Posted by Astounder on November 15, 2007, at 17:56:59
My psych said the problem here is with association of sensation/thought/setting/memory with things inherently aversive (sadness, pain, psychic anxiety, somatic/autonomic symptoms). Obsessive rumination and dysphoria on recall continually reconsolidates these fear.
If one could directly interfere with the formation of the aversive conditioning, even without blocking the acute symptoms, one should be able to prevent the development of avoidance behavior.
The idea here would to be to use short-acting amnestics during acute panic, while not using amnestics while anxiety is low (so that the fear will eventually extinguish itself on its own). Among drugs that would prevent acquisition of memory would be very short-acting benzos like midazolam and Halcion. Propranolol to block the consolidation of memory. These drugs affect fear condition at doses that are not universally amnestic (do not interfere with spatial memory). The sedative and sympatholytic (tremor, palpitations) actions of this cocktail would also palliate the attack.
There's anticholinergics like scopolamine that block fear acquisition, but at unselectively amnestic doses. I also don't understand the dynamics of scopolamine, so maybe a better choice would be Benadryl (6 hr half-life)? Dissociatives also have amnestic effects and block fear acquisition, and the co-treatment with an anticholinergic and/or GABAergic would prevent NDMAR-blockade neurotoxicity.
Might have advantages to chronic, prophylactic use of anxiolytics, in that you may eventually be able to extinguish already conditioned fear.Has anyone tried anything like this?
poster:Astounder
thread:795313
URL: http://www.dr-bob.org/babble/20071115/msgs/795313.html