Have no fear

PUBLISHED : Thursday, 15 January, 2004, 12:00am
UPDATED : Thursday, 15 January, 2004, 12:00am

THE WORD fear plagues the headlines. Saddam Hussein ran a 'republic of fear', Arabs are voicing 'fear' of the 'next US invasion', and whites in Zimbabwe 'fear' a vengeful President Robert Mugabe.

But now the writing could be on the wall for the emotion itself, thanks to a recent scientific breakthrough with potentially wide-reaching repercussions.

Researchers at Emory University near Atlanta, Georgia, announced they had discovered that an antibacterial drug normally used to treat tuberculosis, D-cycloserine, could be enlisted to fight phobias too.

In a trial, the team recruited 30 acrophobics - people afraid of heights - and gave varying doses of D-cycloserine to 20 of them. Ten received a 50mg dose and the other half received a 500mg dose; the remaining 10 patients were given a placebo.

The patients were then forced to confront their fear by donning virtual reality goggles which gave them the feeling they were going up and down in glass elevators. 'As the elevator went higher, they became more and more anxious,' the head of the Emory team, Dr Michael Davis, was quoted as saying in a BBC report. 'But those taking D-cycloserine learned much more quickly to overcome their fear - in two sessions rather than the usual eight.'

The size of the dose apparently made no difference. The drug may, the Birmingham Post reported, also help people keep their nerve when learning dangerous sports such as sky-diving.

Even more significantly, Davis claims it could work in almost any situation where an individual is very on edge. 'It should help you get over whatever it is you are afraid of, as long as you face up to your fear,' he told Chemistry And Industry magazine.

Michael Otto, a professor of psychiatry at Harvard University, acclaimed the findings. 'They represent a new direction for combining medication and cognitive behavioural approaches to psychotherapy,' he said.

The findings seem to suggest that D-cycloserine, which supposedly aids transmission of a brain protein crucial to overcoming fear, could evolve into an all-purpose 'chill pill': a Prozac for the petrified. For that matter, it might even become popular with anyone who thinks their life would be able to gain from the removal of anxiety in general.

But many sources in science and psychology are lukewarm about the drug's alleged wondrous power. Dr Susan Jeffers, the author of the 1995 psychology book on overcoming anxiety, Feel The Fear And Do It Anyway, told the South China Morning Post: 'What I have to say about all research of this kind is that it is very interesting and we shall await further research. Truly nothing should be concluded from this study as I'm sure the researchers would agree.

'You will find studies that agree with the findings here and others that will disagree,' she said. 'The wonderful scientist Richard Feynman said we should view all results of research with a 'satisfactory philosophy of ignorance', and I agree. We really don't know what this study means ultimately. No one does.'

Dr Neil Thomas, senior lecturer in the school of chemistry at the University of Nottingham in Britain's Midlands, was less diplomatic. 'Given the phobia tests were conducted using virtual reality equipment and for small numbers of people I am not sure of their validity,' he said.

He stressed that the validity of virtual reality testing as a scientific tool had not been 'sufficiently substantiated'. He also questioned whether the test group was big enough. 'From the data I have seen, a large study is required to substantiate the claims.'

Moreover, he warned the drug would 'kill large numbers of digestive bacteria making patients nauseous'. Other potential side effects he listed ranged from convulsions and dizziness to headaches, confusion and disorientation. He concluded that a prolonged course of D-cycloserine could possibly result in 'serious neurological effects and possibly addiction'.

Catherine Madigan, a Melbourne-based clinical psychologist specialising in the treatment of social anxiety, also suggested the drug was dubious. She asked whether D-cycloserine could prove addictive, pointing out that drugs such as Valium, which are routinely prescribed for fear, do get patients hooked, inducing physical dependency.

Even if D-cycloserine is safe in this sense, patients might still become psychologically dependent, she warned, stressing that medication was just one treatment option. Individuals afflicted by fear should explore other options such as cognitive behavioural therapy (eliminating unwanted thoughts and beliefs through reason) or meditation.

Nicky Lidbetter, senior manager at Britain's National Phobics Society, was initially more enthusiastic about the part D-cycloserine could play in mental health. She said her organisation 'welcomes any new treatments for anxiety disorders', but then expressed misgivings. She felt the study should be repeated using a much larger sample to produce results that could be classed as 'meaningful'.

The message is clear: the wonder drug in the spotlight has a long way to go before it wins a vote of confidence from the experts. The primal fears which D-cycloserine can supposedly neutralise may well prove a feature of life and current affairs for the indefinite future.