More on propranolol - the drug that doesn't erase memories

The mainstream media are just queuing up to fail in their reporting of the propranolol story from a couple of days ago. To reiterate:

Propranolol is commonly used to treat high blood pressure and prevent migraines in children. But Merel Kindt and colleagues from the University of Amsterdam have found that it can do much more. By giving it to people before they recalled a scary memory about a spider, they could erase the fearful response it triggered.

The critical thing about the study is that the entire memory hadn't been erased in a typical sci-fi way. Kindt had trained the volunteers to be fearful of spidery images by pairing them with electric shocks. Even after they'd been given propranolol, they still expected to receive a shock when they saw a picture of a spider - they just weren't afraid of the prospect. The drug hadn't so much erased their memories, as dulled their emotional sting. It's more like removing all the formatting from a Word document than deleting the entire file.

The drug is not a "memory-wiping pill" (Guardian). It cannot "erase bad/painful memories" (Sun/ Fox News/ Metro/ Daily Mail) and it won't give you a "spotless mind" (Scotsman). Perhaps it's unsurprising given that massive wire agencies said similar things. The Press Association led with claims that the drug can "erase fearful memories". Reuters at least said more cautiously that it was a "step towards erasing bad memories".

To quote the person who actually did the research (and thanks Merel for chiming in on the earlier post): 

"There was no memory erasure, just elimination of the fearful response."

The problem with all of this, of course, is that people have straw-manned the research and are falling over themselves to publish trite editorials that (a) are irrelevant to the actual study and (b) serve to stoke public outrage over an ethical dilemma of their own concoction.

There are exceptions. The Boston Globe got it right and has a brilliant bit at the end that lays out in four simple sentences the bottom line, cautions, what's next, and where the research was published. It has however accompanied the article with an incongruous photo of a koala, presumably some sort of mix-up with the Australian bushfire story.

The mental health charity MIND released a long and well-considered statement, which showed that they had actually read the paper and understood the science. The charity's CEO, Paul Farmer, said:

"This is fascinating research that could transform the treatment for phobias and post traumatic stress disorder. Around 10 million people in the UK have a phobia and about 3.5% of the population will be affected by post traumatic stress disorder at some point yet our understanding of how to treat these conditions is still limited. While we welcome any advancement in this field we should also exercise caution before heralding this as a miracle cure.

"Eradicating emotional responses is clearly an area we would need to be very careful about. It could affect people's ability to respond to dangerous situations in the future and could even take away people's positive memories. We would not want to see an 'accelerated Alzheimer's' approach.

"We still have limited research on how to treat complex mental health problems, with the focus often on pharmacological solutions. Drugs are a somewhat sledgehammer approach and can have unintended consequences. We know from other psychiatric drugs, for example antipsychotics and antidepressants, that individuals react in hugely varied ways to treatments and are often vulnerable to unpleasant side effects.

"We would need to see much more research into the risks and benefits into this treatment before it becomes a reality."

All of that was culled by the BBC into the following:

But British experts questioned the ethics of tampering with the mind.

Paul Farmer, chief executive of mental health charity Mind, said he was concerned about the "fundamentally pharmacological" approach to people with problems such as phobias and anxiety.

He said the procedure might also alter good memories and warned against an "accelerated Alzheimer's" approach.

Do you think it carries the same meaning or sense?

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Who are you? Ben Goldarce?

Which is to say, this a nice bit of reporting. It's always fun to see where quote in the news in their actual context.

Yeah, cheers for the dissection of the press reports. Makes me feel a bit more at ease about it after succumbing (embarrassingly easily) to tabloid panic...

This is one of the current issues that gets little notice. It now seems that if LTP can occur there, it is now a 'memory' structure! My take is that there are 2 memory systems, and a valence system. So in this case, the drug prevented the valence from playing a role in the emitted behavior, but as you state didn't erase anything. It blocked the significance, not the meaning, and that is a very different thing. But also too complex for a populous that as a whole couldn't set the time on a VCR.

It comes from people having a fundamental misunderstanding of what exactly 'memory' is caused primarily by scientists that all want to label (and report as)whatever they happen to study as 'memory' because plasticity is involved. So to the masses, everything is just memory. Memory and Genetics are the two "it" words everything has to relate to right now to have any interest to people!

Yeah, this whole exaggeration and inaccurate reporting thing got under my skin, too (I vented on Nature Network). I just don't get why so many journalists find it so hard to at least glance at the abstract of a study if they're going to write about it. It's like it's taboo to actually read the report you're writing on.

And this happens all the time, with all kinds of studies - it's bad enough when the authors themselves try to pump up their results with correlation/causation fallacies or paper-thin connections to get attention. No wonder the public doesn't understand the importance of science - the journalists can't even convey the details correctly.

Christie - remember that these reporters mostly graduated with a BA in communications or journalism, and probably avoided every science class they could! They probably do read the abstracts, and this garbage is all they can get out of it, and then try to write about at a 4th-8th grade level(the range of targets for most media).

This is top notch blogging. Just wandered in, following a link from another blog and was pleasantly surprised. Keep up the good work.

By Miguel Silva (not verified) on 17 Feb 2009 #permalink

I've been following this reporting and have just been shaking my head. As a physician myself, science and medicine reporting frequently leaves me shaking my head.

I was on propranolol for years as a migraine preventative. I will say that my fear of migraines did not diminish AT ALL while taking propranolol. Just FYI.

A professor of mine said that when a reporter interviews you, ask them how many words of yours they expect to print or quote, and say that many words.

Another nail in the coffin for the theory that it's not the journalists who sell mangled, badly-researched stories, but the scientist's inability to communicate their findings who are to blame for the public misinformation. True, some scientists hype their results like whoa, but a lot of times, journalists don't care for the real story - they just want some nice, steaming pile of controversy to sell.

By Darwin's Minion (not verified) on 17 Feb 2009 #permalink

The Mother> I guess you misconcept your fear of a fear induced by post traumatic experience when fight or flight cndition occurs. I know a few ppl who use this drug combined with benzo and can live normal life again. btw - it seems negative feedback loop diminihes too, so ther's no need to be on drugs all the time.

I work in a lab that does related research on reconsolidation and memory. The reporting is always so sensationalistic. Although, one interpretation of the research is that a memory is being erased, just the fear memory instead of the explicit memory. So, if that interpretation is correct, it is acting as a memory wipe, just a very specific one.

The Mother: I think the results are for a far more specific type of fear than what you are thinking of.

But but but...isn't that precisely what Dianetics claims to be able to do?

(runs away screaming)

I'm disabled, with PTSD, and when I saw these headlines I stopped for a moment to think about whether or not I'd want such a drug to help my PTSD even if it would work, which I doubted (not that I know whether or not it was even discussed for such disorders).
I quickly decided I would not want it.

As far as psych meds being a sledgehammer approach, that's totally my attitude, having been on many meds and having had uniformly (and sometimes spectacularly) negative results.

I remember a story in the 1980s about a man who, chronically depressed, shot himself in the head, survived, and found upon recovering that he had "cured" himself by destroying the part of his brain that caused the illness (I think it was OCD) that he was depressed about.

I think of psych meds as being only slightly more precise.

By Jafafa Hots (not verified) on 18 Feb 2009 #permalink

Oh, and on the subject of accuracy in journalism - on every occasion when I have been interviewed for newspaper articles, I've been misquoted and misrepresented. They ALWAYS get it wrong.

By Jafafa Hots (not verified) on 18 Feb 2009 #permalink

Paul Farmer, not Mark Farmer. I *think* it's not the same Paul Farmer from Partners in Health. Unless he's some kind of health-bot with multiple miracle-working copies around the globe.

JG - I think that's a *very* generous interpretation of the claim ;-)

I agree. It is, however, one of the theories underlying the work in reconsolidation.

Instead of a form of extinction, which is generally considered to be a new memory that supersedes the old memory (such as learning that the spider picture does not mean a shock is coming), the propranolol is hypothesized to block memory reconsolidation (specifically fear-types).

The theory of reconsolidation is, scientifically speaking, fairly new and not without controversy. Basically, after you remember something, you have to store that memory again. At this point, it might be possible to interrupt the storing of that memory, its reconsolidation. The idea is that a drug such as propranolol might interfere with that memory being restored. It probably isn't going to "wipe" it completely, because it is unlikely to completely stop reconsolidation, but it is, according to the theory, a type of partial erasure. It is just not in the way that most people would think of when they think of a concept like memory erasure, because the memory is being weakened (but perhaps not completely wiped out) and it is only the emotional memory, not the declarative memory we normally think of.

Does this study prove that theory? Of course not. But it certainly is nice evidence in the right direction, and the results are exactly what you would expect from reconsolidation theory. It's pretty exciting, overall.

JG - I totally share your interest in reconsolidation theory; think I've probably blogged about it before somewhere. It's a really fascinating concept and I think one that we'll need technically minded people to speak about more and more. It's just so prone to hype and misconception ("memories are destroyed every time your remember"!!!) that some solid communication efforts would be warranted.

Anna - Love the coverage. Love it to bits. Especially the clean, crisp format with all the headings, laying everything out in nice, simple prose. Good stuff.

Thank you for such accurate reporting! I'm a student journalist in NYC, writing an article about just this issue. I recently interviewed the director of a clinical trial at Yale University, involved in using Propranolol on veterans with PTSD. He was very disappointed with the media's coverage on this pill, calling it a "horrific misunderstanding" and further adding that there is a "disconnect interface between science and scientific journalism." Unfortunately, "sensationalism" prevented the story from being written truthfully. This pill does not and is absolutely incapable of "erasing" memories, it simply weakens and removes inapropriate autonomic responses (PTSD symptoms), in order to restore normal functioning.

By Aleksandra (not verified) on 23 Feb 2009 #permalink

I just love it when a company that distributes drugs to a massive population of people have to cover up the fact that it screwed up big time.

"No! You didn't lose your memories. Propranolol just organized them for you. You know, filing, labeling, trashing that which isn't important..."