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Hormone May Help Control Unwarranted Fears

Cortisol interferes with retrieval of emotionally charged memories, study suggests

TUESDAY, March 28, 2006 (HealthDay News) -- Could a simple hormone "cure" debilitating phobias?

Swiss researchers have found that giving people the stress hormone cortisol shortly before they entered an anxiety-provoking situation actually reduced fear and anxiety.

While promising, the results are too preliminary to warrant a sea change in current treatments, the study authors said.

"At this point, we need more clinical studies to know if cortisol is suited for the treatment of phobias," said Dr. Dominique de Quervain, senior author of the paper and a research professor in the division of psychiatry research at the University of Zurich.

The paper appears in this week's issue of the Proceedings of the National Academy of Sciences.

Scientists have known that different phobias spur the release of cortisol in the brain. But it has been unclear if the hormone could influence the fear response as well.

Cortisol, which is a glucocorticoid, has also been shown to interfere with the retrieval of emotionally charged memories, suggesting it might block memory recall, thereby lessening anxiety.

The Swiss researchers tested the hypothesis in 40 people with social phobia and 20 people with spider phobia.

Each participant was given an oral dose of cortisol one hour before being exposed to a fearful situation -- public speaking for those with social phobia or a picture of a spider for those with spider phobia.

Volunteers who received the hormone reported less fear and anxiety when confronted with the object of their fears.

Those with spider phobia actually experienced a progressive decline in their fear as they were exposed to a photograph of a spider six times over a two-week period. This was true even at the final session, when no hormone was administered, the researchers said.

The findings may also shed light on other nuances of anxiety and fear.

Previous researched has shown that cortisol levels increase with generalized anxiety, but not with an acute panic attack. "For a full, out-of-the-blue spontaneous attack that reaches a peak in a brief period of time, cortisol does not go up," said Dr. Eric Hollander, director of the Compulsive, Impulsive and Anxiety Disorders Program at Mount Sinai School of Medicine in New York City.

"The current findings suggest that people who have acute panic attacks develop agoraphobia [a condition in which people avoid situations or places associated with anxiety] because the lack of increase in cortisol means that they really retain the memories to a greater state," Hollander explained. "This leads to more profound avoidance, so it would fit with this notion that increasing cortisol could interfere with memory.

This, in turn, could be helpful in treatment.

The study authors also suggested that cortisol may be suited for the treatment of post-traumatic stress disorder.

Before it can be used in any clinical setting, however, more research is needed.

"Future studies with more patients and longer treatment periods are required to evaluate the efficacy of cortisol in the treatment of phobias," de Quervain said. "Furthermore, we will investigate if glucocorticoid treatment, in combination with exposure techniques in cognitive-behavioral therapy, may help to promote the extinction of phobic fear."

More information

For more on anxiety disorders, visit the U.S. National Institute of Mental Health.

SOURCES: Dominique de Quervain, M.D., research professor, division of psychiatry research, University of Zurich, Switzerland; Eric Hollander, M.D., professor, psychiatry, and director, Compulsive, Impulsive and Anxiety Disorders Program, Mount Sinai School of Medicine, New York City; March 27-31, 2006, Proceedings of the National Academy of Sciences
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