Steroids may relieve social and spider phobias

Treatment with oral glucocorticoids, a type of steroid, can alleviate the fear in individuals with social and spider phobias, according to a report in the Proceedings of the National Academy of Sciences.

The results suggest that glucocorticoid treatment, given with behavioral therapy that includes exposure techniques, "may help to reduce fear and promote extinction of phobic fear," senior author Dr. Dominique J.-F. de Quervain, from the University of Zurich in Switzerland, and colleagues note.

Previous reports have suggested that increased glucocorticoid levels impair the retrieval of emotionally arousing memories. Therefore, the researchers hypothesized that increasing these levels might also block the recall of fear memories tied to phobias.

In the present study, cortisone, a steroid naturally produced by the body and can also be synthesized, was given to 40 subjects with social phobia and to 20 with spider phobia one hour before they were exposed to the cause of the phobia.

In both groups, the glucocorticoid treatment was associated with a significant reduction in fear induced by the source of the phobia. When the subjects were given placebo, or "sugar pill," the amount of natural cortisol released by the body was inversely related to fear ratings, confirming the link between cortisol and fear response.

In the patients with the spider phobia, the reduction in fear was still apparent when they were exposed to the source of the phobia 2 days after cortisol, suggesting that this treatment may have "facilitated the extinction of phobic fear," the authors write.

"In addition to these potentially beneficial effects in phobia, glucocorticoids also reduce retrieval of traumatic memories," and therefore, may have a role in the treatment of posttraumatic stress disorder, the researchers note.

SOURCE" Proceedings of the National Academy of Science USA, April 4, 2006.