THE fastest way to get rid of people鈥檚 fears might be to give them a drug that makes them more fearful 鈥� followed by unrelenting exposure to the object they dread.
Psychologists often treat anxiety disorders such as phobias with behavioural therapy, exposing people to the objects or situations they fear for short periods and then gradually increasing exposure as their fears begin to wane. Calming drugs are sometimes given before therapy to ease people鈥檚 fears.
The method does work, but a typical course of treatment for panic attacks, say, lasts 16 weeks. Speeding up treatments is critical, says Todd Farchione of the Center for Anxiety and Related Disorders at Boston University, because many patients cannot afford frequent sessions or drop out rather than face their fears.
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Mark Barad at the University of California, Los Angeles, may have found ways to do this. His team has been training mice to associate a sound with a mild electric shock and then seeing what the most effective treatment is to end that association. Last year his team showed that mice continuously exposed to the noise took about 20 minutes to overcome their fear. Those exposed to two-minute bursts with intervals of a minute or 10 minutes of silence, however, remained scared.
Now Barad has looked at drugs. His team gave mice either propranolol, an anxiety-reducing drug often used to treat phobias and panic disorder, or yohimbine, an extract from the bark of a West African tree that stimulates the 鈥渇ight or flight response鈥�, and can cause severe anxiety. Then the mice were continuously exposed to the fear-evoking noise.
To the researchers鈥� surprise, the mice treated with yohimbine lost their fear four times as fast as than those treated with propranolol (Learning and Memory, vol 11, p 179). 鈥淲e actually predicted the opposite result, but we鈥檙e happy with what we got,鈥� Barad says. 鈥淎nything we can do to make it faster for people is good.鈥�
The team is now planning to test both continuous exposure and yohimbine in people with phobias and obsessive-compulsive disorder. 鈥淭here is no data to suggest that fear or anxiety could intensify to dangerous levels if unchecked, unless the patient has a pre-existing medical condition,鈥� Farchione says.
In some clinics there has already been a move towards getting patients to feel their fear as intensely as possible, he says. But when it comes to yohimbine, Farchione would need strong evidence that it works before trying it on his patients. Another problem is that the herbal extract is not FDA-approved.