Comparison of bisoprolol and diazepam in the treatment of cardiac neurosis

Abstract

In order to compare the beta blockers bisoprolol and diazepam in the treatment of cardiac neurosis, 40 patients (16 males and 24 females, mean age: 39 +/- 11 years) were examined in a double-blind, crossover study. Following a 4-week placebo period, patients were randomized to receive either bisoprolol 10 mg daily or diazepam 5 mg twice daily for 4 weeks. After a second 4-week washout period on placebo, patients were switched to the alternative regimen for a further 4 weeks. At the end of the placebo periods and during each phase of treatment, the following parameters were evaluated: somatic symptoms by self-assessment questionnaire, anxiety state by Hamilton rating scale, reaction time to both acoustic and visual stimuli, blood pressure, and heart rate. Both treatments were effective in reducing somatic symptoms of cardiac neurosis, but bisoprolol was significantly more effective than diazepam (p less than 0.01). On the contrary, diazepam was superior to bisoprolol in improving the Hamilton scale related to psychic symptoms. Only diazepam prolonged reaction times. Both treatments were well tolerated; however, 12 patients complained of drowsiness and nine of sedation under diazepam. In conclusion, bisoprolol appeared to be as effective as diazepam in the treatment of cardiac neurosis, but with better effects on somatic symptoms and without affecting patients' psychomotor performance.

Sinus Tachyarrhythmias and the Specific Bradycardic Agents: A Marriage Made in Heaven?

“…Management Sinus tachycardia is managed by identifying and eliminating or treating the cause. As an interim measure, ,-blockers can be very useful and effective in patients in various settings, including the management of emotional stress and other anxiety related disorders (46)(47)(48)(49)(50)(51)(52)(53)(54), after acute myocardial infarction (55,56), and in the acute management of symptomatic thyrotoxicosis, in combination with carbimazole or propyIthiouracil before the definitive actions of such agents take effect (35,57). Calcium channel blockers may be of benefit in patients with symptomatic thyrotoxicosis where ,-blockade is contraindicated (58).…”

Somatoform Disorders - Diagnostic Concept, Controlled Clinical Trials, and Methodological Issues

“…In a methodologically weil performed trial, Fogari et al (1992) evaluated in a cross-over fashion the effects of a~-blocker -bisoprolol -and diazepam on cardiac neurosis. While both treatments seemed to be effective, the overall evaluation of a 30-item self-questionnaire and the total score of the HAMA showed bisoprolol to be superior to diazepam.…”