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

Ann Clin Psychiatry. 2013 Feb;25(1):33-40.

Abstract

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.

Trial registration: ClinicalTrials.gov NCT01449955.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Combat Disorders / complications*
  • Combined Modality Therapy / methods
  • Demography
  • Double-Blind Method
  • Drug Monitoring
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Life Change Events
  • Male
  • Memory, Episodic*
  • Memory, Long-Term / drug effects*
  • Mental Recall / drug effects*
  • Middle Aged
  • Pilot Projects
  • Psychiatric Status Rating Scales
  • Sirolimus / administration & dosage*
  • Socioeconomic Factors
  • Stress Disorders, Post-Traumatic* / etiology
  • Stress Disorders, Post-Traumatic* / physiopathology
  • Stress Disorders, Post-Traumatic* / psychology
  • Stress Disorders, Post-Traumatic* / therapy
  • Treatment Outcome
  • Veterans / psychology

Substances

  • Immunosuppressive Agents
  • Sirolimus

Associated data

  • ClinicalTrials.gov/NCT01449955