Effect of a Beta-adrenergic Blocking Agent on Dental Anxiety

Abstract

The effect of propranolol was studied on 23 dental phobics in a double-blind, placebo-controlled clinical trial involving actual dental treatment. The subjects were selected because they showed high physiological reactivity in the dental situation. Twelve subjects received the test drug and 11 subjects received the placebo at individualized doses of either 80 or 120 mg. A significant difference in self-reported anxiety at the injection phase of treatment and less overall pain intensity and aversiveness were observed for the propranolol as compared with the placebo group. No differences were detected for behavior ratings. Beta-adrenergic blocking agents may have utility for reducing anxiety in individuals fearful of dental treatment.

Systemic Propranolol Acts Centrally to Reduce Conditioned Fear in Rats Without Impairing Extinction

“…Propranolol successfully reduced anxiety in dental phobics (38), and avoidance behavior in panic disorder patients (39). Other studies, however, showed no effect of propranolol on subjective anxiety in phobics (40), or expression of cued fear conditioning (7).…”

Recent advances in animal models of chronic antidepressant effects: The novelty-induced hypophagia test

“…In humans, propranolol and other b-adrenergic antagonists have been shown to reduce anxiety provoked by stressful situations (Liu et al, 1991;Dyck and Chung, 1991;Laverdure and Boulenger, 1991) or drug withdrawal (Bailly et al, 1992). These compounds are primarily effective in reducing moderate, but not extreme, autonomic somatic symptoms of anxiety (Tyrer, 1988).…”

The Sedative Effect of Propranolol on Critically Ill Patients: A Case Series

“…As far as we know, the present study is the first to investigate the effect of propranolol for critically ill patients. Previous studies mentioned above have shown the effects of propranolol on various neurocognitive disorders besides hyperactive delirium, and some of these are associated with delirium in the ICU (16, 19, 20). Therefore, treatment of these conditions may lead to a decrease in the incidence of delirium in the ICU (1, 30).…”

“…Liu et al conducted a small randomized controlled trial ( n  = 15) in which they administered either propranolol or placebo 1 h prior to a dental procedure. Patients who received propranolol reported lower pain and anxiety scores on a visual analog scale before, during and after the procedure (16). Vaiva et al were able to reduce the incidence of PTSD symptoms using propranolol in a small ( n  = 19) non-randomized study of trauma patients (18).…”

“…Beta-2 adrenergic receptor activation also appears to be important in the MSA and MPOA, resulting in dose-dependent increases in time spent awake (4). Beta-blocking agents have been less well studied for ICU delirium, although beta-blockers are known to have beneficial effects on anxiety, posttraumatic Stress Disorder (PTSD) and aggressive behavior in a variety of populations (16–20). Propranolol is a non-selective beta-adrenergic antagonist that has good penetration of the blood–brain barrier (21).…”