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“PTSD participants who actively recalled their traumatic event under the influence of propranolol once a week for up to six weeks showed a substantial decrease in symptom ratings compared with placebo,” wrote Alain Brunet, Ph.D., of McGill University and colleagues. “The decrease was evident from both the clinician’s and the participant’s perspective.”
Sixty adults diagnosed with long-standing PTSD were randomized to receive either propranolol or placebo 90 minutes before a brief memory reactivation session, once a week for six consecutive weeks. Patients in the treatment arm received 0.67 mg/kg of conventional (short-acting) propranolol, plus 1.0 mg/kg of long-acting propranolol. The patient-rated PTSD Checklist Specific (PCL-S) scale was administered at the beginning of each treatment session, before propranolol was administered. The Clinician-Administered PTSD Scale (CAPS) was used one week before and one week after the six-week trial.
Sixty minutes after ingesting the medication or placebo, the participants were asked to write a one-page trauma narrative in the present tense, first-person singular, focusing on the event’s most disturbing moments and including five or more bodily sensations drawn from a checklist. The participants were then asked to read the narrative aloud once to the therapist “as if they were back in the event.”
Patients in the propranolol and placebo groups had similar PCL-S and CAPS scores at baseline. At the posttreatment assessment, the scores had decreased in both groups, but the decreases were significantly greater in the propranolol group. At the six-month follow-up, the mean CAPS scores were 52.0 for the propranolol group and 69.2 for the placebo group. Mean PCL-S scores were 38.4 for the propranolol group and 69.0 for the placebo group.
“The effect sizes obtained for pre-reactivation propranolol in our study compare well to those obtained with the best evidence-based treatment for PTSD, namely, cognitive-behavioral therapy, as well as those obtained with the most recommended pharmacological treatment for PTSD, namely, SSRIs,” Brunet and colleagues wrote. “Should these results be replicated in further studies, propranolol blockade of reconsolidation [of traumatic memories] may become a new therapy for some patients with PTSD.”
For related information, see the Psychiatric News article “New Research Shows Multiple Genes May Be Associated With PTSD.”
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