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Interfering with the reconsolidation of traumatic memory: Sirolimus as a novel agent for treating veterans with posttraumatic stress disorder

Alina Surís, PhD, ABPP

VA North Texas Health Care System, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA

Julia Smith, PsyD

VA North Texas Health Care System, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA

Craig Powell, MD, PhD

Department of Psychiatry, Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA

Carol S. North, MD, MPE

VA North Texas Health Care System, Departments of Psychiatry and Surgery/Division of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA

BACKGROUND: Development of novel treatment approaches for combat-related posttraumatic stress disorder (PTSD) is critical, given the increasing prevalence of PTSD in veterans returning from war zone deployment. Established preclinical research using protein synthesis inhibitors (such as sirolimus) to interfere with fear memory reconsolidation provides a compelling rationale for investigation in humans.

METHODS: This double-blind, placebo-controlled translational pilot study examined the effects of pairing reactivation of a trauma memory with a single administration of sirolimus on the frequency and intensity of PTSD symptoms in male combat veterans.

RESULTS: Primary analyses found no significant differences between treatment groups on any of the clinical or physiologic outcome measures. In an exploratory analysis of a subsample of post–Vietnam-era veterans who had more recent combat trauma, PTSD symptom scores fell significantly more in these veterans than in controls.

CONCLUSIONS: The post–Vietnam-era veteran findings suggest that further investigation of this pairing of sirolimus with traumatic memory reactivation may be warranted. Theoretically, interference with the reconsolidation of fear memories could ameliorate military-related psychological trauma symptoms. Future research should focus on veterans of more recent eras whose traumatic memories may be less entrenched and more amenable to pharmacologic modification within this procedure.

KEYWORDS: posttraumatic stress disorder, memory, veterans, memory reconsolidation, novel intervention, trauma, pharmacotherapy

ANNALS OF CLINICAL PSYCHIATRY 2013;25(1):33-40

CORRESPONDENCE: Alina Surís, PhD, ABPP, VA North Texas Health Care System, Mental Health (116A), 4500 S. Lancaster Road, Dallas, TX 75216 USA, E-MAIL: Alina.Suris@va.gov
Annals of Clinical Psychiatry ©2013 Quadrant HealthCom Inc.

 
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