Is There a Central Nervous Withdrawal Syndrome Associated with Discontinuing Long-term Treatment with Propranolol?

Abstract

<jats:p> Thirty healthy volunteers were treated with beta-adrenoceptor blocking doses of long-acting propranolol for at least 28 days before being randomized to continue propranolol treatment, receive identical placebo under double-blind conditions, or discontinue all treatment. No evidence of a central nervous withdrawal syndrome occurred during the next 28 days as assessed by changes in psychomotor tests, rating scales, visual analogue scales, tremor recordings and melatonin excretion. Three subjects in the placebo withdrawal group but none in the propranolol group complained of insomnia for up to 14 days of the withdrawal period. </jats:p>

Melatonin and the control of intraocular pressure

“…This relationship occurring in daytime also applies at night time (Wurtman et al, 1963). Therefore, it was temping to speculate that melatonin could be behind changes in IOP; this hypothesis was correct as demonstrated in different laboratories (al-Qassab et al, 1988;Belforte et al, 2010;Chiou and McLaughlin, 1984;Pintor et al, 2001). Remarkably, melatonin levels may be significantly altered in eye pathologies, for instance, in glaucoma (Ma et al, 2018).…”

Therapeutic uses of beta-adrenoceptor blocking drugs in the central nervous system in man

“…In a recent study, Al-Qassab et al 55 compared the effects of abrupt withdrawal of propranolol with those of continuing treatment on tremor, melatonin excretion and rating scales of sleep, mood and vigilance in normal subjects. The only observation which suggested any form of withdrawal syndrome was a complaint of insomnia in some subjects during the first two weeks ofwithdrawal compared with none in the treatment-continued group, but this did not reach statistical significance.…”