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A β-adrenergic antagonist reduces traumatic memories and PTSD symptoms in female but not in male patients after cardiac surgery

Published online by Cambridge University Press:  20 August 2009

T. Krauseneck ,
F. Padberg ,
B. Roozendaal ,
M. Grathwohl ,
F. Weis ,
D. Hauer ,
I. Kaufmann ,
M. Schmoeckel  and
G. Schelling
T. Krauseneck
Affiliation:
Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany
F. Padberg
Affiliation:
Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany
B. Roozendaal
Affiliation:
Department of Neuroscience, Anatomy Section, University Medical Center Groningen, University of Groningen, The Netherlands
M. Grathwohl
Affiliation:
Department of Anaesthesiology, Ludwig-Maximilians-University, Munich, Germany
F. Weis
Affiliation:
Department of Anaesthesiology, Ludwig-Maximilians-University, Munich, Germany
D. Hauer
Affiliation:
Department of Neuroscience, Anatomy Section, University Medical Center Groningen, University of Groningen, The Netherlands Department of Anaesthesiology, Ludwig-Maximilians-University, Munich, Germany
I. Kaufmann
Affiliation:
Department of Anaesthesiology, Ludwig-Maximilians-University, Munich, Germany
M. Schmoeckel
Affiliation:
Department of Cardiac Surgery, Ludwig-Maximilians-University, Munich, Germany
G. Schelling*
Affiliation:
Department of Anaesthesiology, Ludwig-Maximilians-University, Munich, Germany
*
*Address for correspondence: G. Schelling, M.D., Ph.D., Ludwig-Maximilians-University, Klinikum Grosshadern, Department of Anaesthesiology, Marchioninistr. 15, 81377Muenchen, Germany. (Email: gustav.schelling@med.uni-muenchen.de)
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Abstract

Background

Epinephrine enhances emotional memory whereas β-adrenoceptor antagonists (β-blockers, BBs) impair it. However, the effects of BB administration on memory are sex dependent. Therefore, we predicted differential effects of epinephrine and the BB metoprolol given to male and female patients after cardiac surgery (CS) on traumatic memories and post-traumatic stress disorder (PTSD) symptoms.

Method

We performed a prospective observational study and determined the number of standardized traumatic memories (NTRM) and PTSD symptom intensity in cardiac surgical patients at 1 day before surgery, and at 1 week and 6 months after the procedure. PTSD symptoms and NTRM were quantified using validated questionnaires. Metoprolol could be administered any time post-operatively.

Results

Baseline NTRM was not significantly different between male (n=95) and female patients (n=33). One week after CS, the NTRM in male patients was significantly higher. Metoprolol had no significant effect in either sex. At 6 months, females with metoprolol (n=18) showed a significantly lower NTRM and significantly lower PTSD symptom scores than females without BBs (n=15, p=0.02). By contrast, the totally administered dosage of epinephrine correlated with NTRM in males (r=0.33, p<0.01) but not in females (r=0.21, p=0.29).

Conclusions

β-Adrenergic stimulation with epinephrine enhances memory for adverse experiences in males but not in females whereas β-blockade selectively reduces memory for post-operative adverse events and PTSD symptoms in females.

Keywords

β-Adrenergic antagonistscardiac surgeryintensive care unitstress disorderstraumatic memory
Type
Original Articles
Information
Psychological Medicine , Volume 40 , Issue 5 , May 2010 , pp. 861 - 869
Copyright
Copyright © Cambridge University Press 2009

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