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Propranolol, post-traumatic stress disorder and narrative identity
  1. J Bell
  1. Dalhousie University, Halifax, Nova Scotia, Canada
  1. Ms J Bell, 1234 Le Marchant Street, Halifax, Nova Scotia B3H 3P7, Canada; jah.bell{at}utoronto.ca

Abstract

Funding: Research funded by Canadian Institutes of Health Research, NNF 80045, States of Mind: Emerging Issues in Neuroethics. While there are those who object to the prospective use of propranolol to prevent or treat post-traumatic stress disorder (PTSD), most obstreperous among them the President’s Council on Bioethics, the use of propranolol can be justified for patients with severe PTSD. Propranolol, if effective, will alter the quality of certain memories in the brain. But this is not a serious threat to the self understood in terms of narrative identity. A narrative identity framework acknowledges that memory is always being subtly altered or modified. For severe cases of PTSD propranolol may help victims who don’t respond to any other therapy or therapy combination regain their authentic self-narrative and engage once more in life activities. For those whose symptoms are not so severe the potential risks and side-effects of the drug may outweigh the benefits. Patients and family members should be allowed to decide, in consultation with their physician, whether this drug is appropriate in their case.

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Footnotes

  • Competing interests: None declared.

  • i See http://clinicaltrials.gov/ (accessed 7 Sep 2008) 2005a.

  • ii The author wishes to thank the reviewers for clarification of this process. For an excellent discussion of the neurobiology of emotional memory, see Glannon.9

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