Confidence boosting drug may also help obsessive compulsive disorder symptoms

From a recent article in New Scientist: Drug that boosts confidence in your own actions may help OCD:

Comparing the volunteers’ self-assessed confidence with their actual performance revealed the effect of each drug. The drug that reduced noradrenaline boosted metacognitive insight – it made volunteers more aware of their own performance, without affecting the accuracy of their decisions. A person was more likely to say they’d been correct when they were, and to know if they’d been wrong. Neither the drug that blocked dopamine nor the placebo had any effect.

“This study is very intriguing – it’s the first to show that metacognition can be selectively enhanced by drugs in the absence of differences in task performance,” says Steve Fleming, at University College London, who wasn’t involved in the study.

Propranolol is already being prescribed, but this is the first time it has been used off-label to treat OCD symptoms–it may also have beneficial effects for those without OCD.

Blocking noradrenaline seems to allow people to better assess their confidence in an action. The drug, called propranolol, is currently used to treat high blood pressure, but it may also prove useful for treating psychiatric symptoms like some of those seen in OCD and schizophrenia.

It’s possible that some people without conditions like these may also benefit from cutting the amount of noradrenaline in their system.  “There’s quite some variability in metacognition,” says Hauser. “It is likely to have an effect in real life decision-making. Whether you trust what you’re writing, whether you’re confident in what you’re saying – all our actions involve metacognition.”

“Good metacognition is useful for a range of reasons – being aware of our skills and abilities is important for guiding learning and collaborating with others,” says Fleming. He says it would be interesting to see if the same drug might improve our insight into our performance in other aspects of cognition, such as memory.

One reddit user shares their personal experience:

I took propranolol for ~3 years and recently made the decision to get off it, which was quite a struggle. My experience with it was initially positive as it does slow your heart rate so severe anxiety does not produce the physical symptoms like racing heart and shakiness. However, as time went on I realized it was making me tired, slow, and apathetic. It reduces the effects of adrenaline in your body, so for nervousness or crippling physical symptoms of anxiety it has its place. Beyond that be prepared to lose your edge and instincts that are related to adrenaline, because adrenaline has its benefits too.

The original research can be found on elifesciences.org.

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