IS PTSD CURABLE?

An opinion piece in the New York Times [January 22, 2016] by Richard A. Friedman discussed recent brain research regarding memories and a medication that can help the brain let go of fears, with the example of being fearful of spiders, by blocking the activation of a fear conditioned response.  Merel Kindt and her colleagues at the University of Amsterdam reported that in the study, people were exposed to a spider and also given a medication called propranolol and they were no longer having fear responses to seeing spiders up to a year after the initial pairing up of the spider and propranolol.  There are also a number of studies showing that giving propranolol immediately after a traumatic event may mitigate the fear response and may prevent PTSD from developing.

So what is propranolol?  Propranolol is a non-selective beta blocker that blocks the action of epinephrine and norepinephrine on beta 1 and beta 2 adrenergic receptors.  Propranolol works in part by inhibiting the effects of norepinephrine in the brain.  Norepinephrine is a neurotransmitter that works by enhancing memory consolidation.  The inhibition of norepinephrine by propranolol may be related to its ability to reduce stress associated with PTSD and other fear conditioned experiences. It is possible that propranolol blocks some of the fear responses so that people can use their coping skills to demonstrate to themselves that they are no longer at the mercy of past stressful experiences.

I have found that propranolol can be helpful in reducing symptoms related to PTSD.  More recently, I have found that a long acting form of propranolol seems to work better to block some of the fear conditioned responses that people with PTSD have, compared to the immediate release type of propranolol.