23-05-27

"propranolol"

The movie <Eternal Sunshine> is one of the masterpieces released in the 2000s selected by the British <BBC>, and many people also consider it a life movie. At times, director Michel Gondry's endless imagination was exercised only to the extent that everyone could understand. The movie deals with what happens when only the memories of the person who failed in love are erased with the help of a 'memory erasure company'.

When I was young, I looked for a medicine that improved my memory, and when I got older, I looked for a medicine that prevented dementia. In a busy youth, there are many difficult and painful memories that you want to forget, which can lead to post-traumatic stress disorder (PTSD) in severe cases.

There are many drugs that inadvertently paralyze memory. Similar to the film tearing often experienced after binge drinking, benzodiazepine hypnotics can interfere with the process of memory formation. Midazolam, administered before sedation endoscopy, is also a drug in this class, making it impossible to remember at all what actions and words were said while conscious before and after the examination. Other sleeping pills other than benzodiazepines also occasionally report side effects such as driving or not remembering conversations after taking them. Narcotic analgesics such as fentanyl and oxycontin, which are used to control severe chronic pain, are also known to inhibit memory processes. Among the drugs used for urinary incontinence, anticholinergic drugs can also cause memory problems. Conversely, donepezil, which enhances the action of acetylcholine, is the most commonly used prescription drug for Alzheimer's disease. Antihistamine-type allergy drugs, some antidepressants, and anticonvulsants can also have a bad effect on memory, but it is unclear whether these actions cause drowsiness or have a direct effect on memory.

Antihypertensive drug Propranolol inhibits 'memory retention'

These drugs are drugs that block the creation of memories in the first place, and other strategies are needed to selectively erase painful memories. Memory is formed through the process of encoding → storage → consolidation and re-consolidation → retrieval. Conscious and unconscious regeneration of memories is possible because memories can be maintained for a long time through the process of reconsolidation. Therefore, if you recall the memories you want to forget in a stable environment and prescribe drugs that can suppress the process of memory reconsolidation, you will be able to quickly forget your memories. Are there any such drugs?

Memories, such as painful or frightening or intensely pleasurable, are linked to emotional changes. Animal experiments have reported that activation of the noradrenergic nervous system in the basolateral amygdala, one of the brain regions associated with strong emotional changes, reconsolidates negative or pleasant memories and is associated with post-traumatic stress disorder, fear, and drug/alcohol addiction. there is a bar

Propranolol is a relatively safe drug that has been used for a long time as an antihypertensive drug. It is also known to have the effect of relieving anxiety symptoms, such as heart racing and blood pressure rising. When recalling memories, when this drug penetrates the basolateral amygdala, it blocks noradrenergic neurotransmission, suppressing reconsolidation and reducing the consolidation of emotional memories. There have been several reports that using propranolol after visiting a hospital and recalling painful memories in writing, words, or images in a stable environment reduces painful memories and improves stress-related clinical indicators in normal people or patients with post-traumatic stress disorder. Of course, there are studies that have little or no effect, but last year, Professor Alain Brunet's team at McGill University in Canada reported an interesting result. As a result of a meta-analysis and reporting of 14 studies on 478 healthy adults and 12 studies on 446 patients with post-traumatic stress disorder, a statistically clear reduction in painful memories and clinical efficacy were observed.

Like 'Eternal Sunshine', you can erase memories, but...

If science develops further and it becomes possible to easily measure and control the fine activity of each brain part in real time, a closed-loop selective memory that selectively suppresses only the retrieval of that specific memory by mobilizing electromagnetic methods every time a memory you want to forget is about to come to mind. It may be controllable. (Even in <Eternal Sunshine>, during the amnesia procedure, an electronic device is worn on the head and recalls the memory.) With the current technology level, selective memory erasure is a drug that inhibits the re-consolidation of memories that one wants to forget. The way you use it will be realistic. Further research on several drugs including propranolol is expected.

Daniel Schacter, an American psychologist, summarized the shortcomings and errors of memory in seven categories in his book <The Seven Sins of Memory>. According to Schacter, △extinction over time △forgetting important things while distracted △things that linger in the mouth and not come to mind △misleading memory connections △memory errors due to suggestion △memory bias according to one’s thoughts and environment Errors that embellish too much △ Unwanted memories last for a long time. It is necessary to remove painful memories caused by accidents, crimes, and wars, but we do not recommend erasing the memories of loved ones, even if it is technically possible. The original title of <Eternal Sunshine> is ‘eternal sunlight shining on the spotless heart’. Memories make stains. If you try to warp the memory, you get more stains. But love, perhaps like the sun, will always shine through the whole heart. The name of the company that erases memories in the movie is 'Lacuna'. This word, which comes from Latin, means a gap, an empty space, a missing piece. If we erase the memory of the person we loved, wouldn't our lives be left as empty spaces?

Konkuk University Medical School Professor Shin Chan-young

A psychopharmacologist who admits that my mind is different from yours. As a pioneer in basic research on brain development disorders, he has published more than 190 papers on animal models and mechanisms of brain diseases.