Excerpt from “No Fear: Memory Adjustment Pills Get Pentagon Push”

By Katie Drummond
12-16-11; www.wired.com

The Pentagon hasn’t come close to solving the PTSD crisis plaguing the current generation of
troops. But a cutting-edge realm of treatment might change that — by wiping away the fear that
military personnel associate with traumatic memories.

The Pentagon this week announced an $11 million grant for three research institutions, all of
them long-time hubs for the military’s ongoing PTSD investigations. Experts at Emory
University, the University of Southern California and New York-Presbyterian/Weill Cornell
Medical Center will study the effectiveness of D-Cycloserine (DCS). DCS is a pharmaceutical
thought to help extinguish fearful memories. It’s usually taken right before exposure therapy, a
process that involves recalling traumatic experiences in an effort to nullify the menacing
associations that accompany them.

“We already know that exposure therapy is an effective [therapy] for PTSD, and we want to
figure out how to optimize it,” Dr. Barbara Rothbaum, who will lead the Emory team’s research,
told Danger Room. “I really think that this study will move beyond the theoretical. We can
rescue people.”

Exposure therapy is thought to work by allowing patients to revisit traumas in safe settings.
Every time the mind remembers an event, it “rewrites” that recollection. By helping a patient
rewrite traumatic memories to be less frightening, studies suggest that exposure therapy can
significantly improve symptoms like nightmares and flashbacks.

Adding DCS seems to hasten that process, targeting the precise brain pathways responsible for
regulating fear responses.

Researchers will look at two different kinds of exposure therapy: Virtual reality, where a patient
is fully immersed in digital combat scenarios, and prolonged imaginal exposure therapy, which
asks them to simply remember and recount fearful memories. A total of 300 patients, all of them
veterans from Iraq and Afghanistan, will partake. They’ll undergo seven individual weekly
sessions of one of the therapies. Before each session, half will receive DCS, and the rest will get
a placebo.

Experts have already spent plenty of time figuring out how DCS works. It’s been around since
the 1960s, when it was used to treat tuberculosis. Now, however, researchers are more excited
about the drug’s potential ability to alleviate symptoms of depression, schizophrenia, obsessive-
compulsive disorder and, of course, PTSD — without a lifetime of pill-popping.

“Most drugs, you dose every day,” Rothbaum says. “But DCS is only useful during exposure
therapy, so you’re taking the drug right before the session. And when your series of sessions end,
the medication ends too.”

DCS seems to enhance the brain’s learning process. For PTSD treatment, the drug could,
ostensibly, help patients more quickly internalize that, say, driving down a suburban American
highway is far different — and less dangerous — than driving on a Baghdad street. The drug also
binds to receptors in the amygdala, the region of the brain that governs fear response. So by
blocking out fearful reactions while a patient revisits trauma, experts think DCS can, literally,
“extinguish” fear right at the source.

…even a glimmer of hope seems to be enough for the Pentagon. So far, what they’ve tried to
treat PTSD — which afflicts at least 250,000 of this generation’s soldiers — isn’t working.
Conventional approaches, like antidepressants and behavioral therapy, have been a massive
failure. So it makes sense that military officials are increasingly open to out-there ideas: They’re
already funding research into yoga and acupuncture, neck injections and “digital dream”
computer programs — although promising approaches taking advantage of “illicit” substances,
like marijuana and ecstasy, have thus far been nixed.

Of course, the idea of using drugs to tweak memories isn’t without controversy: An online
debate flared last year among two camps of neurologists and neuroethicists, arguing over
whether the existence of such drugs would “alter something that makes us all human,” or open a
Pandora’s Box of illicit use “by people doing things they’d like to forget themselves, or that they
would like others to forget.”