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February 9, 2010 3:48 PM   Subscribe

Are beta blockers used in combat?

It seems as though the effects of beta blockers would be desirable in a combat situation. One AskMe question hints that they might. Has this been studied?

I understand that some training, especially realistic scenarios, are (at least partially) designed to "take the edge off" the fight-or-flight response, so that fine motor responses and calmer reasoning are available to the participants. (I'm recalling the "stress inoculation" training described in Blink [p.238], and a Nova [?] special on secret service training.)

Sure, even in modern combat theater, there likely still value in the fight-or-flight response that you wouldn't want to eliminate completely. (Off the top of my head - more sensitive hearing, perceptual time dilation and positive reinforcement from the "reward" of adrenaline.)

But even just using it to attenuate some of the less desirable effects? A steady shootin', clear-headed, non-tunnel vision soldier seems pretty handy when you're in the shit.
posted by BleachBypass to Science & Nature (10 answers total) 1 user marked this as a favorite
I would doubt it- beta blockers also lower your blood pressure and mellow you out, sometimes fatiguing you. Not helpful effects in a fight.
posted by xmutex at 3:53 PM on February 9, 2010

Best answer: There may be a few specialized roles where beta blockers would be useful. Snipers would be the one that springs immediately to mind, but someone who knows more than I would have to address whether they actually use them.

But for general combat roles the military is far more likely to give you amphetamines (speed) than a downer like a beta blocker. Beta blockers may help steady your hand but they also have a lot of what in a combat soldier would be very undesirable effects. Target shooting is not combat.

Meth yes, Propranolol no!
posted by Justinian at 3:55 PM on February 9, 2010

Well, it's not a combat situation, but here is an abstract of a study where propranolol was administered to returning veterans in a military burn center to see if it would be effective as a prophylaxis against PTSD (didn't work).
posted by strangely stunted trees at 3:59 PM on February 9, 2010

Best answer: Beta-blockers have an intended/side effect of preventing the heart rate from increasing very much. If a person were in a combat situation, on beta-blockers, and had to do some high caloric output activities, they'd be pretty screwed.
posted by 517 at 4:26 PM on February 9, 2010

Best answer: "...the "reward" of adrenaline."

Sorry, I can't let this one go. Short, little adrenaline kicks are fun for most people. The constant adrenaline surge a soldier gets is fun for almost no one. Soldiers will actually experience an adrenaline kick to the point where the hormones, adrenaline, are depleted from the body, after which point they reach the stage of exhaustion.

The the sympathetic arm of the autonomic nervous system is your friend. It has been refined over millions of years of evolution. It's going to be a long time before man finds something better.
posted by 517 at 4:34 PM on February 9, 2010

Without having access to the journal article itself, I'm not terribly surprised by those results, strangely stunted trees. If they're administering propranolol at the same time that they're administering anesthetic/analgesics like morphine (or any opioid, really), which is the gist I get from the abstract, I'm not entirely sure what they expect propranolol to do that the opioids aren't already doing. Simply speaking, the high level of painkillers I'd imagine would be given to a burn patient are already working to numb the brain as much as possible to stress/trauma-based enhancement of memory; PTSD, in turn, is in part caused by the existence of one or more overly powerful, traumatic memories. So, if the opioids are already working to attenuate (as much as is possible) the remembered trauma of the burn-unit experience itself, it's unclear to me why the researchers would expect the two groups (pro/not pro) to differ significantly from each other in terms of developing PTSD.

(It'd be a different situation if the propranolol was administered to them, say, around the time of the burn experience but before opioid painkillers entered the picture; though, if the emergency medics, have propranolol lying around, I'd conjecture-without-much-evidence that they'd also have painkillers, thus leading to the same confounding variable.)
posted by Keter at 4:41 PM on February 9, 2010

That's a good point, keter.

When you frame it like that, I guess the only interesting edge case would be where, as a true prophylaxis, the propranolol had already been administered at the time of the traumatic stimulus. Which, getting blown up being notoriously unpredictable, even in Iraq, brings us back to the OP's scenario of routine use in the theater of war.

Presumably that's one area where beta blockers would at least outshine opioids, though, if my extensive knowledge of the Vietnam War gained through watching overwrought movies about it is anything to go on, going through most of the war blasted out of your mind on heroin and morphine has also been attempted.
posted by strangely stunted trees at 6:51 PM on February 9, 2010

No way, a lipophilic beta blocker like propranolol would be bad news in a combat situation.
posted by candasartan at 7:08 PM on February 9, 2010

Response by poster: Some clarifications and questions.

Regarding: Side effects. I know that the dose for say, performance anxiety, is significantly lower than the regular, predictable use for controlling blood pressure. And since that is off-label, I don't know where to find side-effects for those dosages.

For example, I have taken propranolol and had no problem performing cardiovascular exercise. It's not an on-off scenario that I am imagining, but rather, would the soldier perform any better with less adrenaline? And stress eradication training for combat, which strives to get the heart rate lower (170 the first time you are forced to confront a vicious dog, vs. 120 for the fifth time).

Justinian: I'm under the impression amphetamines are being phased out... the effect on the soldier's judgement being an unacceptable trade off. I had thought the Airforce was replacing "go pills" with modafinil (Provigil).

517: The "reward" I refer to comes very second or third hand, mainly watching Iraq theater documentaries where (the surviving) soldiers come back from a firefight and are amped... "Holy fucking shit that was crazy, did you see me blow the top of that motherfucker's skull off?"

But I'm with you on the exhaustion, which is why it would seem like ~modest~ attenuation of the amount of adrenaline would be your friend, and an improvement on the sympathetic arm of the autonomic nervous system.

candasartan: Because it's lipophilic? I'm not certain I understand that term, and Wikipedia, as usual for the sciences, has been taken over by the overly-technical-is-better mentality. If it is not because of Otherwise, I'll have to take your word on it.
posted by BleachBypass at 7:44 PM on February 9, 2010

Response by poster: Also, isn't the biathalon a fairly cardio intensive event?

I found some of the answers here insightful.
posted by BleachBypass at 10:00 AM on March 4, 2010

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