This is part of Breakup Week. We just can’t do this anymore.
A medical treatment that can repair a broken heart sounds like the stuff of science fiction. It was, in fact, the beguiling premise of the 2004 film Eternal Sunshine of the Spotless Mind, which depicted two ex-lovers trying to escape their pain by having all memories of one another erased from their brains. The movie presents the procedure as dystopian and counterproductive, but the prospect also sounded tempting. Moving on from a breakup, happy and open-hearted, without having to wait in agony for time to heal all wounds? Who could resist?
The concept stirred the imagination of psychiatry professor Alain Brunet. Brunet made his name researching treatments for post-traumatic stress disorder that use propranolol, a beta-blocker commonly used to treat high blood pressure, which, some studies suggest, can dull the impact of traumatic memories when given under specific circumstances. The protocol he developed and trademarked, the Brunet Method, has helped patients grappling with the aftermath of all manner of harrowing incidents: veterans returning from war zones, survivors of sexual abuse, victims of terrorist attacks, and more.
“There is no limit to the type of trauma or memories that we can treat. It works just the same,” Brunet said. It stood to reason that the drug could speed along recovery from other painful experiences, too.
So about a decade ago, when one of Brunet’s students at McGill University came looking for a topic for her dissertation, he thought back to the Eternal Sunshine treatment and suggested she look into whether his PTSD protocol could help people get over heartbreak. The resulting study, published in the Journal of Affective Disorders in 2022, found that 85 percent of the 61 victims of “romantic betrayal” who underwent Brunet’s propranolol treatment saw marked improvements in their symptoms of distress. The results presented an irresistible narrative for reporters: “This Drug Can Mend a Broken Heart,” read one representative headline that winter.
But Brunet recalled that some observers belittled the study. They accused the authors of pathologizing a normal life experience and robbing participants of the personal growth that can come from overcoming adverse events. “There’s this Judeo-Christian idea that you have to suffer, that suffering is good for you,” Brunet said. “Well, up to a certain point, yes. But does that mean that we should not have palliative care? If you have a headache, does it mean that you should not take Advil?”
According to Brunet, struggling to get over a former partner—especially in cases of duplicity, sudden abandonment, or infidelity, the main issues at play in the study—may be the foremost reason why people seek mental health care. A potential pharmaceutical solution is not just a new tool for therapists, he said. It’s “questioning our relationship with psychological suffering” altogether.
Even aside from its potential as a heartbreak remedy, propranolol is having a moment. The drug blocks the effects of adrenaline, such as shakiness and a racing heart, making it a helpful crutch for nerve-racking events. Aided in part by telehealth companies like Hims & Hers and Kick, prescriptions have risen 28 percent since 2020, with an increase of about 530,000 patients between 2020 and 2023 alone. Celebrities, podcast hosts, and influencers are openly promoting the medication as a must-have for big occasions and a cure-all for everyday stress.
Though the companies that hawk the drug mostly market it as a performance-anxiety pill, they hint that it could have broader applications. On the website for Kick, a blog post tells the story of a woman who started taking beta-blockers for work presentations, a common use case for consumers who aren’t taking them for medical reasons. One day, the woman decided to pop one of the pills before meeting her ex for drinks. During their conversation, under the influence of propranolol, “she felt in control of her thoughts and in control of her feelings,” the post reads. The woman got closure and was supposedly “able to just move on.”
Some people regularly take propranolol to deal with physical symptoms of angst after a breakup, especially in the U.K., where it has been specifically approved to treat anxiety. (In the U.S., anxiety is an off-label use, and some research has disputed the effectiveness of beta-blockers for people with anxiety disorders.) Doctors might also prescribe it to treat very real “broken heart syndrome,” whereby the risk of heart attack spikes in the days and weeks after a loved one dies.
The treatment at the center of Brunet’s study is something different altogether. Instead of aiming to block symptoms directly, it seeks lasting results by targeting a process in the brain known as memory reconsolidation.
Memories aren’t like books in a library, replaced in pristine condition after they’re taken out to be read. They’re more like sculptures made of wet clay, prone to being reshaped with each handling. Whenever the brain recalls a given event, the memory must be encoded anew in long-term storage. Some substances interfere with that re-saving, or reconsolidation. Propranolol is one of them.
“If you recall an emotional memory under the influence of a memory reconsolidation blocker like propranolol, this memory will be attenuated, degraded—mostly its emotional strength,” Brunet said.
Researchers first discovered the malleability of long-term memories about 25 years ago, in a study on rats. That led Brunet and others to experiment with propranolol as a way to destabilize traumatic memories. In one landmark study published in 2015, Dutch psychology professor Merel Kindt exposed one group of participants with arachnophobia to a tarantula in a jar for two minutes, then gave them a dose of propranolol. She gave another group a placebo, and gave a third group propranolol without the tarantula exposure, to see if the drug alone could cure their fear of spiders. The arachnophobes who got the exposure and the drug that first time were much less anxious in subsequent sessions with the tarantula; some were even able to hold it in their hands. Their improvement lasted at least a year, when Kindt stopped evaluating them. The other two groups of participants remained just as fearful as before.
The standard protocol for phobias has long been exposure therapy. If patients are exposed to their triggers enough times, their emotional response will eventually decrease, Kindt said. But this treatment has a major drawback. “The memory itself remains intact, and this explains the high percentages of relapse,” Kindt said. By taking propranolol while their fear memory was activated—and thus destabilized—participants may have weakened it more permanently.
That was the hope with Brunet’s study on heartbroken Canadians whose ex-partners had cheated or perpetrated other misdeeds. “Romantic betrayal is really life-shattering. And so what happens is that people keep thinking about it all the time,” Brunet said, explaining that it’s not entirely dissimilar from more severe forms of trauma. One participant, Anne Lantoine, had moved to Montreal from France with her daughter while her husband stayed back in Marseille with their two other adult children to complete the sale of their house. After she applied for permanent residency for their whole family, Lantoine found out that her husband wasn’t coming: He had filed for divorce and moved his mistress into their home, which was technically Lantoine’s.
Lantoine was a wreck. She suffered recurring nightmares and found it hard to function in the daytime due to lack of sleep. “What put me in this mental state was not because he wanted to divorce,” she said. “It was the way he treated me.” When she saw a recruitment announcement for the propranolol study, she signed up.
At the time, she was still in denial that her symptoms of what psychologists call “adjustment disorder”—acute distress in response to a stressful event—were severe enough to be affected by medical treatment. “I didn’t expect anything. In a way, the only thing I was sure of was that it wouldn’t hurt,” she said.
At her first session, Lantoine was given a dose of propranolol and, after it kicked in, asked to write down the story of her husband’s betrayal. She also filled out a survey that assigned a numerical value to how much it was disrupting her life. Each week for the next four weeks, Lantoine returned to the hospital, after taking another propranolol pill, for a 25-minute session in which she would read her written narrative aloud to a graduate student, then take the survey again.
Around the third or fourth session, Lantoine noticed a change. It felt like less of a burden to go to the session, and it was less painful to read the text. Her nightmares became less frequent and severe. She could still remember everything that happened with her husband, but it didn’t hurt as much to think about. “I felt less trapped in my problems,” she said.
Over the six weeks of the study, the vast majority of participants saw a “clinically meaningful” reduction in their symptoms. The results persisted at a follow-up four months after the end of their treatment.
But the study shows some weaknesses. There was no placebo group, just a pre-treatment waiting period of four weeks—during which the subjects’ symptoms mostly did not improve—to gave researchers a baseline comparison. It is possible, then, that reliving their heartbreak over and over again to an empathetic listener may have contributed to the participants’ progress in addition to the drug. As with any drug, there’s also the possibility of placebo effect.
David J. Ebaugh, an Oregon-based trauma recovery therapist, has his own reasons for skepticism about propranolol’s use as a breakup drug. “Propranolol is really pretty good for helping to process experiences that are really visceral, in which there’s not really an emotional component to it beyond fear,” he said. Phobias, in other words, are a tried-and-true use case for the blunt instrument of a beta-blocker. Complex emotional recovery, like in the aftermath of sexual abuse or a broken heart, can demand a more refined approach.
That’s because much of the damage lies in the way we make meaning of these experiences and the stories we tell ourselves about why terrible things happen to us. People often come out of abuse or romantic betrayal burdened by self-blame, shame, or a feeling that they are unworthy of love. “You learn that the world is not a safe place. You learn that you don’t have any kind of sense of agency,” Ebaugh said. If you come out of a breakup with a distrust of all romantic relationships, propranolol is not going to help you get over that. It also carries the risk of side effects that non-pharmaceutical therapies do not.
Ebaugh points to recent research that showed no difference between propranolol and a placebo in the treatment of 46 patients with PTSD. In his trauma work, Ebaugh prefers other therapeutic techniques that involve memory reconsolidation, like eye movement desensitization and reprocessing (EMDR) and brainspotting, both of which have also been used by clinicians to help patients recover from breakups. Like the propranolol protocol, these therapies attempt to permanently defang the traumatic memory while it is taken out of brain storage (and thus pliable), but without the use of a drug. Instead, by talking through the memory while the patient performs specific physical actions, the therapist helps the patient arrive at new insights and a feeling of safety and resolution, which are then stored with the memory in place of raw pain.
Brunet believes his treatment is easier on patients than these alternatives. Propranolol makes it less stressful to talk about difficult memories, because it blocks the physical symptoms of anxiety, whereas with EMDR and brainspotting, “you essentially have to do it cold turkey,” Brunet said. “I have nothing against EMDR, but I’m a researcher. I’m interested in the treatments of tomorrow, not the treatments of today.”
But thanks in part to Brunet’s research, propranolol trauma therapy is a treatment of today. Thousands of clinicians have taken Brunet’s three-day training and offer his propranolol protocol as a therapeutic option. He keeps a directory on his website for patients seeking a nearby practitioner. Not all of them offer the treatment for breakups, but those that do are joining a burgeoning (and highly profitable) breakup industry, including breakup coaches, breakup retreats, breakup dietitians, and clinicians offering ketamine therapy and nerve blocks for the recently dumped.
Some experts have cautioned that there may be unintended consequences to taking the emotional charge out of our memories. In a 2012 interview with the New York Times, neuroethicist S. Matthew Liao wondered whether using propranolol to treat military veterans with PTSD could lead to “conscienceless soldiers” unbothered by the violence of war or the destruction they’ve wrought. “Memories can affect your personal identity,” he said. “They can impact who you think you are.” For what it’s worth, Eternal Sunshine of the Spotless Mind, the inspiration for Brunet’s research on romantic betrayal, did not present its mind-wiping treatment as an aspirational procedure. The film can be interpreted as a reminder that painful memories still hold value—or that without the ability to learn from our romantic misadventures, we are doomed to repeat the past.
Brunet disputes the idea that a little pharmaceutical assist could cheat a patient out of life lessons or salutary inner work. The participants in his study, like Lantoine, were suffering debilitating symptoms of stress years after their relationships dissolved. They needed a lift to get on with their lives.
Still, Brunet wouldn’t recommend propranolol as a first resort. He suggests the newly brokenhearted try to get by on their own for a while, maybe find a therapist and talk things through. And if they’re still struggling after a couple of months? “Then we’ve got something else to help you,” he said.
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