Nursing Voices

Thursday, March 22, 2007

The Orwellian Pill

I saw a news story today that gave me chills. Scientists are doing research to see if Propranolol is an effective treatment for post-traumatic stress disorder. This sounds great until you look at the deeper ethical issues. Who will be put in charge of deciding what is a traumatic event? Will we have "brain police" deciding who can be given Propranolol for the treatment of post-traumatic stress disorder? In his satirical novel, 1984, George Orwell depicts a futuristic totalitarian state in which the government uses mind control to subjugate its citizens. The whole idea of erasing someone’s memory with a pill is a bit too Orwellian for me. Decide for yourself after reading this ABC news story.


Blogger Jean-Luc Picard said...

A lot of things in '1984' seem to have come through.

3:45 PM  
Blogger The Curmudgeon said...

So I get these pills -- open them up or crumble them -- then sprinkle them on my bills and send them off... will the computers on the other end forget why they're billing me? And maybe forget to bill me ever again?

You know, MJ, there could be something to this... let's not be hasty and jump to a negative conclusion....

5:37 PM  
Blogger AzRN said...

MJ, in your professional opinion are there treatments for PTSD that work well? I don't that much about psych nursing (it was a looong time ago :D)

10:47 PM  
Blogger Not Nurse Ratched said...

Thanks for that link: that's so freakin' creepy. I take propranolol for anxiety and understood that its utility for psych disorders simply involved blocking the effects of the sympathetic nervous system, not erasing memories! How is that possible---and if it does do that, how is it even ethical? Ewwwwww! (FWIW: my memories are still here. I think....)

9:33 AM  
Blogger Shrinked Immaculate said...

Well, theoretically speaking the premise is sound. Its not as sinister as it sounds. Memory is of many types, and the memory that is involved in PTSD is troublesome because it is invariably and intimately linked to the emotional circuits. What PPnl is likely to do is reduce the anxiet/emotion part of that memory thus ;eading to reduced intrusive flashbacks, reliving of the experience etc. Its not like a tape that has been erased, I dont even think thats possible unless consolidation is stopped completely and that is another story altogether.

10:15 AM  
Blogger Fresh Hell, Texas said...

It does not erase memories.

However, the fact that people keep claiming that it does just might raise the hysteria level so that the whole idea gets killed.

11:55 AM  
Blogger poody said...

I could use a mind sweep! I go crazy thinking about my ex. I try so hard not to but find I think about him at least once a day!It has been over 1 year since we split up!

1:16 PM  
Blogger marachne said...

A friend who is an Air Force reservist RN told me they are routinely gviing SSRIs and beta blockers (didn't mention which one) to soldiers who are in in Iraq and Afghanistan--not waiting until they're diagnosed with anything. Strikes me as a bit Orwellian for sure. I also think the "1 in 8" stats are very conservative for PTSD--so many of the troops are there for too long, there are no "front lines" 'cause it is all front lines, and for the reservists there is no prep for being in this insane situation. As a VA nurse, I am very, very worried about what's coming down the pike and how our system will be overwhelmed, because of course, they're not funding us any better than the military hospitals.

4:21 PM  
Blogger greensunflower said...

As an ECT survivor/patient I could say that there are much worse ways to lose your memory.

8:34 PM  
Blogger Shrinked Immaculate said...

ECT is one way...some drugs, head injury etc. But even ECT is not permanent.

6:13 AM  
Blogger greensunflower said...

Well it has been 4 years and I still dont have the memories back, so I am assuming they are gone forever.

7:06 PM  
Blogger 911DOC said...

i have lots of patients of propranolol for hypertension and cardiac problems. i guess the theory here is that it blunts the adrenergic response in ptsd patients. heard of it given for similar anxiety states in the past. it doesn't have too many bad side effects and is not psychoactive, rather, it makes the symptoms easier to tolerate. it's been around forever and is safe. not sure it's the orwellian pill that you are afraid of. my two cents.

12:20 AM  
Anonymous Cinder said...

I was given Propranolol for excessive sympthertic NS excitement and it slowed me down SO much, I was SO fatigued and I have NEVER been so depressed in my life. And BTW,my pulse was running around 44bpm. I was on a low dose and have heard many c/o depression when taking this pill. Careful we don't replace one disease with another. My 2 cents.

11:38 PM  
Blogger Spirit of 1976 said...

At my local trauma clinic here in Wales (funded jointly by the local NHS trust and the police) they usually use cognitive-behavioural techniques for PTSD. Mostly phased desensitisation and Eye Movement Desensitization and Reprocessing.

Certainly it would make sense to me that since PTSD is by its nature psychogenic, you need to take a psychological rather than pharmaceutical approach.

4:11 AM  
Blogger Shrinked Immaculate said...

ECt will sometimes cause retrograde and anterograde amnesia, again by the process of interference of memory consolidation. So it is possible that some of the memory around the time of ECT (like a few hours to a day) may be lost. But at the same time as a psychiatrist, and as someone who has administered ECT to many patients, I am firmly convinced that ECT as a treatment is extremely safe, extremely quick acting and saves lives.

8:27 AM  
Anonymous Cinder said...

Me again. I was diagnosed w/ PTSD and an experienced and caring therapist used EMDR on me to desensitize me to the traumatic memories. I relived to an extent some of the traumas in a controlled setting and was able to reframe them and no longer had the excessive SNS response to them. It was the most helpful tx that I ever received.
These returning soldiers are going to need so much help,I feel for them.

12:44 AM  
Blogger Kim said...

Since when did propanolol start erasing memories? I know many, many patients who must be running around amnesiac (is that a word?)

5:24 PM  

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