Date of Graduation

Summer 8-10-2019

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

Abstract

Background: Posttraumatic stress disorder (PTSD) is a psychiatric disorder affecting millions of the US population. Symptoms and comorbidities of the disorder can dramatically affect the lives the sufferers. First-line treatment has been either antidepressants, psychotherapy, or a combination of both. However, success rates are lacking. Recently, the beta blocker propranolol has been shown to have effects on disrupting memory reconsolidation in humans through inhibitory actions on protein synthesis and norepinephrine. This could potentially translate to disrupting the traumatic memories in PTSD and becoming an adequate treatment for the condition.

Methods: An exhaustive literature search of MEDLINE-Ovid, MEDLINE-Pubmed, Google Scholar, and Web of Science with the terms PTSD, Posttraumatic stress disorder, reconsolidation, and propranolol was conducted. Bibliographies were also searched for relevant studies. The studies were evaluated using GRADE criteria.

Results: A search of currently available research yielded 232 articles, 3 of which met inclusion criteria. One of the studies was a meta-analysis from 2013, one study was a continuation from a previous study included in the meta-analysis, and one study was a randomized control trial. Decreases in psychophysiological response (heart rate and skin conductance) to traumatic imagery with propranolol-treated subjects was observed and considered statistically significant. A follow-up study also showed these results lasted over 4 months. Clinician-administered PTSD scale (CAPS) scores and PTSD Checklist (PCL) scores were found to be significantly lower in propranolol-treated PTSD subjects when compared to placebo after memory reconsolidation and at follow-up.

Conclusion: Both early and recent studies have shown promising results of propranolol blocking memory reconsolidation in PTSD patients to reduce symptoms, but its routine use in practice would be premature. Study limitations and uncertainties warrant the need for extension and replication in larger samples of the population. If further studies can duplicate the findings, propranolol use in conjunction with memory reactivation exercises may be an effective, safe, and affordable treatment for PTSD.

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