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#83371 - 01/15/06 09:22 PM PTSD Pill?
Ken Singer, LCSW Offline
Moderator Emeritus
MaleSurvivor

Registered: 08/24/00
Posts: 5773
Loc: Lambertville, NJ USA
'Trauma Pill' Could Make Memories Less Painful
By MARILYNN MARCHIONE, AP

Researchers say the pill would reduce the effect of stress hormones that etch unpleasant events into memory.


(Jan. 14) - Suppose you could erase bad memories from your mind. Suppose, as in a recent movie, your brain could be wiped clean of sad and traumatic thoughts.

That is science fiction. But real-world scientists are working on the next best thing. They have been testing a pill that, when given after a traumatic event like rape, may make the resulting memories less painful and intense.

Will it work? It is too soon to say. Still, it is not far-fetched to think that this drug someday might be passed out along with blankets and food at emergency shelters after disasters like the tsunami or Hurricane Katrina.

Psychiatrist Hilary Klein could have offered it to the man she treated at a St. Louis shelter over the Labor Day weekend. He had fled New Orleans and was so distraught over not knowing where his sisters were that others had to tell Klein his story.

"This man could not even give his name, he was in such distress. All he could do was cry," she said.

Such people often develop post-traumatic stress disorder, or PTSD, a problem first recognized in Vietnam War veterans. Only 14 percent to 24 percent of trauma victims experience long-term PTSD, but sufferers have flashbacks and physical symptoms that make them feel as if they are reliving the trauma years after it occurred.

Scientists think it happens because the brain goes haywire during and right after a strongly emotional event, pouring out stress hormones that help store these memories in a different way than normal ones are preserved.

Taking a drug to tamp down these chemicals might blunt memory formation and prevent PTSD, they theorize.

Some doctors have an even more ambitious goal: trying to cure PTSD. They are deliberately triggering very old bad memories and then giving the pill to deep-six them.

The first study to test this approach on 19 longtime PTSD sufferers has provided early encouraging results, Canadian and Harvard University researchers report.

"We figure we need to test about 10 more people until we've got solid evidence." said Alain Brunet, a psychologist at McGill University in Montreal who is leading the study.

It can't come too soon.

The need for better treatment grows daily as American troops return from Iraq and Afghanistan with wounded minds as well as bodies. One government survey found almost 1 in 6 showing symptoms of mental stress, including many with post-traumatic stress disorder. Disability payments related to the illness cost the government more than $4 billion a year.

The need is even greater in countries ravaged by many years of violence.

"I don't think there's yet in our country a sense of urgency about post-traumatic stress disorder" but there should be, said James McGaugh, director of the Center for the Neurobiology of Learning and Memory at the University of California at Irvine.

He and a colleague, Larry Cahill, did experiments that changed how scientists view memory formation and suggested new ways to modify it.

Memories, painful or sweet, don't form instantly after an event but congeal over time. Like slowly hardening cement, there is a window of opportunity when they are shapable.

During stress, the body pours out adrenaline and other "fight or flight" hormones that help write memories into the "hard drive" of the brain, McGaugh and Cahill showed.

Propranolol can blunt this. It is in a class of drugs called beta blockers and is the one most able to cross the blood-brain barrier and get to where stress hormones are wreaking havoc. It already is widely used to treat high blood pressure and is being tested for stage fright.

Dr. Roger Pitman, a Harvard University psychiatrist, did a pilot study to see whether it could prevent symptoms of PTSD. He gave 10 days of either the drug or dummy pills to accident and rape victims who came to the Massachusetts General Hospital emergency room.

In follow-up visits three months later, the patients listened to tapes describing their traumatic events as researchers measured their heart rates, palm sweating and forehead muscle tension.

The eight who had taken propranolol had fewer stress symptoms than the 14 who received dummy pills, but the differences in the frequency of symptoms were so small they might have occurred by chance - a problem with such tiny experiments.

Still, "this was the first study to show that PTSD could be prevented," McGaugh said, and enough to convince the federal government to fund a larger one that Pitman is doing now.

Meanwhile, another study on assault and accident victims in France confirmed that propranolol might prevent PTSD symptoms.

One of those researchers, Brunet, now has teamed with Pitman on the boldest experiment yet - trying to cure longtime PTSD sufferers.

"We are trying to reopen the window of opportunity to modulate the traumatic memory," Pitman said.

The experiments are being done in Montreal and involve people traumatized as long as 20 or 30 years ago by child abuse, sexual assault or a serious accident.

"It's amazing how a traumatic memory can remain very much alive. It doesn't behave like a regular memory. The memory doesn't decay," Brunet said.

To try to make it decay, researchers ask people to describe the trauma as vividly as they can, bringing on physical symptoms like racing hearts, then give them propranolol to blunt "restorage" of the memory. As much as three months later, the single dose appears to be preventing PTSD symptoms, Brunet said.

Joseph LeDoux, a neuroscience professor at New York University, is enrolling 20 to 30 people in a similar experiment and believes in the approach.

"Each time you retrieve a memory it must be restored," he said. "When you activate a memory in the presence of a drug that prevents the restorage of the memory, the next day the memory is not as accessible."

Not all share his enthusiasm, as McGaugh found when he was asked to brief the President's Council on Bioethics a few years ago.

"They didn't say anything at the time but later they went ballistic on it," he said.

Chairman Leon Kass contended that painful memories serve a purpose and are part of the human experience.

McGaugh says that's preposterous when it comes to trauma like war. If a soldier is physically injured, "you do everything you can to make him whole," but if he says he is upset "they say, 'suck it up - that's the normal thing,"' he complained.

Propranolol couldn't be given to soldiers in battle because it would curb survival instincts.

"They need to be able to run and to fight," Pitman said. "But if you could take them behind the lines for a couple of days, then you could give it to them after a traumatic event," or before they're sent home, he said.

Some critics suggest that rape victims would be less able to testify against attackers if their memories were blunted, or at least that defense attorneys would argue that.

"Medical concerns trump legal concerns. I wouldn't withhold an effective treatment from somebody because of the possibility they may have to go to court a year later and their testimony be challenged. We wouldn't do that in any other area of medicine," Pitman said. "The important thing to know about this drug is it doesn't put a hole in their memory. It doesn't create amnesia."

Practical matters may limit propranolol's usefulness. It must be given within a day or two of trauma to prevent PTSD.

How long any benefits from the drug will last is another issue. McGaugh said some animal research suggests that memory eventually recovers after being squelched for a while by the drug.

Overtreatment also is a concern. Because more than three-quarters of trauma victims don't have long-term problems, most don't need medication.

But LeDoux sees little risk in propranolol.

"It's a pretty harmless drug," he said. "If you could give them one or two pills that could prevent PTSD, that would be a pretty good thing."

Klein, the Saint Louis University psychiatrist, said it would be great to have something besides sleep aids, antidepressants and counseling to offer traumatized people, but she remains skeptical about how much long-term good propranolol can do.

"If there were a pill to reduce the intensity of symptoms, that would be a relief," she said. "But that's a far step from being able to prevent the development of PTSD."

Only more study will tell whether that is truly possible


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#83372 - 01/15/06 10:32 PM Re: PTSD Pill?
reality2k4 Offline
Member
MaleSurvivor

Registered: 07/06/04
Posts: 6838
Loc: Stuck between water, air, and ...
Ken,

I think she would find all the guinea pigs she needs in this place.

Whilst it may be good for trauma that has recently happened, it may be harder for deep seated trauma, as survivors do not tend to bring up the deep parts until they feel safe.

Having not read into it so much, and just reading what you have quoted, it would be hard to see the benefits, unless it truly is a wonder drug.

I do believe that memory is stored in the body through trauma, it makes so much sense, and without relieving the body stresses through touch and awareness, then it is hard to see how it could work without knocking out some other emotional capabilities.

Let us hope it is what they say, and say goodbye to MS,

ste

_________________________
Whoever stole the Sun, put it back and we'll drop all the charges!

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#83373 - 01/16/06 05:32 PM Re: PTSD Pill?
johnsurvived Offline
Member
MaleSurvivor

Registered: 11/20/05
Posts: 332
Loc: Arlington, Virginia
Ken,

This is one of those drugs that, if approved for clinical use, is going to touch off some pretty deep debates about the politics of mental symptoms and individuality -- much as Prozac did when it was first introduced. It will very much matter who is prescribing the drug, to whom, and why. If the thing is given as part of an on-going therapist/client relationship, with mutual understanding on both sides of what it might and might not do, including potential side effects, then fine.

But that article talked about potential use on some very wide scales, like giving it to returning vets from Iraq & Afghanistan. I can just see some Army medic standing at the foot of the airplane stairs as soldiers deplane, saying "Here soldier, take these and you'll feel all better about what happened over there." Would that be right? I don't think so. It would, perhaps, reduce the population of pissed-off traumatized veterans, which would be good for reducing the need for VA support resources for them. But would it allow them to 'own' their experiences and make their own sense and story from them, the way Anthony Swofford did with 'Jarhead?' There is something disturbing about what this drug is claiming to do. Pacification of entire populations -- vets, disaster victims, whatever -- sounds more like a political strategy than a therapeutic one.

I have to own up to some personal feelings of anger when I read the article. I couldn't at first distinguish between the conflicting threads of relieving the trauma, erasing the memories, making people feel less about what they've experienced. It seemed to me that the pill is a way of minimizing the importance of what initiates trauma. Is it really right and proper that we should take a pill and - poof! - that nasty rape experience will be re-stored in the brain like last year's company picnic. And you'll retrieve both memories with much the same body reaction. If traumatic events are really traumatic, shouldn't we be allowed to be traumatized, to bear actual, real trauma?

Of course, people asked these same questions when SSRI's first came out for depression. As a person living with depression that's being successfully treated with Lexapro, I can honestly say that no, I don't see these drugs as taking something away from me that is part of me, truly mine. I don't know whether I'd feel the same about the pill described in this article, however.

Thanks for an extraordinarily thought provoking post,
John

_________________________
Take for us the foxes, the little foxes that spoil the vineyards; for our vines have tender grapes. Song of Solomon 2:15

But let justice roll down as waters, and righteousness as a mighty stream. Amos 5:24

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#83374 - 01/16/06 11:01 PM Re: PTSD Pill?
Lloydy Offline
Administrator Emeritus
MaleSurvivor
Registered: 04/17/02
Posts: 7071
Loc: England Shropshire
_________________________
Go confidently in the direction of your dreams! Live the life you've imagined. As you simplify your life, the laws of the universe will be simpler.
Henry David Thoreau

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#83375 - 02/03/06 02:16 PM Re: PTSD Pill?
reality2k4 Offline
Member
MaleSurvivor

Registered: 07/06/04
Posts: 6838
Loc: Stuck between water, air, and ...
I hope you guys are thinking the same on this.
I flash read this article, but there seems to be huge side effects.

Drugs and therapy is the way.
You cannot mask trauma, especially when it is stored in the body, not just the mind.

Google body memory and read that, it will tell you that this pill is dangerous.

What do you think?

Pill could make painful memories a thing of past

Common drug may help to fight post traumatic stress
Scientists study the way brain stores information

Alok Jha, science correspondent
Friday February 3, 2006
The Guardian


Imagine being plagued with bad memories, images of such terrible trauma - an accident or an instance of abuse - that they produce an uncontrollable emotional reaction. Now imagine being able to wipe away the pain of those memories.

Scientists are working on a way to do just that. By studying how we lay down our memories, research shows that it is possible to select and alter the way memories are stored in our minds.

Roger Pitman, a psychiatrist at Harvard University, has already shown that giving certain drugs to victims of trauma when they were brought in to hospital meant that they were less likely to develop conditions such as post-traumatic stress disorder (PTSD). Now he believes he can even cure PTSD sufferers years after the event.

"Our theory about PTSD is that there's an excess of stress hormone that sears the memory too deeply into the brain," said Dr Pitman. "If we can block the effects of those stress hormones, we may be able to prevent people from getting these overly strong memories that can become PTSD."

The work takes advantage of the way memories - essentially networks of brain cells that each store information on a single event or object - are formed.

"When you form a new memory, it's not immediately stored in the brain," said Karim Nader of McGill University, Montreal. These new memories exist as temporary modifications to already-existing networks of brain cells that, over the course of a few hours, stabilise into networks of their own.

To get into the long-term memory, the temporary modification has to stabilise or fix into a new network of brain cells. The traditional view among neuroscientists has been that, once these memories become fixed, they are difficult to change.

But this view was challenged when Dr Nader carried out experiments on rats. He trained them to be fearful of particular stimuli, such as heat. He later made them remember those fearful memories by exposing them to the stimuli again.

Dr Nader found that calling up a fixed memory from deep in the brain made that memory go back to an unstable state, the same as a new memory, which then has to be re-stabilised if it needs to be stored. "If you block it from being restabilised, then the memory is essentially no longer there," said Dr Nader.

"Each time the synapse is activated, as it is memory, there are processes going on that could result in a strengthening or a weakening," said Dr Pitman.

How memories are fixed also depends critically on any emotional response we might have had at the time of the incident. "We can all better remember things that have emotional meaning to us than things which are neutral, so your first date, the first time you were in love, your first divorce," said Dr Nader. "When something emotional happens, it causes the release of adrenaline in the body. Via a cascade of receptor mechanisms in the brain this is going to turn up the intensity switch on the information that is being stored."

In conditions such as PTSD the emotional part of this fixing process is turned up so high that the memory sears itself deeply into the brain and ends up overwhelming that person for years afterwards.

Dr Pitman carried out a pilot study on humans where he gave patients at the Massachusetts general hospital who had recently undergone trauma a drug called propranolol, a beta-blocker used for decades to treat high blood pressure but which acts on the receptors in the brain involved in storing memories. He gave 19 victims of accident or rape either 10 days of the drug or 10 days of dummy pills.

Three months later, the patients listened to tapes describing their traumatic events. Dr Nader found that the people on propranolol had fewer stress symptoms than those on the dummy pills.

But for many PTSD sufferers the trauma might have occurred years before. "If you reactivate the trauma in somebody who has PTSD and that memory returns back to an [unstable] state, then maybe it means that memory can be manipulated," said Dr Nader.

Dr Pitman and Dr Nader, along with colleague Alain Brunet of McGill University have recruited around 20 people in the Montreal area who were traumatised a long as 20 or 30 years ago by child abuse, sexual assault or accidents. Traumatic memories will be brought to the front of their minds by talking to counsellors. This enables these memories to be modified by drugs before being stored again.

"The thing we're working on now is to have people who already have PTSD recall their memories and thereafter give them propranolol to reduce the re-storing of those memories, so the memory gets stored in a weaker version than it was originally stored in," said Dr Pitman.

But deleting memories is not the aim of this particular project because, for many PTSD sufferers, the bad memories are part of their identity. "What we want to do is turn it down a bit so it's not so overwhelming and bring them into a range where they're responsive to the traditional ways of treatment - therapy and psychiatric treatment," said Dr Nader.

_________________________
Whoever stole the Sun, put it back and we'll drop all the charges!

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#83376 - 02/03/06 03:23 PM Re: PTSD Pill?
roadrunner Offline
Administrator Emeritus
MaleSurvivor

Registered: 05/02/05
Posts: 22045
Loc: Carlisle, PA
This one fills me with a lot of conflicting feelings, much as John is describing. I sure could do without the PTSD, but at the same time what was done to me doesn't become less terrible just because some drug prevents me from reacting to it as before. It seems to me that being drugged isn't the same thing as being healed; these feelings are mine and I'm not sure I want to lose custody of them.

Much love,
Larry

_________________________
Nobody living can ever stop me
As I go walking my freedom highway.
Nobody living can make me turn back:
This land was made for you and me.
(Woody Guthrie)

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#83377 - 02/04/06 05:53 AM Re: PTSD Pill?
johnsurvived Offline
Member
MaleSurvivor

Registered: 11/20/05
Posts: 332
Loc: Arlington, Virginia
Well put, Larry. I agree.

_________________________
Take for us the foxes, the little foxes that spoil the vineyards; for our vines have tender grapes. Song of Solomon 2:15

But let justice roll down as waters, and righteousness as a mighty stream. Amos 5:24

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