Sunday, June 01, 2008

My Three Shrinks Podcast 46: Fugetaboutit!

[45] . . . [46] . . . [47] . . . [All]

Whoa!  Sorry about the long delay, folks.  In case you missed Podcast #45, with Ray DePaulo, the Chair of Psychiatry at Johns Hopkins, we talked about cosmetic psychopharmacology -- taking psychotropic medications to improve one's mental performance better than one's normal baseline. We then had two related posts, I Forgot (what happens when memory does not work well) and Now I Remember (when people remember too well, such as traumatic memories and PTSD).

The current podcast takes off from there, so you may want to review the above links for, as Paul Harvey would say, "the rest of the story."

June 1, 2008: #46 Fugetaboutit!

Topics include:
  • PTSD. A Psychiatrist Who Learned From Veterans commented that "A really towering paper in the Posttraumatic Stress Disorder literature deals with the excessive stickiness of memory in PTSD. The data comprises case reports of the month long use of Cortisol (Cortef) 10 mg a day, this is a low dose of glucocorticoid, by Amanda Aerni. R Greene at the Dallas VA has a nice paper using rats in a related paper; impressive statistics in the latter." These papers are discussed in the podcast, and mentioned in more detail below.
  • Cortisol for PTSD.  Amanda Aerni, et al., published "Low-Dose Cortisol for Symptoms of Posttraumatic Stress Disorder" in the August 2004 American Journal of Psychiatry. This was a 3-month observation study on three people with chronic PTSD, using a low-dose of cortisol in a double-blind, placebo-controlled manner. They found "cortisol-related reductions of at least 38% in one of the daily rated symptoms of traumatic memories, as assessed by self-administered rating scales."
  • Memory "Erasure".  Wen-Hui Cai, et al., published "Postreactivation Glucocorticoids Impair Recall of Established Fear Memory" in the September 2006 Journal of Neuroscience.  This study exposed mice to a trauma (loud noise).  After developing mousie PTSD, exposure to glucocorticoids at some later time after the traumatic memory is being triggered caused the fear response to be much less.
  • More PTSD Talk.  Pink Freud commented that "On the surface, I find the thought of preventing the formation of memories (traumatic or otherwise) to be repugnant. It's experiencing, working through, and ultimately making meaning of what life deals us that defines the human condition."  Here follows lots of discussion about what is a "trauma" (such as being hit by a flying, flaming toilet seat [Youtube] from the space shuttle as in the show Dead Like Me, or being tasered at a political event [Don't tase me, bro]) and how some people are at increased risk for developing PTSD given similar traumas.  Also, discussion about reducing the strength of the connection between a traumatic memory and a pathologic fear response.
  • Dinah's Flomax (tamulosin).  Dinah discusses the discrepancy between the focus on benign prostate conditions and other more serious ones.

Find show notes with links at: The address to send us your Q&A's is there, as well (mythreeshrinksATgmailDOTcom).

This podcast is available on iTunes (feel free to post a review) or as an RSS feed or Feedburner feed. You can also listen to or download the .mp3 or the MPEG-4 file from
Thank you for listening.


Roy said...

Also, check out this BBC article about a recent study showing that folks who chose not to talk about 9/11 soon after it happened fared better than those who did talk about it.

Anonymous said...

It should be very simple to figure out the reason that Flomax for a guy on a kayak trip is not stigmatized. Number one: Does anyone really want to see some old fart peeing over the side of a boat? Number two: it is tough to stand up in a kayak.
Flomax therefore saves us all from being trauamtized by this guy peeing in the water and/or falling out of the kayak and leaving us to read about it in the paper the next day.

April said...

There was a really good interview in the newest Sun Magazine about the prevalence of PTSD and how we can heal it our soldiers coming home from war. "We need public apologies, public confessions, and public grief for all that we have done to our veterans, to other nations, and to the earth."

The Girl said...

Thanks for another great podcast. :)

Anonymous said...

I just found this blog, and I think the issues surrounding psychiatric practice are really interesting from a political and social view point. But I always find that about half way through listening to a podcast my mind wanders a bit from all the intelligent things being said, does anyone else think roy’s voice is kinda sexy? Dinah should post a poll on it to get him back for the Dr. Phil prank.