Single-dose propranolol tied to ‘selective erasure’ of anxiety disorders
mdedge.com
mdedge.com
The use of beta blockers in anxiety is commonly associated with reducing the effects of stress on heart rate and blood pressure, not necessarily on affecting the brain directly which appears to be happening here. That is, beta blockers are usually a band aid rather than a fix, so this discovery is exciting.
(As an aside, if you suffer from unusual levels of physical response to certain stimuli while intellectually remaining calm or indifferent, propranolol may be worth investigating for you as it has helped me a lot. At your own risk, of course.)
I do like that (for me) Propranolol has minimal side effects other than mild drowsiness.
The physical withdrawal symptoms of cold turkey are pretty eye opening.
That’s quite a sales pitch! Propranolol worked for me for occasional use for stage fright scenarios. It was an amazing feeling the first couple of times to be able to go into those situations without the anxiety. But far from the Limitless example, for me a couple of hours after taking it I would slow down mentally and a few hours after taking it I would be exhausted and absolutely done for the day.
I stopped using it, and learned the hard way to do public speak.
Anxiety is complex and is not just the mental experience, which is why therapy for anxiety uses "hot cross bun diagrams" to describe the feedback loops that physical sensation contribute to.
See the "physical" boxes: https://www.researchgate.net/figure/Five-aspects-of-the-hot-...
http://cbtmidsussex.co.uk/aboutcbt.html
So they're not really a band aid, they're helping with one part of that feedback loop.
Like what kind of response?
Additionally, these effects may actually elicit anxiety in some individuals (especially those who get anxious over changes in their mental state and whatnot), which in turn also affects its effects on the heart rate. In such cases hydrophilic beta-blockers would do the job. I prefer labetalol as it has alpha-blocking properties and counters the catecholamine-induced (from anxiety) alpha stimulation which contributes to the increased heart rate as well.
As someone who's dealt with an oppressive government (which is where the PTSD and anxiety came from), I wonder if this therapy can be weaponized by the powerful to oppress the powerless. The rise of the warrior cop is bad enough, but what about a crack squad that has been chemically desensitized to killing in cold blood, taking orders from corrupt officials? Great for the warrior cop's medical prognosis, not so great if you're his target.
I believe many people in prison got there through some form of fear. Fear they'd get found out, fear they'd lose something, fear for their life, fear from their childhood they lost the ability to deal with, fear they self-medicated leading to a crime. If this technology makes it out of the proverbial Petri dish, I'm hoping we as a society could substitute a session for 10+ years of incarceration. We'd end up safer, less poor, and more just.
There are I think 2 main reasons why not:
- Stormtroopers are people who have non functioning empathy, by nature or nurture, they don't experience killing in cold blood as horrific.
- Stormtroopers are a cheap commodity. The oppressive government doesn't mind using them up.
On the other hand the people who are subject to crippling PTSD are victims of stormtroopers, directly and via losing friends. And a few doses of this stuff smuggled in might effectively reignite the fire in a resistance movement.
It's part of why you see generational cycles of violence. Each traumatized generation traumatizes the next.
I read Eichmann in Jerusalem recently. One of the main arguments of the book is that people don't need to be extraordinary (i.e. lacking a conscience or particularly fanatical) in order to do terrible things.
The book is controversial but I think that argument is correct. The problem with Nazi Germany was not a generation of Germans who happened to be born without consciences. And, horrifyingly, we've seen this pattern repeat across time and space. It just isn't necessary to chemically alter people to get them to perform actions that we would describe as evil.
In Brave New World, this was soma. "A gram is better than a damn."
I take it only before public speaking, not regularly. The only downside is it leaves me with dry eyes and exhaustion at the end of the day, but it’s a small price to pay for the huge QoL improvement.
Thanks for sharing your experience!
The ideal approach would be to take propranolol, then use that confidence to take public speaking classes.
Beta blockers were the only thing that let me experience public speaking where everything was actually fine. Now I don't need them anymore, but I never would have gotten past it without them.
Before this it was easy to shut down and avoid confronting bad memories. Now I can just brush away everything. Another great property to propranolol is it reduces the jitteriness from caffeine. Granted, if your anxiety is bad enough to need beta blockers that's definitely not a good thing, but at least the medication works well for what it does.
This kind of medication is far superior to benzos for anxiety disorders. It was pure luck to have been prescribed this instead of getting put on some horrible downer, developing a tolerance in a few months, and then having to detox with rebound symptoms that are worse than the illness being treated. There seems to be a lot of promising developments in psychiatry recently.
This medication is absolutely brilliant and harmless. Also keeps my resting heart rate around 55.
If you struggle with migraines, talk to your neurologist, for me it was a life changer.
That would be considered mild bradycardia.
It took about a year and a half to finally have a light bulb moment that the Propanolol was the major difference between the most successful and prosperous years of my life and the parts of my life where I've been an anxious hot mess. I'm so glad I stumbled upon this medicine as it's truly made my life more meaningful in allowing me to achieve what I'm really capable of as a software developer.
My best guess as to the origin is the environment at home when growing up. Without going into too much detail, it was very stressful and I felt like I didn't have a voice.
I'm not sure if I've noticed a difference with anxiety while on it, other than the mitigation of anxiety from ADHD medication.
I guess I should try taking it alone.
That being said, a large part of my psychological issues are due to anxiety, but I haven't seen any treatments that have been compelling enough for me to try (SSRI's/benzos mainly).
I do exercise, try to be good about sleep, try to force myself to get out with friends or family every other week or so.
Additionally, I've noticed meditation to be a large help for me with anxiety. It took me a while to where I really notice the difference, but I've reached a point where I can say I notice if I've meditated the night before or not.
(I'm not advocating for or against any medication, individual situations vary, and people should consider treatment in the context of their situation with their doctor)
Happy to hear someone else does this as well. It's really done wonders and has helped me think more clearly in stressful situations — whereas, with stimulants alone, things can become a little more stressful when you're stressed due to increased heart rate and blood pressure.
“In a 1987 study by the International Conference of Symphony and Opera Musicians, it was shown that 27% of interviewed members admitted to using beta blockers such as propranolol for musical performances.[70] For about 10–16% of performers, their degree of stage fright is considered pathological.[70][71] Propranolol is used by musicians, actors, and public speakers for its ability to treat anxiety symptoms activated by the sympathetic nervous system.[72] It has also been used as a performance-enhancing drug in sports where high accuracy is required, including archery, shooting, golf[73] and snooker.[73] In the 2008 Summer Olympics, 50-metre pistol silver medalist and 10-metre air pistol bronze medalist Kim Jong-su tested positive for propranolol and was stripped of his medals.[74]”
Honestly yes. And it even sounds a bit scary, to me, that a drug that is very un-selective produces such a selective effect (erasing a specific kind of memory under very specific conditions). It sounds a little bit like striking a welding arc a couple times in just the right way next to a computer to flip a few specific bits in it's main memory -- absolutely astounding that it works, but who knows what else happened in there?
That being said I very much hope that this turns out to not produce {short,long}-term damage, because anxiety orders are very difficult to treat and are a huge waste of human ability.
Why do you think it erases the memory?
emotional/fear association sounds like a type of memory to me.
https://www.newscientist.com/article/mg22429941-200-the-life...
Oh wow, I'd be keen to give it a go:
1. Standing next to an edge of a tall building.
2. In a tightly enclosed space.
So like think loading a block of memory then rewriting it, but this time you rewrite the memory without the associated anxiety.
I took it as a product of not having a photographic memory. When my mind recalled the memory, there were a lot of parts missing: hand gestures, voice volume, other students, etc. So my brain filled in those gaps with "reasonable" guesses. And, during a depressive episode, it was reasonable to assume other people didn't like me. These additions became part of the memory.
Even with the depression and anxiety under control, I keep in mind that memories can be emotionally altered. So I'm more willing to believe my memories are wrong. And I don't let myself obsess over a memory, which was never productive, anyway.
What about a group who was exposed to the tarantula without the propranolol?
Coincidentally, I recently listened to an interesting Revisionist History episode that covered the importance and controversy of a semicolon in the interpretation of a section of the constitution
http://revisionisthistory.com/episodes/21-divide-and-conquer
Edit: I read the side effects are basically the same, including ED.
That you can acquire the drug readily for other medical reasons is not in any way a reason to start self-prescribing it for anxiety. Without the trauma-inducing psych session, the anti-PTSD benefit they describe has no chance to occur. And it’s a bad plan to give yourself traumatic recall flashbacks - a bad trip by any definition - without some sort of competent mental support from competent human beings.
He was being helpful and it saved me time
I didn't see one.
Taking a dose of propranolol prior to a stressful situation is a different type of environment with different goals for how will interact with the environment.
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This is not new research for we had replication research of the connection with specific Beta receptors in the amygdala and the hippocampus in 2004 with fear and Yadda, Yadda, Yadda... with prior breakthrough research happening even earlier. But there are so many interactions with so many systems that research after 2004 is about learning the "best practices and best applications" of how to treat patients. Science and Medicine is a continuous undertaken process. This researcher M Soeter has a dozen important scientific papers on the detail of this process from 2009 to 2018.
I realize I’m just one data point, but as someone with anxiety, I studied up on the use of propranolol in fear extinction and was able to get my doctor to prescribe it around 5 years ago. It had absolutely no positive effect on me. I may as well have been taking aspirin. It did, however seem to have some negative effects on my memory. If I met someone while on it, I would often not recognize them if we met again. It’s like it prevented my brain from recording their face to my long term memory.
I was on nothing else but blood pressure medication, by the way.
Imagine this being used to erase more complex memories, like that person you dated for two weeks that broke your heart.
Would you lose your feelings of love?
This seems like an incredible drug, I’d like to do some self experimentation.
Also, if people have been taking this for anxiety, why haven’t they been cured?
You gain retention by assimilating facts at the same time you have some emotional experience, this is one of the reasons why professors who are entertaining can sometimes also be much better teachers. Laughing while assimilating works better than simply trying to memorize stuff.
Even looking at rote memorization, most experts in memorization tell you to associate places and emotions with whatever you're currently trying to memorize.
So by removing the emotional payload from the memory, you're effectively also removing the memory itself, even if superficially the facts remain. What will happen over time is that since there's less emotion associated with the facts, the facts will be forgotten -- like all the other facts in your life day-to-day are forgotten.
I knew all of that and thought others did too. Next time I'll try assuming that is not the case.