Ethics and Memory-Altering Drugs

In the last several years new research has come out that may indicate that our memories are not set in stone and may perhaps be erasable. In the article Give memory-altering drugs a chance, author Adam Kolber presents many ethical challenges facing research of memory altering drugs. Kolber writes that society is alarmed by the prospect of altering memories fearing a person’s sense of identity may be lost as well as the ability to lead a true and honorable life. However, this fear and excessive debate over the ethics of memory alteration is, at this point, extreme and could delay key research in therapies for people who are debilitated by their memories. I believe that the current research on memory modification is worth pursing and with proper regulations, like any intense therapy, can meet most ethical challenges.

Current research has shown that beta blockers, used to control hypertension like propranolol, can reduce the emotional association to a memory when taken after a distressing event. One such study found that patients who received two weeks of propranolol treatment showed a significant reduction in post-traumatic stress disorder (PTSD) symptom levels compared to the control group.¹ However, this line of research only suggests that emotional salience of these memories can be reduced, not the memories themselves. Ongoing studies in rodents have suggested that if impeding the process of memory consolidation, either during the initial consolidation or after memory retrieval, memories can be erased.² Many of these studies require direct drug infusions into the brain and are currently not applicable to humans.

Kolber writes that the use of pharmaceuticals to alter memories has led many bioethicists to argue that rather than seeking a pill bottle, we should do the rewarding emotional work to change a bad experience into a good one. I believe this argument is not at all persuasive. It is possible that some memories, war or natural disasters for example, have no positive aspects to them. Some people who experience these events are very negatively affected by their memories. These pharmaceuticals may be a key tool in aiding and accelerating counseling. Schiller et al recently published a study that propose noninvasive techniques, no pharmaceutical intervention, which are able to eliminate fearful memories in humans³. However, studies with similar paradigms to the Schiller et al study in rodents have produced opposite and varying results under what appear to be identical conditions^4-5. These studies seem to indicate that behavioral manipulation alone may not be an effective treatment for every patient, and that the aid of pharmaceuticals could be very beneficial to these patients. Kolber cites psychiatrist Peter Kramer who describes, in his book Listening to Prozac, that some patients even report feeling more like themselves after taking antidepressants.

Future research into these potential beneficial effects of memory altering pharmaceuticals should not be prohibited; however ethical concerns may reveal contexts under which these drugs would need to be regulated. Kolber writes that there is already a precedence to prevent egregious uses citing the use of alcohol to prevent a person testifying is an obstruction of justice. Researcher’s should be encouraged to pursue new therapies for people trying to cope with trauma rather than dissuaded by potential ethical concerns that with proper regulation, could be avoided.

--Katie MacPherson

Neuroscience Graduate Program

Sources

1. Vaiva G. et al Biol. Psychiatry 54, 947-949 (2002)

2. Nader K. et al Nat Rev Neurosic 1, 216-219 (2000)

3. Schiller D. et al Nature 463, 49-53 (2010)

4. Monfils M. et al Science 324, 951-955 (2010)

5. Chan W. et al Learn Mem 17, 512-521 (2010)

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The Benefits of Memory-Altering Drugs

Pharmaceutical drugs that dampen memories and/or dissociate memories from physiological reactions have the potential to provide powerful benefits for society. There are widespread wars, natural disasters, and other traumatic events that cause people to suffer from their memories of these events, the most extreme manifestation being PTSD. Post-traumatic stress disorder has been notoriously difficult to treat with therapy alone and the addition of pharmaceutical drugs to the treatment regimen may speed the healing process and make it more complete. Propanolol, for example, has been shown to reduce physiological responses during mental imagery of a traumatic event (Brunet et al. 2007). In PTSD, strong physiological responses tag memories as important and increase the frequency with which the brain recalls the traumatic memory, thereby driving a positive feedback loop, which is difficult to disrupt. A drug like propanolol that decreases physiological responses associated with a traumatic memory may be a promising way to disrupt the positive feedback loop and pave the way towards a faster and more efficient healing process.

Drug addiction is another illness that could greatly benefit from the application of these memory-dampening pharmaceutical drugs. Drug addiction is driven in part by reward learning mechanisms in the brain, such that learned associations between cues and illicit drugs contribute strongly to the addiction. People who are recovering from drug addiction may fall into drug usage again if they walk by a particular street or see a certain person that they strongly associate with the rewards of using the illicit drug. One study found that a drug called ZIP causes cocaine-addicted rats to forget the locations where they had received cocaine (Li Y.-Q. et al. 2011). Drugs comparable to ZIP that are developed for humans could help drug addicts unlearn strong associations that drive them to relapse, thereby speeding the rehabilitation process.

These memory-dampening drugs have great promise in treating debilitating disorders and continued research should not be delayed or hampered by the unwarranted ethical arguments against them. Some bioethicists argue that the use of these drugs may weaken peoples’ sense of identity and cause them lead less genuine lives. Instead, these bioethicists argue, people suffering from trauma or addiction should go through the difficult work of therapy rather than resorting to pharmaceuticals. This argument is weak because oftentimes therapy and pharmaceutical drugs are working towards the same end—unlearning associations as well as decoupling memories from physiological reactions—but accomplish them through different means. For example, one study demonstrated that a non-pharmaceutical approach allowed subjects to forget a learned association between a visual cue and a shock (Schiller at al. 2010).

The bioethicists’ arguments are not so much about the end goals that therapy and pharmacological interventions are striving for—as this distinction is weak—but instead belie a bias against pharmaceutical intervention itself. If we could successfully treat drug addiction and PTSD with therapy alone, these bioethicists might have a leg to stand on. But as it stands, these disorders and illnesses are extremely difficult to treat and there is a high rate of relapse. If the application of pharmaceutical drugs could increase the speed and efficacy of recovery, it seems unethical to deny people this treatment option. If further research reveals the efficacy, side effects, and cost of pharmacological interventions to be less optimal than treatment with therapy alone, we can decide then to abandon it. However, because it shows promise at this point in time, we should pursue research into these pharmacological interventions or risk forgoing discovering a treatment option that could potentially heal trauma faster and more completely than therapy alone. Perhaps one day we will learn how to treat mental illnesses and disorders without any pharmacological interventions, but until that day arrives, it is unethical to deprive people of the possibility of a speedier and more complete recovery afforded by pharmaceutical drugs.

--Melanie Pincus

Neuroscience Graduate Program