Propanadol has of late become one of the drugs in humanity's long quest for eliminating the sometimes profound after-effects of having undergone trauma. Relatively recently, CNN presented a program about the rising suicide rate in survivors of Hurricane Katrina. Perhaps, researchers reasoned, such post traumatic stress reactions could be reduced or eliminated from victims who are close in time to when the trauma occurred. Whether, for healing returning troops from battle areas of the world or for the treatment of victims of natural disasters, such as the California wildfires of 2007, the search has been a long and persistent one.
It is believed that it takes time for the traumatic event to become engraved in the brain. It was theorized by some that if perhaps before the trauma has been "frozen" in situ, it could be treated with timely intervention with propanadol. It is not a new drug and is presently used for in the treatment of fear of public speaking and other social anxiety situations. Its first use in post traumatic stress disorders seem to have been successful. It was no surprise to us, in primal-oriented psychotherapies, when psychologist Alain Brunet said: "It's amazing how a traumatic memory can remain very much alive. It doesn't behave like a regular memory. The memory doesn't decay." (Quote from an AP article by Marilynn Marchione.)
Joseph LeDoux, neuroscientist, is also working with propanadol. He believes that "each time you retrieve a memory it must be restored." His experiment is aimed at reactivating the memory in the presence of propanadol so that the memory would be less accessible. Its proponents claim that the drug must be given within a couple of days of the trauma. And after being weakened, some contend that the strength of the original memory returns. One more new pill and one more study. That is how it seems to have always been.
More recently scientists have been investigating old memory traces in the prefrontal cortex of the brain. Physiology professor, Vania Apkarian, at Northwestern University's Medical School, has been successful in concentrating efforts where the storage of the emotional memory of pain resides rather than the neural mechanisms for its physical expression - its sensation. The drug is D-Cycloserine and tellingly its past use was to treat phobias. Dr. Apkarian is quoted, "We are saying there's a cognitive memory and emotional component in the brain that seems abnormal. Easing that may have a bigger effect on suffering." Physical pain and emotional pain are separate issues. He says that with the use of MRI images of the pre-frontal cortex, he can predict the number of years the pain has been present. The study is published in Pain: The Journal of the International Association for the Study of Pain.
Long before the news about propanadol and D-Cycloserine, there was the story of the discovery of the endorphins, those internal pain-killers manufactured in the brain. Its discovery has an interesting history.
During the 1960s drug addiction problems were getting a
lot of federal government attention and money. The goal was to see if basic research could show how addiction worked physiologically; if so, it night be possible to effect a cure.
One discovery was that there were two forms of morphine, one a
powerful drug and the other completely inert. The molecular structure of the two morphines were almost identical, but one being a
mirror image of the other. it was thought that perhaps the brain contained areas which the active molecule would fit, such as a
key would fit a lock, while the other molecule, even though only slightly different, would not bind to those same sites.
At the same time, scientists at a university in Sweden also began looking for the location of the then-hypothetical morphine receptor sites. Brains of rats were liquified and the resultant material spun in a centifuge which divided the material so that only synapse areas (those gaps between nerve cells, which transmit "messages") could be studied. In an attempt to prove the existence of receptor sites at the synapse areas, radioactive morphine was added. After thorough washings, it was found that morphine molecules did bind to the synapse sites since geiger counter readings detected the radioactive material remaining in the synapse locations.
At John Hopkins University, the same tests were run with similar positive results. Drug addiction gave a further clue to the existence of these receptor sites since an overdosed person could be brought out of a coma within thirty seconds by an injection of naloxone (now known to be a morphine antagonist).
Further experimentation showed that naloxone also reversed the analgesic effects of electrical stimulation of the brain in rats. Studies of the analgesic effects of acupuncture were made and it was found that naloxone was also able to lower the pain threshold in the subjects which implied that pain relief involved chemical reactions at the opiate sites. It was reasoned that since there were naturally occurring receptor sites for opiates, the body had to have been involved in the production in its own endogenous morphine. Why would the body produce a lock if a key did not exist or could be produced by the body?
In Scotland, investators found naturally occuring brain opiates which they called enkephalons. After painstaking work these compounds were analyzed, then synthesized and the synthesized material was found to bind to opiate receptor sites. Other similar substances were found in camel pituitary glands (camels are notoriously impervious to pain) by U. S. investigators. All of this work seemed of great importance since it held out hope for the alleviation of pain and by implication, the ravages of drug addiction.
Another important contribution at this time was the discovery of a possible explanation of the placebo effect. This effect is the result of using suggestion to alleviate pain by using an inert substance without the subject's knowledge that the substance is inert. In many cases naloxone reversed the pain-relieving effect of the placebo. The conclusion drawn was that endorphins are involved in the placebo effect and that expectation and mood affect pain perception.
Studies showed endorphin levels in pregnant women were much higher than in nonpregnant ones. An extra lobe of the pituitary glad is present both in a pregnant woman and in her fetus, and it is believed by some that the fetus passes its gestation period with its receptor sites loaded with endorphines so that nervous stimulation effects and the perception of pain are at a minimum. Some in regressive psychotherapies who have experienced intra-uterine experiences might beg to differ with the experts!
It seems that endorphins are always around and if they are not present we try to produce these "feel good" chemicals. Whether its the highs which the teen age "cutters" get, or which the gambling addict or the compulsive runner receives, these self induced endorphin highs are in high demand as they are excellent defenses against emotional and physical pain.
Even though it is theorized that our memories are laid down as electrical charges, there has been no electronic technique devised to lower the strength of our repressions, except the crudeness of electro-shock treatment. If propanadol and other new pills "work" it might have to be through a chemical means unless the chemical would influence the electrical circuit which keeps the memory active.
Dr. Arthur Janov had speculated in The Anatomy of Mental Illness (1971) that perhaps one day a way would be found to discharge the electrical charge of specific repressed memories directly from the brain itself.
Whether it is searching for a cure of addiction or the cure of the results of trauma, if the search discovers a pill which cures addiction it should logically also "cure" the unwanted effects of repressed trauma.
Perhaps all of this research will lead to the eventual acceptance of the primal theory contention that neurosis and post traumatic stress disorder are the same - that only the level of the traumas are different.
Expectation and postive thinking and hope can actually increase the production of endorphins and result in a lessening of symptoms. This explanation goes a long way in explaining the actual mechanism of how faith-healing works.
The history of the search for a cure to our psychological ills reveals that this quest is not new. In the nineteenth centry, opium was looked upon as a cure for alcoholism and even Freud had mistakenly touted cocaine as a cure for the morphine habit. When heroin was first refined, it too was regarded as a cure for morphine addiction. In the 1940s, first Demoral, then later Percodan were similarly hailed as being nonaddictive. More recently, we have heard of the many cases of heroin addicts becoming methadone addicts.
The similar fate of eventual uselessness probably awaits propanalol and D-Cycloserine. Eventually, disillusionment always sets in. We also had the very recent downplaying by its manufacturers that Oxycondin had severe potential for abuse and addiction. Will we ever learn? The quest for the Holy Grail of cure continues as new esoteric chemicals replace each other in the never ending search for emotional contentment.
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