Integrating psychotherapy with psychiatry- a new, powerful drug treatment for anxiety

Richard Friedman, MD, is a progressive psychiatrist who also a contributing op-ed writer for the New York Times.  He consistently writes thoughtful and provocative commentaries about mental health issues, and often is critical of the psychiatric status quo, and supportive of behavioral treatments.  The NYT published his commentary “A Drug to Cure Fear” on 1-22-16.  This is a detailed discussion of the limitations of current treatments for anxiety disorders, including severe PTSD, including both medication and psychological/behavioral therapies.  He goes on to describe recent research using medication that seem to effectively erase the emotional fear response in healthy people with arachnophobia. A recently published study found that people with intense fear of spiders could actually handle tarantulas with their bare hands after the new treatment, which uses the beta-blocker propranolol.  He discussed the theory about how this remarkable outcome occurs, and acknowledges, “Some may view any attempt to tamper with human memory as disturbing because it seems at odds with what we ought to do as a culture with the darker aspects of our history: Never alter the facts, even if we have divergent interpretations of them.” He concludes, “I see nothing wrong with doing all we can to rid ourselves of pathological anxiety, including using drugs to alter our painful emotional memories.”

This article provides a helpful update to therapists about anxiety disorders, the limitations of our current treatments and one direction that the research is taking. This drug therapy is not likely to eliminate the need for psychological/behavioral treatments for anxiety, but may someday be a valuable option for patients/clients who are unable to obtain adequate benefit from psychological/behavioral treatment.

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