MONDAY, March 28 (HealthDay News) -- Adding the stress hormone
cortisol to more traditional exposure therapy may help anxious
patients overcome their fear of heights, researchers say.
Exposure therapy involves gradually exposing people to the thing
they fear -- be it height or spiders -- in order to reduce fear
responses.
But while promising, this experimental treatment is not yet
ready for prime time, said the authors of a study published online
March 28 in the
Proceedings of the National Academy of Sciences.
"This is a first study -- a proof of concept, if you wish," said study lead author Dr. Dominique J.-F. de Quervain, director of cognitive neuroscience at the University of Basel in Switzerland.
"We now need more studies to explore the therapeutic potential of cortisol in combination with psychotherapy in the treatment of anxiety disorders," de Quervain said.
The study involved 40 people with clinically diagnosed
acrophobia -- fear of heights -- all of whom took three "virtual"
outdoor elevator rides.
An hour before experiencing each fear-inducing situation, half
of the participants took 20 milligrams of cortisol, while the other
half took an inactive placebo.
Their reactions were assessed three to five days and one month
after the last elevator ride, or exposure session.
Those who took cortisol suffered less anxiety than those who
took the dummy drug. This was evident in their answers to a
standard acrophobia questionnaire and through skin conductance
tests, which measure how well the skin conducts electricity. The
skin is thought to be a better conductor when the body is aroused
and producing sweat.
The authors also reported that cortisol could reduce social and
spider phobias.
But why would adding a stress hormone actually reduce fear?
Aren't these the hormones produced when people are in
anxiety-provoking situations?
The answer to the latter question is yes, but cortisol plays a
more complicated role in learning and memory, which might explain
this benefit.
They are able to recall the incident, but their body remembers
the way it felt to be fearful and those physical feelings are
re-experienced when thinking about the incident, explained Keith
Young, vice chair for research of psychiatry and behavioral science
at Texas A&M Health Science Center College of Medicine and core
leader for neuroimaging and genetics at the Center of Excellence
for Research on Returning War Veterans in Temple.
Rather, they're remembering subsequent episodes of fear, Young
said.
And it's those memories that need to be overwritten and replaced
with new, better ones. "Enough of the old memory is there to
remember the incident, but not enough to remember and trigger the
fearful feelings," Young said.
"Cortisol inhibits retrieval of the fear memory and promotes the storage of corrective experiences," said de Quervain.
Other researchers have had enough success that Young's group is
starting to do clinical research on the idea.
More information
The U.S. National Institute on Mental Health has more on
anxiety disorders.