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VA TO DO MORE RESEARCH WITH ANTI-PTSD DRUG
PROPRANOLOL -- The study, involving dozens of
Boston-area veterans with chronic PTSD,
is scheduled to begin this summer.
Some background information on
propranolol here...
http://www.vawatchdog.org/07/nf07/nfMAR07/nf032107-5.htm
http://www.vawatchdog.org/old%20newsflashes%
20JAN%2006/newsflash01-14-2006-4.htm
http://www.vawatchdog.org/nfDEC06/nf120306-9.htm
Today's story here...
http://content.hamptonroads.com/
story.cfm?story=123872&ran=150202
Story below:
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Drug to be tested on vets with mental scars
By NANCY YOUNG, The Virginian-Pilot
You're safe, but your amygdala doesn't know it.
Just the thought of the battle, the crime, the accident can rack this
almond-shaped structure in the brain, leaving you bathed in fear as
though it were happening again for real.
That, in essence, is post-traumatic stress disorder - a condition that
could be relieved, some researchers say, by a drug that soon will be
tested on war veterans.
Some critics have said propranolol could become a memory-robbing pill.
But researchers say that if it works as hoped, memories will be
preserved - just without the traumatic emotional baggage that keeps
people from moving on with their lives.
About 7.7 million Americans - or 3.5 percent of adults in the United
States - have post-traumatic stress disorder in a given year, according
to the National Institute of Mental Health. PTSD can be caused by events
including combat, natural disasters and violent attacks such as rape.
About a third of Vietnam veterans experienced PTSD at some point after
the war, and growing numbers of men and women who served in Iraq and
Afghanistan are struggling with it. At the Veterans Affairs hospital in
Hampton, the number of veterans being treated for PTSD and other mental
health issues related to their war-zone deployments increased from 120
at the end of 2005 to about 350 now, according to the VA.
Some of the drugs being used for PTSD and other anxiety disorders were
originally developed to treat something else. Propranolol, which will be
studied starting this summer in veterans suffering from PTSD, is most
familiar as a medicine for high blood pressure. It has been in use for
decades.
"It's very safe," said Scott Orr, a psychologist who directs research at
the VA medical center in Manchester, N.H. Orr, who is also an associate
professor at Harvard Medical School, is one of the researchers on the
Army-financed study of propranolol's effects. The study, involving
dozens of Boston-area residents, is scheduled to begin this summer.
Propranolol is in a class of drugs commonly called beta blockers, which
for years have also been used to treat the physical symptoms of anxiety
disorders and to help performers overcome stage fright. The drugs block
the effects of the hormone epinephrine, more commonly known as
adrenaline.
When adrenaline interacts with the brain's amygdala, it can make the
memory much more disturbingly intense. Propranolol and other drugs may
be able to "shut down or decrease the excitability of the amygdala" in
those suffering from PTSD, said Dr. David Spiegel, a psychiatrist and
assistant professor at Eastern Virginia Medical School in Norfolk.
PTSD, if untreated, can cause depression and other problems. Eventually,
even an ordinary sound or smell can bring back a traumatic event. It can
become so constant a threat that there's a "pulling away from people, a
pulling away from life," Spiegel said.
In the Army's propranolol study, headed by Dr. Roger Pitman, a
psychiatrist at Harvard Medical School, the focus will be on veterans
with chronic PTSD.
Orr said some of the veterans will be given a single, moderate dose and
then will be asked to describe the traumatic incident. Some of the
veterans will be given a placebo, and some will receive propranolol but
without describing the traumatic event.
Scientists generally believe that memories, even pleasant ones, become
less intense over time. In someone with PTSD, however, memories can
become reinforced with each recall. Researchers involved in the
propranolol study hope to find out if the drug can short-circuit that
process and cause the memory to be less overwhelming.
The idea of chemically calming memories has its critics. The President's
Council on Bioethics in 2003 warned that the power could be used to
quickly desensitize people to disturbing events. Others have worried
that the pill could be passed off as a cheap substitute for
psychotherapy or could erase memories altogether.
Spiegel said that the criticisms of the pill are overblown.
"You're not going to forget it happened," he said. "It's going to
prevent the reliving phenomena."
Even if the drug works as hoped, people with PTSD will still need
psychotherapy to help deal with the after-effects of the trauma, Orr
said.
The hope is the propranolol would make the therapy process easier.
That's especially the case with those who shun such help in hopes of
escaping the memory.
"You can't work through anything if all you want to do is avoid it,"
Spiegel said.
Orr warned that while a similar small pilot study in Canada was
promising, researchers are a long way from claiming success.
"I want to caution folks that this is very preliminary," Orr said. "We
don't want to raise false hopes, but we hope we're on to something."
Staff writer Kate Wiltrout contributed to this story.
# Reach Nancy Young at (757) 446-2947 or
nancy.young@pilotonline.com.
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Larry Scott --
