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Propranalol

Discussion in 'Medications & Substances' started by losses, Sep 29, 2006.

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  1. losses

    losses New Member

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    I just started taking propranalol for the physiological symptoms of PTSD. Does anyone else take this?
     
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  3. anthony

    anthony Renovation Aficionado Founder

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    Now that is interesting.... what is the brand name associated to propranalol?
     
  4. losses

    losses New Member

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    propranolol

    Oops. That's "propranolol." The name-brand is INDERAL. It's an older drug, originally used for high-blood pressure. As of late, it's been studied to see if it can prevent PTSD - some people call it a "memory eraser." Yeah, right!

    Background:
    I find the physiological symptoms of PTSD to be debilitating. Regardless of whether I am emotionally upset or not, my body becomes progressively more "stuck" as the day progresses. Often, by afternoon, I will be dizzy, dazed, my senses will be "dull" (i.e., things sound cloudy, and I can't taste very well), my joints feel stiff, my fine motor skills are compromised (and my spelling:crazy-eye), I may shake and cry uncontrollably, my throat is constricted, it's hard to breathe, etc. Emotionally, I'm fine; physically, I'm semi-paralyzed in a sympathetic nervous sytem "freeze." This makes anything other than sitting in front of the television extremely difficult - I would consider brushing my teeth and taking a shower an incredible accomplishment for a day like that.

    Anyhoo. It has been explained to me that the process of becoming "frozen" may begin with a "trigger," however miniscule or insignificant (milk, a fork, eating breakfast, looking at the alarm clock...) This is called "kindling," and sets the stage for "rekindling," which is rather like an avalanche: the first trigger makes it easier for the second trigger, then a third, and so-forth.

    A psychologist mentioned the use of propranolol to me to help with this nightmare, so I mentioned it to my psychiatrist. I have been trying this drug for a couple of weeks, and have found it to have an impressive result. When I take it in the morning, and then again in the afternoon, the kindling effect never happens, and my body is fine. It doesn't do anything to my mind or emotions, but it stops that cycle from happening.

    It's described in a different way here:
    "Primarily intended as heart medicine, beta blocker drugs like Propranolol have long been used "off label" to treat anxiety patients because they have a unique property of either lessening patients awareness of parasympathetic (peripheral) nervous system (PNS) activation, or actually lessening that activation (I'm not sure which!). A socially phobic patient who normally would freak out during a speech can take Propranolol and not notice their palms getting sweaty, or their heart palpitating while they present. Because they are not distracted by internal arousal symptoms, they are better able to remain focused on their speaking task and to execute it without incident."
    http://mentalhelp.net/poc/view_doc.php?type=weblog&id=51&wlid=6&cn=109
    Now, if I wake up and I'm already "frozen," due to some nightmare or something, it doesn't work as well, or at all sometimes (like today:dontknow:).

    Like I said, it's new to me, so I was wondering if anyone else had tried it.
     
  5. anthony

    anthony Renovation Aficionado Founder

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    Personally from what I just researched about it, the properties of the medication, nor its desired outcome, would be suitable for the application of PTSD, because anyone trying to suppress the memories are only go to find themselves on a lifetime of drugs, instead of just dealing with the trauma and then getting on with life without the lifetime use of drugs. I am sure the drug companies would push as much as possible in order to attempt avenues of lifelong medication, which they do enough by making medications addictive vs. natural alternatives that do the exact same job, often better because less side effects come from them, and without addictive properties to withdrawal is not an issue.
     
  6. losses

    losses New Member

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    Yes, the research I've read actually angers me. I dislike the idea of supressing memories that may or may not lead to PTSD. I'm not interested in that aspect of the drug, especially since the window of time in which a doctor would have had to prescribe this medication for me was, oh, twenty years ago. It's far too late for the intended use of the drug in those experiments to have its desired effect on me.

    I'm trying to find information about how this drug has been used for already-existing anxiety disorders - to see if others have experienced relief from physiological symptoms.

    Indeed, the idea of being a drugs for a lifetime is extremely unappealing to me. I have recently started attending a therapy group which consists of learning meditation methods that can, over time, become just as effective as medication. I hope that, in time, I will reach that point. It is a process, though, as we all know. I've also learned incredibly valuable skills through taking over a year of DBT workshops - that information was like gold.
     
  7. anthony

    anthony Renovation Aficionado Founder

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    Hey Losses,

    I think I can now answer many of both our questions. I spoke with Dr Roerich last night, and he enlightened me to more what this is about, and that this treatment is actually quite beneficial not for overall symptoms, but immediate relief, opposed to popping an SSRI which does nothing immediately, because they work on long term exposure to the body, not short term.

    Why they have decided to use propranolol is to help people with their panic and anxiety attacks as such, not actually use it for the treatment of anxiety itself. The way it was explained, and I can actually see this as beneficial in this light opposed to using it permanently to suppress memories, is that when one has an axiety attack the heart beats faster, thus anxiety increases, etc etc... and where the use of propranolol comes in, is immediate relief past anxiety / panic attacks to slow the heart and provide a calming effect. I take back some of my original statement, and can see this could have scope, especially when those are running around with uncontrolled PTSD and having panic attacks just trying to get food or the like. One of these will slow the heart, slow the immediate stress, thus the panic resides very rapidly.

    But yes, I do hold as per you do, in that the use of this as a permanent medication is very unsuitable, because people are going to deal with nothing, thus rely on drugs to help them when they actually won't need them, or very minimal use of them, during their life once trauma is dealt with head on and understood.

    My good mate Dr Roerich explained this too me, and I see some light on this, and he is also no avid supporter of prescription medication, though can see that this could have some immediate relief for those who suffer frequent panic attacks at a large scale for temporary relief until trauma is dealt with.

    This is very interesting losses, and thank you for bringing this up, because I have learnt some new things about this now, having to investigate more and then speak with trauma experts about it for more detailed synopsis.
     
  8. Roerich

    Roerich M.D.

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    More info from Dr. Altemus

    Is medication sufficient to control PTSD

    Heart Drugs Could Ease Trauma Memories

    (HealthSCOUT)

    Updated: Jul 29th 2005

    FRIDAY, July 29 (HealthDay News) -- Widely used heart medications called beta blockers may take the terror out of disturbing memories in people with post-traumatic stress disorder (PTSD), researchers report.

    In both animal trials and preliminary work with humans, use of the beta blocker propranolol during a PTSD attack appeared to help separate the fear that's characteristic of PTSD from the memory that once triggered it.

    The researchers don't think the beta blocker erases or diminishes the memory.

    "Our expectation is that we're reducing the hyperarousal associated with the memory -- we expect that the memory will still be there," explained lead researcher Dr. Margaret Altemus, an associate professor of psychiatry at the Weill College of Medicine at Cornell University, in New York City.

    But this new approach to easing PTSD symptoms isn't without its critics, one of whom worries the drug might be misused to desensitize individuals, such as soldiers, to acts of atrocity.

    At this point in the research, though, it's too early to tell how well beta blockers might work even as a therapeutic aid, Altemus said.

    "There were two small studies that have already been done using propranolol for PTSD, where they treated people right when the accident happened -- they found people in the emergency room. One study was done in France, and one was done in Boston," she said. "They did find they were able to reduce the [emotional] intensity of traumatic memories by giving people propranolol for the first 10 days or so after an accident."

    But Altemus also pointed out that PTSD is rather rare, with less than 10 percent of accident victims experiencing the recurrent flashbacks, isolation and avoidant behaviors that are hallmarks of the condition. So, it wouldn't make sense to hand out propranolol to everyone who'd suffered a traumatic event, she said.

    In theory, beta blockers such as propranolol work to reduce memory-associated fear through their effects on hormones linked to fear and arousal.

    "Every time you have that intense, overwhelming fear in a PTSD attack you release catecholamines -- another word for adrenalin hormones," Altemus explained. "Those actually make the memory stronger and more intense. So, it's a kind of vicious circle for people with PTSD."

    "What propranolol does is block one of the [cell] receptors that catecholamines work on, the beta-adrenergic receptor," she added. The theory is that by blocking this hormonal response during memory-evoked PTSD attacks, individuals will gradually be able to remember the triggering event without its attendant panic and fear.

    In animal studies, Altemus' team found that mice trained to fear a tone followed by an electric shock lost that fear if given propranolol just after the tone started.

    The researchers have also done work in healthy, non-PTSD individuals, conditioned in the lab to fear seeing a blue square because it had previously been linked to a mild electric shock.

    "In our preliminary analysis that we presented at the Society of Neuroscience meeting last year, we did see that -- at least initially -- people that took propranolol had less of a fear response [to the square] on the third day. That work hasn't been published yet, but it's encouraging," Altemus said.

    Beta blockers are not the first drugs to be used in the treatment of PTSD; the U.S. Food and Drug Administration long ago approved selective serotonin reuptake inhibitors (SSRIs) such as Paxil and Zoloft for the condition. But the most effective and widely used treatment by far is "exposure therapy" -- where the patient is exposed to stimuli associated with the traumatic event. Altemus said many patients would welcome a treatment option that allowed them to avoid that type of re-living of the experience, however.

    She stressed that beta blockers, if proven effective, "could be used to augment other therapies. It might be something you could add to exposure therapy, to help it work better," she said. The drugs have few side effects, but they are not recommended for individuals with either asthma or diabetes, the researcher added.

    However, one expert is concerned the drugs might have a darker side. In an interview with Nature magazine this week, Dr. Paul McHugh, a psychiatrist at Johns Hopkins University in Baltimore, worried that, "If soldiers did something that ended up with children getting killed, do you want to give them beta blockers so that they can do it again?"

    McHugh, who is also a member of the President's Council on Bioethics, believes "psychiatrists are once again marching where angels fear to tread."

    But Altemus believes McHugh is looking at trauma's aftermath in the wrong way.

    "I think Dr. McHugh may have been assuming that what prevents soldiers from committing atrocities is this overwhelming fear," she said. "I've never been in a war, but my guess is that they do these things because they are really angry, or through some kind of group attitude."

    Altemus also believes that effective PTSD treatments might "unlock" individuals otherwise emotionally frozen by traumatic events. "If you take someone who has been in the Holocaust or was raped -- their ability to change laws or prevent that event from happening again is actually inhibited by having PTSD," she said. "PTSD is a really disabling illness, and people are able to be themselves and be more active if they don't have it."

    According to the Associated Press, a study released Thursday by the U.S. Army surgeon general's office estimates that between 4 percent and 5 percent of returning Iraqi veterans with combat experience suffer from PTSD.

    Funded by a grant from the National Institutes of Health, Altemus is currently working to recruit PTSD patients for a large-scale trial of propranolol -- a tough job when effective interventions such as exposure therapy already exist. She said that as soon as she's able to recruit the 60 people needed for the trial, results should be available within a year.

    More information

    For more on PTSD, head to the National Institute of Mental Health.

    SOURCE:

    Margaret Altemus, M.D.
    Department of Psychiatry
    Weill Medical College, Cornell University
    Box 244, 1300 York Ave
    New York, NY 10021
    212-746-3751 (phone)
    212-746-3870 (fax)
     
  9. permban0077

    permban0077 Policy Enforcement Banned

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    OK, maybe it is because it is about 3 AM, but I have a hard time wrapping my mind around this. I mean lets take the addictive qualities out of xanax, you still are going to be depedant on it because it stops the attacks, which when you can stop one it is pure bliss. Addictive or not we know if we can halt a panic attack we are on cloud nine! How would this be different? With the Panic disorder mine would cycle out of control. I needed a horse's dose to calm down. But after taking it head on and addressing the PD I stopped them cycling with CBT. I still get alot of them and some days worse than others. I know what they are now and are harmless, just not a fun ride and they normally do not trigger one right after another for hours anymore. But I can have a day of none as I address my issues.

    It is painful and certainly not the easy way out of panic attacks, and I certainly know how bad they can get with all the hospital trips to back it! But it just seems counter productive. You are not going to heal at all if you can take a pill and calm you. I could do things like shop if I took enough xanax... Now I can't, or rather won't, and have to face my fears since it doesn't cover it up anymore. This would be a patch just as the rest and if the fear is taken out like the other pills do where and how do you get to a point of healing?

    If it is not addictive it is great to have to give to someone new to attacks until they get proper counsel on how to control them and learn to not fear the attack itself anymore (traing wheels). But again, you have to go through attacks again to get even there at some point... But I could see being useful if not addictive like the crap I am kicking for people who have the "pleasure" of their first cases of Panic Attack or Disorder.

    As for long term use, I just see it as another pill controlling how I think and respond and it makes me uncomfortable, I would rather fight to feel somewhat sane most of the time and when I am not scared know it is because I faced my fears and retrained my mind how to respond. And man is it a bitch doing it.
     
  10. anthony

    anthony Renovation Aficionado Founder

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    I agree whole heartedly veiled. I think this could be a variation instead of the harder hitting drugs such as xanax, where when people are first diagnosed, you need that reprieve a little so you can get some relief from the symptoms allowing one to work on the issues at hand. As you well know, once you get onto some off these drugs, they give you one hell of a rollercoaster getting off them, compared to something like this that doesn't contain such addictive qualities, nor do they remain in your system like an SSRI does to treat overall anxiety. I think these would serve purpose to those first diagnosed if their anxiety wasn't out of control to extreme levels, and their PTSD was more centered around major panic attacks (anxiety attacks) vs. anxiety in general.

    But yes, at the end of the day I hold with my original statement within this thread, that no medication is a long term benefit nor something to be relied upon to help PTSD. One way, one way only... head on with the trauma.
     
  11. annafennutchi

    annafennutchi Active Member

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    As a nurse, my only concern would be the cardiac effects it may have, even though used for non heart related reasons, it is still a cardiac drug. Seems a little risky, but if we don't take risks we don't learn anyhting new, eh?
     
  12. anthony

    anthony Renovation Aficionado Founder

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    I thought about that myself Anna, but don't know enough about it to really say. I thought that intentionally slowing the heart could have possible side effects, ie. blood pressure medications, but wasn't sure of the risk. I used commonsense I guess, in that if you had high blood pressure, then the medication would do something, but if you didn't, the medication would only be treating the rapid heart rate, because the high blood pressure is not a permanent thing, and would only increase as the heart rate increases during a panic attack.

    Could you tell me more about this please, because I would like to know more, and have as many facts as possible for people to make an informed decision for themselves.
     
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