More Drugs For Ptsd Victims

[Rocky]

ARLINGTON, Va. — The Army has agreed to fund research to see if a drug used to treat high blood pressure might be able to lessen the emotional impact of memories associated with post-traumatic stress disorder.

CBS’ “60 Minutes” first reported Nov. 26 that the Army was looking at whether the drug Propranolol could be used to treat PTSD.

Researchers hope to recruit several dozen veterans who served in Iraq and Afghanistan from the greater Boston area for the study, said psychologist Dr. Scott P. Orr, who will help conduct the research.

The study will look at whether Propranolol can reduce veterans’ emotional responses to certain memories by cutting down on the accompanying surge of adrenaline, said Orr, who works at the Department of Veterans Affairs Medical Center in Manchester, N.H.

In initial tests, people given the drug were observed to have reduced physiological responses, such as heart rates, to certain memories, said Orr, who is also part of the department of psychiatry at Harvard Medical School and Massachusetts General Hospital.

Orr stressed that the drug would not erase veterans’ memories. “It isn’t that the memory’s being changed — the memory is still there,” he said. “It’s that the emotional response that is attached to the memory is being reduced.”

But Dr. Judith Broder, a Los Angeles-based psychiatrist who is the founder of a nonprofit organization that provides free mental health services to veterans, said she has some reservations.

“I worry about several things,” Broder said in a Friday e-mail to Stars and Stripes. “First, I believe our soldiers often feel dehumanized by their time in the service. To then ‘treat’ them with a drug that potentially ‘numbs’ them, may further alienate them.”

She also said she fears that the VA, underfunded and facing an increasing number of veterans returning with PTSD, might resort to “cost-effective” solutions, such as giving veterans with PTSD a pill rather than the therapy they need.

“Another issue of concern is that of ‘informed consent,’” she said. “Soldiers are used to following orders. These soldiers are now suffering from a disorder and of course want relief from their suffering. Is it really possible to give informed consent to an experimental procedure under these conditions?”

Orr said in response that the research is not intended to see if Propranolol can produce “emotional numbing.”

“If anything, what it does is it reduces the intensity of the emotion such that the emotional reaction may become more manageable for the person,” he said.

“It is not a replacement for psychotherapy — rather, it becomes an adjunct; it becomes a useful tool for psychotherapy,” Orr said.

As for the issue of informed consent, Orr said researchers “generally bend over backwards” to give people participating in research all the information they need on the potential risks and benefits they would face.

Orr said the upcoming research will be headed by one of his colleagues, Dr. Roger Pittman at Harvard University.

The Army and Pittman are still negotiating how much his grant will be and how the study will unfold, said Chuck Dasey, a spokesman for Army Medical Research and Materiel Command at Fort Detrick, Md. Pittman could be awarded up to $625,000 a year for four years to conduct the research, Dasey said.

Rocky's comments:

Not that we don't have the VA putting us on enough drugs to placate us, now they want to add another one to their arsenal. In my opinion, most of the drugs now used by the VA for treatment of PTSD simply mask the problem and serve only to have us running around taking more and more pills; pills to help us sleep; pills to cause us not to dream or have nightmares; pills to keep us from getting angry; pills to elevate our moods and easy our depression; pills for every thing that haunts us except for pills to totally block our memory, which is getting worst on its one anyway. Pretty soon they will claim that they can cure PTSD and be looking to take away our disability payments and give us even more pills, which they may or may not decide they will pay for. The VA has already come out with the statement hat Gulf War Syndrome no longer exist, so is PTSD next? May sound like something that would never happen? Don't bet on it. The VA has already begun to state that most vets returning from Iraq don't have PTSD but Acute Combat Stress, something that is, in their words, curable and only short lived. They already have pills for that!

 

[ArcticWolf]

Erasing memories vs de-sensitising

I'm not a veteran, and so I may not be allowed to voice my opinion, however I'd like for everyone to hear me out on this one.
==========================================
On most things, I agree with Rocky.
I've seen this blog recently and it's worthwhile reading.:

http://ptsdcombat.blogspot.com/2006/03/scientists-racing-to-ease-painful-ptsd.html

My personal experience is that drugs, as Rocky says, only masks the memory, but when the drugs are stopped these memories come back with a vengeance.

The only existing way (my personal opinion and experience) to deal with traumatic memories is to work through them, as painful as it is. It gets worse before it gets better. But during that process it's extremely important to have support from family, friends and possibly any healthcare system that should be there to help people with PTSD, combat-related or not.

When I first heard of these trials - I work in the pharmaceutical industry for a Clinical Research Organisation, CRO, (this is not equal to a pharmaceutical company by the way) - I was really excited as it sounded as though the memories would be 'removed'.

However, on looking further into it, I have to admit that the brain is a complicated organ and messing with memories can have unforeseen consequences. Just look at people who have lost all their memory, due to accidents. Our entire lives are dependent on our memories. We wouldn't be where we are without them. Perhaps we'd be in a better place, true, but we'd be in a worse place too.

The human brain is incredibly adept at dealing with traumatic memories. OK, I know it sounds like a paradox... And perhaps I'm completely wrong, but even though my memories were with me every day, and still are, my mind was refusing to accept it had happened and I just thought I was going crazy. When I finally felt safe enough to deal with these memories and experiences, my mind 'let go' and plunged me into the hell that is realising that everything happened and the horrors of re-experiencing it to such a degree that you're unable to work/study/live. All you see, feel, hear, smell and even taste reminds you of what happened. It keeps playing over and over and over and over in your mind and you're unable to sleep and function as a person. My point is that I only started dealing with it all when I felt safe enough. I don't know if that's the experience veterans have though.

Anyhow, de-sensitising a memory is only a short-term solution. It may help you to go about your life, work/study/live and be present in 'the now' instead of 'the past'. It may help you to work through your memories without being institutionalised in a mental health facility, or even prison, in the process.

There has been a lot of discussions regarding clinical trials, informed consent and all things related this year in the UK media if nowhere else. This industry is one of the most tightly regulated, and informed consent is one of the most important aspects there is for a clinical trial, because all subjects/patients have to be made aware of all the risks involved and what the clinical trial is testing and what they're hoping to achieve in the long term.

It is important to make all subjects/patients aware that a clinical trial may be successful or unsuccessful. It's never possible to know the outcome of a clinical trial. The informed consent has to take this into consideration and each person must be aware that they may not get better if taking a new drug.

Please remember that most clinical trials do not deal with existing medications (as in the case with Propanolol), but with new ones, that are not on the market yet and may not be for many years or ever, depending on the outcome of the clinical trials conducted.

I do not agree with clinical trials being conducted with only veterans. PTSD affects a lot of people from various traumatic events and experiences. I can however see why they'd turn to that kind of trial/study population. After all, you are the people that fight for all of us, and if we could help sooner rather than later, then that would be great.

 

[Rocky]

My main concern lies with the Veterans Administration in the US using such drugs to lessen the flow of patients coming in for actual group or individual sessions to help learn to live with PTSD. The masking of the symptoms, in this type of situation, serves only to save money for the VA and to ease crowding of said groups. The patient is all to often left at home, drugged up, without any means of hands on help. I have seen this all to often. There are some great PTSD groups that operate out of specific VA hospitals, North Chicago VA for example, where the use of drugs is minimal. In fact they attempt to have the patients drug free when attending the IN-Patient program so that they can work on issue with the patient having a clear mind. The out come of this type of treatment is lasting as the patient learns how to cope with and understand the PTSD symptoms, which over time in therapy become less in dynamics and not as debilitating. Drug therapy does not offer this relief but only serves to mask the core symptoms which remain simply hidden waiting to come on even stronger should the medications be stopped. To me it goes back to the saying, "feed a hungry man a fish and his hunger will be lessen, teach a man to fish and he will never know hunger again." I think those with PTSD will be better served if they are taught how to deal with their PTSD rather than becoming dependant on drugs to simply make life easier for a time.

Note: I am 100% Total and Permanent under the VA for PTSD and on no drugs.