Reconsolidation Therapy With Propranolol as a Treatment for Chronic Pain

NCT ID: NCT05085782

Last Updated: 2025-09-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

48 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-02-07

Study Completion Date

2025-08-31

Brief Summary

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The primary aim of this study is to document the feasibility and acceptability of an intervention consisting of pain neuroscience education and reconsolidation therapy with propranolol in adults suffering from chronic pain (chronic low back pain or fibromyalgia).

The secondary aim of the study is to estimate the effect size of the intervention on pain and function one month post-intervention, and to obtain data for sample-size calculation for a subsequent randomized controlled trial.

Detailed Description

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Background: Many patients with chronic pain exhibit abnormal synaptic changes in the central nervous system - including hyperactivity in the amygdala - reminiscent of those seen in post-traumatic stress disorder (PTSD). A recently developed psychiatric treatment for PTSD involves reactivating the synapses to make them temporarily malleable and then blocking their reconsolidation with propranolol, thereby reducing the hyperactivity in the amygdala and decreasing the intensity of the symptoms in a lasting way. Considering the similarities between PTSD and chronic pain, this treatment could also be beneficial for patients with chronic pain.

Objectives: The primary objective of this study will be to document the feasibility and acceptability of a combined pain neuroscience education and reconsolidation blockade intervention with oral propranolol (or placebo) in adult patients with chronic pain (specifically, low back pain or fibromyalgia). The secondary objective will be to estimate the effect size of the intervention on function and pain one month post-intervention, and to obtain the data necessary for a sample size calculation of a subsequent larger scale study.

Description: The research design is a quantitative, placebo-controlled clinical trial (Phase II) feasibility study. The sample will consist of French-speaking adults with chronic low back pain or fibromyalgia (n=24 per population; 12 control and 12 experimental participants for each population; allocation by minimization); participants with a contraindication to propranolol or a neurological diagnosis will be excluded. All participants will receive education on the neuroscience of pain (video vignettes) and will participate in 6 weekly intervention sessions. During these sessions, they will receive propranolol or placebo capsules (double-blind; dosing based on size) and participate in a reactivation procedure (description and/or visualization of painful movements). Feasibility measures will be collected throughout the study; acceptability and efficacy measures will be assessed 4 weeks post-intervention, with the exception of physical function (primary efficacy measure), which will also be measured at each intervention session.

Relevance: This study will be the first to use reconsolidation blockade for the treatment of chronic pain. The postulated mechanism of action is plausible and supported by scientific evidence, but to date has never been tested in humans with persistent pain. If our results demonstrate that the intervention is feasible, acceptable, and has the potential to be effective, randomized clinical trials may follow our study to robustly evaluate the effect of our intervention in the short and long term. The intervention could also be evaluated in other chronic pain populations with central sensitization, such as pelvic pain, chronic neck pain (whiplash), etc.

Conditions

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Chronic Low-back Pain Fibromyalgia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Propranolol

1. Pain neuroscience education (10 short videos - 2 to 4 mins each)
2. 6 weekly sessions of Reconsolidation therapy with propranolol. At the beginning of each session, participants will take 2 to 4 capsules of 20 mg propranolol (dose calculated based on sex and height). One hour after ingestion of the propranolol, participants will undergo a reactivation procedure, wherein they will be asked to describe/visualize painful movements/activities.

Group Type EXPERIMENTAL

Propranolol Hydrochloride

Intervention Type DRUG

6 weekly doses (40 to 80 mg) 1h before the reactivation procedure

Reactivation procedure

Intervention Type BEHAVIORAL

Description/visualization of painful movements/activities

Pain neuroscience education

Intervention Type BEHAVIORAL

In the form of 10 videos that participants will watch on their own time

Placebo

1. Pain neuroscience education (10 short videos - 2 to 4 mins each)
2. 6 weekly sessions of Reconsolidation therapy with a placebo. At the beginning of each session, participants will take 2 to 4 capsules of 20 mg placebo (dose calculated based on sex and height). One hour after ingestion of the placebo, participants will undergo a reactivation procedure, wherein they will be asked to describe/visualize painful movements/activities.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

6 weekly doses (40 to 80 mg) 1h before the reactivation procedure

Reactivation procedure

Intervention Type BEHAVIORAL

Description/visualization of painful movements/activities

Pain neuroscience education

Intervention Type BEHAVIORAL

In the form of 10 videos that participants will watch on their own time

Interventions

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Propranolol Hydrochloride

6 weekly doses (40 to 80 mg) 1h before the reactivation procedure

Intervention Type DRUG

Placebo

6 weekly doses (40 to 80 mg) 1h before the reactivation procedure

Intervention Type DRUG

Reactivation procedure

Description/visualization of painful movements/activities

Intervention Type BEHAVIORAL

Pain neuroscience education

In the form of 10 videos that participants will watch on their own time

Intervention Type BEHAVIORAL

Other Intervention Names

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Experimental group Control group

Eligibility Criteria

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Inclusion Criteria

* French speaking
* Suffering from \[chronic low back pain OR fibromyalgia\] for \>6 months
* Average pain at least 4/10
* Central sensitization (assessed via a standardized physiotherapy evaluation and the Central Sensitization Inventory)

Exclusion Criteria

* Health condition for which propranolol is contra-indicated
* Medication with which co-administration of propranolol is contra-indicated
* Severe or uncontrolled neurological/psychiatric condition (including post-traumatic stress disorder, substance abuse, suicidal ideation, etc.)
* Surgery of the lower-back in the last 3 years
* Litigation surrounding the painful condition
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Université de Sherbrooke

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Guillaume Leonard, PhD

Role: PRINCIPAL_INVESTIGATOR

Université de Sherbrooke

Locations

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Centre de recherche sur le vieillissement (CdRV)

Sherbrooke, Quebec, Canada

Site Status

CRCHUS: Centre de recherche du centre hospitalier universitaire de Sherbrooke

Sherbrooke, Quebec, Canada

Site Status

Countries

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Canada

Other Identifiers

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2022-4092

Identifier Type: -

Identifier Source: org_study_id

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