PTSD Symptom Reduction by Propranolol Given After Trauma Memory Activation

Launched by VA OFFICE OF RESEARCH AND DEVELOPMENT · Mar 19, 2008

Keywords

ClinConnect Summary

OBJECTIVE: In the first of two preliminary studies, the investigators demonstrated in individuals with chronic PTSD that a single (combined 40 mg short- and 60 mg long-acting) 24-hour oral dose of propranolol, compared to placebo, given immediately following reactivation of the PTSD-related memory of the traumatic event, significantly reduced physiological responses during script-driven imagery of that event measured one week later. These results support blockade of reconsolidation of the traumatic memory, a process that is entirely distinct from extinction. In addition, the investigators f...

Gender

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Eligibility criteria

• Inclusion Criteria:
• • OEF/OIF veteran diagnosed with combat related posttraumatic stress disorder
• Exclusion Criteria:
• • 1. Not diagnosed with current, chronic PTSD
• • 2. Current PTSD related to a traumatic event other than the event being treated
• • 3. Age\>65.
• • 4. Systolic blood pressure \<100 mm HG or resting HR less than 60 BPM.
• • 5. Medical condition that contraindicates the administration of propranolol, e.g. history of congestive heart failure, heart block, insulin-requiring diabetes, chronic bronchitis, emphysema, or asthma. With regard to asthma, because many persons who say they have had an asthma attack, especially as a child, may only have had hay fever, another allergy, or another non-asthmatic episode, a blanket exclusion criteria may be overly restrictive. Therefore asthma attacks will only be exclusionary if they a) occurred within the past 10 years, b) occurred at any time in life if induced by a beta-blocker, or c) are currently being treated, regardless of the date of last occurrence. Cardiological consultation will be obtained as necessary;
• • 6. Previous adverse reaction to, or non-compliance with a beta-blocker.
• • 7. Current use of medication that may involve potentially dangerous interactions with propranolol, including, other beta-blockers, antiarrhythmics, calcium channel blockers, and potent P450 2D6 inhibitors, e.g., fluoxetine, paroxetine, micnazole, sulconazole, metaclopramide, quinidine, ticlopidine, and ritnavir.
• • 8. Presence of drugs of abuse, viz., opiates, marijuana, cocaine, or amphetamines, as determined by urine testing.
• • 9. Pregnancy (in women of child- bearing potential, a pregnancy test will be performed) or breast feeding.
• • 10. Contraindicating psychiatric condition, e.g., current psychotic, bipolar, melancholic, or substance dependence or abuse disorder.
• • 11. Initiation of, or change in, psychotropic medication within the previous two months. For subjects receiving stable doses of pharmacotherapy, they and their providers will be asked not to change the regimen except in clinically urgent circumstances. If this becomes necessary, a decision will be made on a case-by-case basis whether to retain the subject in the study or terminate participation.
• • 12. Current participation in any psychotherapy (other than supportive). Subjects will be asked not to initiate psychotherapy during the course of the proposed study except in clinically urgent circumstances; if this becomes necessary, a decision will be made on a case-by-case basis whether to retain the subject in the study or terminate participation.
• • 13. Inability to understand the study's procedures, risks, and side effects, or to otherwise give informed consent for participation.