University of Lille, and Dr. Alain Brunet, Department of Psychiatry, McGill University and the Douglas Hospital Research Center in Montreal, Canada.
The research was supported by funds from the French Institute of Health and Medical Research.

[Alfa]

Low doses of propranolol are also used against anxiety or stress during driving exams, court cases, speeches, interrogations or other situations SWIY may need to get trough without blinking an eye.

[darawk]

http://60minutes.yahoo.com/segment/21/memory_drug

These clips from the 60 minutes yahoo site were pretty convincing to me. When talking about using it for treating ulcers or other purposes there have to be a few things taken into account. First, dosage. The doses required for treating an ulcer may be totally different than those required for treating PTSD. Second, it doesn't seem to produce actual memory loss in the human subjects interviewed on 60 minutes, but rather dissolves emotional triggers associated with them.

[~lostgurl~]

Hmmm, so a rape victim is walking home late at night and thinks 'well it wasn't THAT bad' and decides to take the shortcut down the ally way where she was raped only months before......... ok maybe that is a bit over the top but really if it works and works that well it could in reality cause more damage than the event that they are trying to forget. There is something to be said for learning from ones experiences, how else can risk be associated personally with any situation?

Reputation Comments on this post:

good point

[Nagognog2]

That was a point I raised in another thread, lostgurl, regarding the use of MDMA used for combat troops suffering from PTSD: If a drug works so well to treat people for psychological distress from murdering and torturing people, what would prevent the military use of it to it's full advantage?

"Everybody knows you can trust a CIA man."

[WrtngCocaineTutorial]

hmmm. this memory thing with adrenaline, which makes you remember. Even if it's excrated after a event.


maybe it even works to do coke the day following studying.
although best to combine them.

[Nagognog2]

Cocaine and propanolol are contra-indicated. Seems this combination can be dangerous.

[WrtngCocaineTutorial]

didn't think about combining the drugs. thought about combining coke+study.

it's said to be the best. although it might actually have some effect to do the coke/adrenaline rush after the reading

[Nagognog2]

Major problem with using things like coke/amphetamines etc. is that after the drug wears off - all that brilliant insight and understanding one had...POOF!

Even more fun if one writes a paper in that state and submits it! It comes back with a note from the professor to see him later. You re-read it and realize it's psychotic gibberish! LOL!! Now to draft your excuse...

[~lostgurl~]

Originally Posted by Nagognog2

Major problem with using things like coke/amphetamines etc. is that after the drug wears off - all that brilliant insight and understanding one had...POOF!

Even more fun if one writes a paper in that state and submits it! It comes back with a note from the professor to see him later. You re-read it and realize it's psychotic gibberish! LOL!! Now to draft your excuse...

Maybe you should add here that this is your opinion Nag? Many people find stimulants beneficial for study.

[Kristy]

Originally Posted by Nagognog2

Major problem with using things like coke/amphetamines etc. is that after the drug wears off - all that brilliant insight and understanding one had...POOF!

Even more fun if one writes a paper in that state and submits it! It comes back with a note from the professor to see him later. You re-read it and realize it's psychotic gibberish! LOL!! Now to draft your excuse...

LOL, did that actually happen to SWIY?

SWIM gets propranolol on repeat prescription

[~lostgurl~]

Really? How do you find it? Tell us about it, I'm interested in reading a personal experience on this!

[Nagognog2]

If it works for SWIM, have fun. But I've seen this happen with people who fiend-out on the stuff - and these were the results. And many folks find it too easy to become fiends with coke and/or amphetamines. On the plus-side, they quickly learned to avoid doing that again!

[~lostgurl~]

There is a difference between being tweaked out and potentially psychotic, and using more moderate doses to aid study. As with most drugs, stimulants need to be respected for their benefits as well as their consequences.

[Nagognog2]

My monkey ducked that bullet. But I saw other monkeys end up like that. Worst case was one that washed out of law school and went on to a glorious career as a male meter-maid in Boston, Massachusetts.

He spent his entire tuition on coke. His parents were so proud of him! LOL! He could have used the propanolol after that stunt.

[Nagognog2]

Propanolol (Inderal) has been on the market for decades. It is a common beta-blocker used for such diverse conditions as hypertension, migraines, depression, and ulcers. It is not a controlled substance as it has no recreational value. A google-search will find one a warehouse full of info.

[allyourbase]

Im willing to bet this drug is a multisubstituted benzodiazapine analogue

[Zaprenz]

^No Propranolol looks more like a PEA than a benzo.

In fact if you look at all the structures of Beta-blockers they all look vaguely similar to PEAs(some of them are). If you've read PIHKAL and liked comparing the structures you might automatically do the same with beta blockers as they look like they are temptingly close. On further inspection it makes sense why they are antagonists. You can definately see the one half of salbutamol substitution pattern contained in their structure usually. (Salbutamol is a BETA agonist)

SWIM found propranolol to be usefull especially for interviews and exams.

For many years SWIM has read about second generation beta blockers being better than first generation as they dont enter the brain (Its slightly more complicated but for example atenolol is far more cardio selective than propranolol).

However SWIM has always found propranolol the best for what he believed was the fact that it DOES enter the brain. SWIM hypothesized this was beneficial because of beta adrenergic systems in the brain having something to do with the psychological flight or fight response.

Having been told "beta blockers only treat the symptoms of anxiety - high blood pressure, fast heart rate etc". SWIM questions this and wonders whether beta-adrenergic receptors in the brain place a pivotal role in these PTSD "bad" memories. (This might be what the article is talking about when it mentions future drugs) Although there are apparantely many problems with propranol such as vivid dreams/nightmares which are blammed on this effect (think its something to do with blocking melatonin or maybe more complicated)

SWIM would not be surprised if propranolol is beneficial but atenolol and other more selective blockers are not so beneficial for PTSD.

Reputation Comments on this post:

Good info, thanks

[augentier]

Just saw this on MSN.com .. it's a 5-page article so I won't quote it here, but here's the link: http://health.msn.com/centers/depres...48859&GT1=9301

Interesting read