By : Amélie BERNARD, Daisy JEANNOT-GOUPILLEAU and Camille PIVAULT
Who has never dreamed of being free of his fears ? For some years, studies are focusing on the effects of a molecule named propranolol. Its purpose is to reduce the intensity of emotional memories associated with traumatic situations. With the occurence of tragic events in France these last years, this drug may prove to be relevant in the care of victims of terrorist attacks who fail to resume their lives.
Propranolol is a beta-blocker originally used in the treatment of high blood pressure by working against noradrenalin (Riffaudeau, 2017). However, for a couple of years now, this molecule is being studied by Alain Brunet, a psychiatric researcher in Montreal, in a completely different framework. Actually noradrenalin is a neurotransmitter related to learning processes and sensitivity to emotional signals (Thierry Souccar Editions, n.d.). It also plays a role in some circuits of memory involving chronic stress. Blocking this neurotransmitter could decrease the intensity of the emotional dimension of a traumatic memory.
In 2015, a study conducted by Merel Kindt, a psychology professor in Amsterdam, showed a decrease in the emotional response in people with arachnophobia who took propranolol. Those people were able in the medium and long term (a year later) to take spiders in their hands without showing any particular emotional reaction (Friedman, 2016).
Thereby the aim of this treatment is to weaken emotional memory by decreasing or removing the primary emotional response without affecting the biographical and factual memory that triggered the phobia. For example, among people scared by dogs, emotional memory is bind to a dread consequence such as the fear of being bitten. Even if this person has never been bitten, it is this memory of fear which create phobia. Thus treatment must be taken at the same time as exposure to phobia (physical exposure, mention of the traumatic memory with great details, etc.).
Exposure is a technique of recalling the traumatic memory. However this process of reminder makes the memory very vulnerable to alterations in relation to reality (Friedman, 2016). Indeed it involves mechanisms that put back together the memory based on actual facts and other elements drawn from personal history, personality, emotional state, etc. Therefore exposure would embody the best time to administer propranolol in order to influence the emotional dimension of traumatic memory.
Under the current french circumstances, this treatment has been offered by Alain Brunet to a hundred of victims after the terrorist attacks that took place in Paris on November 13th 2015. The clinical trial was named “Paris Mémoire Vive” (Riffaudeau, 2017). Protocol is made of 6 sessions with a psychiatrist during which each patient must take a pill while remembering his experience of the attacks. Sadly more terrorist attacks happened since (July 14th 2016 in Nice), so new victims joined the trial.
Following this trial, it turns out that the treatment works on two thirds of the patients (Riffaudeau, 2017). Therefore, propranolol could be a promising therapy in the next future but its use could also raise ethical objections regarding the drug administration procedure which requires patients to go through their traumatic experiences multiple times. Some people just cannot bear it while it is a necessary step.
Furthermore, it would be interesting to estimate the ratio profits-risks of this drug. How do the people live with their “reprogrammed” memory ? What is their perception regarding this new aspect of their traumatic memory ? Could emerge some kind of feeling of oddness owing to the fact that there is little to no feeling at all concerning traumatic events ? Moreover emotions are adaptive responses to the environment. They allow us to set up motor reactions when a potential danger occurs, such as running away. So what can be the consequences of an absence of emotional answer in this kind of situation ? For example, would not fear trigger a life-saving response ?
Bibliography
Friedman, R A. (2016). A drug to cure fear. Retrieved from https://mobile.nytimes.com/2016/01/24/opinion/sunday/a-drug-to-cure-fear.html
Riffaudeau, H. (2017). Envoyé spécial : la pilule qui atténue les traumas des victimes d’attentat. Retrieved from http://teleobs.nouvelobs.com/actualites/20170905.OBS4278/envoye-special-la-pilule-qui-attenue-les-traumas-des-victimes-d-attentat.html
Thierry Souccar Editions. (n. d.). Les 6 super-neurotransmetteurs de votre cerveau. Retrieved from http://www.thierrysouccar.com/bien-etre/info/les-6-super-neurotransmetteurs-de-votre-cerveau-388
