Hello
Thanks for using DoctorSpring for posting your query.
I have gone through your question in detail and I can understand what you are going through.
Yes, propranolol will help in PTSD and adding therapy sessions is all the more effective. Normally for PTSD short sessions are not that useful but combined with Propranolol which impacts the process of consolidation of the memory, even short sessions are useful and yes they minimize extinction and induce only re consolidation. But even if the sessions extends upto 2 hours, the benefit is only partially lost may be in the tune of around 5-10%. Overall the therapy will be still very effective.
Infact even giving propranolol alone without therapy itself has a lot of benefit.
Hope that helps, please feel free to discuss further.
Regards
Dr.Srikanth Reddy MD
Patient replied :
Thankyou so much for being able to give me an answer so far! My problem is I actually have a phobia which I've had for about 6 years which is sometimes quite hard to have a social life at all. And I've just started the propranolol sessions with a prescription from my gp. I've done 3 sessions, which consisted of me typing up from when my phobia began in great detail and how it effects me in great detail. I've done two 2 hour sessions and the third one I did today I kept short due to worrying I wasn't doing it right.
I felt that I could get all the details down in more detail and give more thought doing it for 2 hours. Also I'm doing up to 7 sessions.
My questions are, with the 2 hour sessions and my phobia being a developed phobia (an eye contact phobia), should the propranolol in 7 sessions make me back to normal and socialising and facing people fully again?
Hello
Thanks for the follow up query.
Yes propranolol with therapy is a good option and has a good response rate. There is around 70% chance that you will become fine and start socializing again. If you tend to be unlucky and fall in the remaining 30% then still the symptoms will reduce to the extent that your quality of life will improve for sure.
Cognitive behavioural therapy is also a good option. This therapy is taken by either a psychologist or a psychiatrist in which the therapist identifies impaired cognitions (Thoughts) and try to correct them. They are 15-20 min weekly session and there should be around 8-10 sessions to help you with your illness.
Along with all these therapies its worthwhile to consider taking paroxetine as a anti depressant. At the dose of 12.5 mg at night, it is good drug for anxiety disorders and phobias as well.
Regards
Patient replied :
Ok thanks for the info. Is 180mg propranolol spaced out over 3 days a week for 3 weeks safe to stop abruptly after the third week without any withdrawal symptoms?
Also after taking propranolol can the memory loss effects last for say more than 24hrs to benefit you if you reconsolidate a thought?
Hello
No medicine in supra normal dosage should be withdrawn abruptly. Especially propranolol has wid range of effects including the heart and it would be wise to tapper it of gradually. You may consult your treating psychiatrist regarding this aspect. He may like to go for twice a day dose then a daily ones dose and then alternate day dose and then reduce the strength gradually and stop it over 10 to 15 days period.
Regarding your second part the effect on consolidation of memory after taking propranolol certainly lasts beyond 24 hours even if you re consolidate a thought.
Regards
Patient replied :
Hey just one last question, this is in regards to paracetamol and alcohol use. I take 2 paracetamol a day about 5 times a week for about 1 year and never drink alcohol on the days I take the paracetamol. But a few times and recently on my days off, I've drunk on one day 2 glasses of wine and on another day 1 beer. I leave about 20-24 hours before I take the paracetamol again. Is this safe and enough time? (worried because ive read some places online that it takes 5 days for alcohol to come out your system and even more for paracetamol)(NHS online says what I'm doing is completely fine though) Also I'm worried because today I was lying in bed and had really itchy feet for a few minutes.(I'm hoping this is just from stressing all the time not liver damage, and I have no other symptoms)
If you could please answer all my questions because I'm very worried and want to know if I'm doing the right thing. The paracetamol is 2 500mg tablets by the way. Thanks again
Hello
Thanks for your follow up question.
Its true that both paracetamol and alcohol are hepato toxic. However there is no contraidnication to use of alcohol while you are taking paracetamol provided your are not alcohol dependent and have a damaged liver already. Even in them paracetamol can be given but it has to be under observation.
So in your case no worry and you can take alcohol with paracetamol and that will cause no problem.
The other thing is why do you need to take paracetamol two times a day for five days a week. That is an excess use of paracetamol and by itself can cause hepatotoxicity. Let us know through doctor spring or contact your local doctor to varify the requirement of paracetamol and also identify some alternatives.
Hope that was useful
Wish you good health
Regards