Effects of propranolol on the modification of trauma memory reconsolidation in PTSD patients: A systematic review and meta-analysis.

Autor: Raut SB; Schools of Psychological Sciences, College of Health and Medicine, University of Tasmania, TAS, 7250, Australia., Canales JJ; Schools of Psychological Sciences, College of Health and Medicine, University of Tasmania, TAS, 7250, Australia., Ravindran M; Department of Psychiatry, North West Private Hospital, Burnie, TAS, Australia., Eri R; Health Sciences, College of Health and Medicine, University of Tasmania, TAS, 7250, Australia., Benedek DM; Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University School of Medicine, Bethesda, MD, 20814, USA., Ursano RJ; Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University School of Medicine, Bethesda, MD, 20814, USA., Johnson LR; Schools of Psychological Sciences, College of Health and Medicine, University of Tasmania, TAS, 7250, Australia; Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University School of Medicine, Bethesda, MD, 20814, USA. Electronic address: Luke.Johnson@utas.edu.au.
Jazyk: angličtina
Zdroj: Journal of psychiatric research [J Psychiatr Res] 2022 Jun; Vol. 150, pp. 246-256. Date of Electronic Publication: 2022 Apr 04.
DOI: 10.1016/j.jpsychires.2022.03.045
Abstrakt: Post-traumatic stress disorder (PTSD) develops after an exposure to a life-threatening event and is characterized by intrusive memories. According to memory reconsolidation theory retrieval of memory under certain conditions leads to its labilization and subsequent re-storage which could be disrupted by drugs. Propranolol has been the most commonly investigated drug for memory reconsolidation therapy in clinical trials. Intervention with propranolol have shown mixed results in PTSD patients with some studies showing improvement in symptoms while other failing to replicate these findings. We conducted a systematic review and meta-analysis to determine the efficacy of trauma memory disruption by propranolol on PTSD symptoms and physiological responses in PTSD patients. 3224 publications were assessed for eligibility. Seven studies on effects of propranolol on PTSD symptoms and 3 studies on effects of propranolol on physiological responses were incorporated in the meta-analyses. Overall, results indicate that propranolol did not show a beneficial effect on PTSD symptoms (standardized mean difference: 1.29; 95% CI = -2.16 - 0.17). Similarly, propranolol did not influence skin conductance (standardized mean difference: 0.77; 95% CI = -1.85 - 0.31) or EMG response (standardized mean difference: 0.16; 95% CI = -0.65 - 0.33). However, propranolol significantly reduced heart rate after trauma memory recall compared to placebo (standardized mean difference: 0.67; 95% CI = -1.27 to -0.07). This study finds a lack of evidence for the efficacy of propranolol on traumatic memory disruption, in PTSD patients, to recommend its routine clinical use. However, a high level of heterogeneity, variation in propranolol dosage and inadequate sample sizes mean that these findings require cautious interpretation.
(Copyright © 2022 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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