Beta-blockers in anxiety disorders

Abstract

Studies evaluating the antianxiety and antipanic properties of beta-blockers do not support their routine use in treating either generalized anxiety disorder or panic disorder. The use of propranolol for anxiety disorders accompanied by physical symptoms, especially cardiovascular complaints, may be effective in some patients when combined with benzodiazepines or perhaps in some non-responders to conventional treatment. Better designed studies are needed to evaluate the exact role of beta-blocking agents in treating anxiety. The efficacy of propranolol in patients with panic disorder has not been widely researched, but preliminary results have not been encouraging. Propranolol may provide symptomatic relief in some patients with residual somatic complaints (i.e., palpitations and tachycardia), when combined with the patient's ongoing drug regimen. Because beta-blockers may induce depression, they should be used cautiously--if at all--in panic patients with concurrent depressive illness.

Biphasic effects of propranolol on extinction of rewarded responding

“…This has not been described clinically, although there have been reports that propranolol can produce depression (Hayes and Schulz, 1987). Nevertheless, the different explanations proposed for the present results would suggest that the anxiolytic-like effects of propranolol might prove to be limited either to a brief period after administration or to situations or patients in which the level of anxiety is not great.…”

“…It has recently been argued that this family of drugs is of little value in anxiety (Noyes et al, 1981;Hayes andSchulz, 1983, 1987). Nevertheless, there remain isolated reports that they have been effective treatments for chronic (Kathol et al, 1980;Chaturvedi, 1985), acute (Neftel et al, 1982) or experimentally induced (Erdman et al, 1984) anxiety.…”

Psychophysiological Aspects of Phobic Fears: An Evaluative Review

“…Despite these findings, Hayes and Schulz [1987] con cluded in their extensive review on beta-blockers in anx iety disorders that the research findings do not support the routine use of beta-blockers in clinical treatment. This is an important conclusion, since it means that the use of beta-blockers is still 'research issue', with no apparent clinical routine consequences.…”

Pharmacotherapy for anxiety disorders: drugs available

“…Although it has been suggested that ß-adrenoceptorantagonists may have a role in the treatment of social phobia, recent studies have been rather disappointing (Marshall et al, 1993). There is no systematic evidence that ß-adrenoceptor antagonists are useful in the treatment of other anxiety disorders such as panic disorder (Hayes & Schulz, 1987), although many patients receive them from general practitioners.…”