Could a pill help fade traumatic memories?

Painful memory doesn't decay
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.”

Part of the human experience
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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