The purpose of this investigation is to see if propranolol will reduce the
psychophysiological hyperactivation associated with memories of combat stress in Veterans
with Posttraumatic Stress Disorder.
The goal of this translational research project is to generate a pilot sample of data from
an investigation of a novel therapeutic approach to post traumatic stress disorder (PTSD).
Current treatments for PTSD include exposure and other aspects of cognitive therapy as well
as drug therapies based on serotonin-reuptake inhibiting antidepressant agents. However,
these treatments are often unsuccessful, and symptoms in affected individuals may persist
for decades. The central hypothesis guiding this research project posits that acquired fear
responses, such as those in PTSD, when reactivated by recall become sensitive to
noradrenergic modulation and thus may be permanently attenuated by blocking noradrenergic
transmission. Further, we predict that this attenuation will facilitate subsequent therapy.
In the current study, we will be investigating this model in three groups of Veterans of
either Operation Iraqi Freedom or Operation Enduring Freedom (OIF/OEF) with PTSD: 1)
Individuals who receive propranolol following recall of a traumatic memory
(Propranolol-trauma); 2) Individuals who receive a placebo following recall of a traumatic
memory (Placebo-trauma), and; 3) Individuals who receive propranolol following recall of an
affective neutral memory (Propranolol-neutral). In addition, traumatic memory recall will be
psychophysiologically assessed by measuring Veterans' facial corrugator electromyography
(EMG), skin conductance, blood pressure and cardiovascular inter-beat interval responses
pre- and one month post-medication administration.
- Participants will meet the clinical criteria of PTSD (DSM IVTR) secondary to combat
- Current illicit substance use or alcohol consumption, as determined by urine
toxicology and alcohol breath test.
- Any diagnosis of current comorbid psychotic disorders, bipolar disorder, or illicit
substance or alcohol abuse or dependence.
- Any current prescription medication usage or supplement (dietary or herbal) usage
that is contraindicated with propranolol.
- Active enrollment into any psychiatric or psychological treatment.
- Any condition that contraindicates the use of propranolol, such as:
- history of bronchial asthma.
- heart block.
- sinus bradycardia.
- congestive heart failure.
- insulin-dependent diabetes.
- initial systolic blood pressure < 100 mmHg.
- Thyroid disease.
- Renal or liver impairment.