Findings may lead to new treatment strategy for phobia

A new study published in the latest issue of Biological Psychiatry reports the successful and instant reduction of fear in spider-fearful participants following a 2-minute exposure combined with a single dose of a regular pharmacological treatment.

Typical behavioral therapies for phobia take many sessions to produce the desired effect. If recovery could be accelerated, it would reduce distress and save time and money.

Drs. Marieke Soeter and Merel Kindt, Department of Clinical Psychology, University of Amsterdam, sought to build on the notion of "reconsolidation", identified 15 years ago by Dr. Joseph LeDoux. He and his team discovered that when memories are activated, they may be modified in fundamental ways to strengthen or weaken them.

This neuroscience breakthrough resulted from their findings that administration of a drug upon activation of a fearful memory induced amnesia for that learned fear. However, pharmacologically induced amnesia has only been convincingly demonstrated for fears created in the laboratory in animals and in healthy participants.

In this study, Soeter and Kindt recruited 45 volunteers with spider fear. The participants were randomized to receive a single dose of either propranolol, a beta blocker used to treat high blood pressure and heart conditions, or placebo following brief exposure to a tarantula.

Those who received propranolol displayed drastically reduced avoidance behavior and increased approach behavior, an effect that persisted for one year.

"Here we show for the first time that an amnesic drug given in conjunction with memory reactivation transformed avoidance behavior to approach behavior in people with a real-life spider fear. The new treatment is more like surgery than therapy," said Kindt.

"Currently patients with anxiety disorders and PTSD receive multiple sessions of cognitive behavioral treatment or daily drug intake with a gradual (and often temporary) decline of symptoms," added Kindt. "The proposed revolutionary intervention involves one single, brief intervention that leads to a sudden, substantial and lasting loss of fear."

More research is necessary, to extend these findings to patient populations and more severe phobias, in addition to testing the outcome with other variables. However, as Dr. John Krystal, Editor of Biological Psychiatry, commented, "This elegant study may suggest a strategy for accelerating the recovery from anxiety disorders."

Indeed, these promising findings may ultimately lead to a new treatment strategy that erases the emotional impact of intensely fearful memories, which would signify a true paradigm shift in the practice of psychotherapy.