Propranolol in Schizophrenia: A Double Blind, Placebo Controlled Trial of Propranolol as an Adjunct to Neuroleptic Medication

Pugh, Cheryl; Steinert, J.; Priest, R. G.

doi:10.1192/bjp.143.2.151

Cited by 38 publications

(20 citation statements)

References 18 publications

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“…Similar negative results of the combination were reported by Myers et al [1981]. However, Pugh et al [1983] carried out a double-blind, placebo-controlled study, in neuroleptic-treated, chronic schizophrenics with florid symptoms. The duration of the study was 12 weeks and the dose of propranolol was 320 mg twice a day.…”

Section: Beta-adrenergic Receptor Blockerssupporting

confidence: 79%

Novel approaches to the pharmacotherapy of schizophrenia

Meltzer

1986

Drug Development Research

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Meltzer, H.Y.: Novel approaches to the pharmacotherapy of schizophrenia. Drug Dev.Res. 9:23-40, 1986. Numerous attempts to extend the pharmacotherapy of schizophrenia beyond conventional neuroleptics are reviewed. Clozapine and melperone are atypical neuroleptics that produce few extrapyramidal side effects during acute usage and possibly less tardive dyskinesia with prolonged use. Decreasing dopamingeric activity with a tyrosine hydroxylase inhibitor or dopamine autoreceptor agonists may also be of value. Neuroleptics that block voltage-sensitive calcium channels or calcium channel blockers per se have been advocated for treatment of negative symptoms or the deficit state. Among other possible clinical approaches reviewed are: beta adrenergic blockers, clonidine, tryptophan, 5-hydroxytryptophan, fenfluramine, GABA drugs, including high dose benzodiazepines, lithium, carbamazepine, opioid agonists and antagonists, gamma-endorphins, TRH analogs and vasopressin. Most studies indicate these agents produce inconsistent or slight-to-modest benefits, either in comparison with standard neuroleptic drugs or in addition to neuroleptics, in groups of schizophrenic patients, including some double blind placebo-controlled trials. Those individuals who do respond sometimes, but not always, fail to relapse when the experimental drug is discontinued or fail to respond to it in subsequent trials. Consistent with the presumed heterogeneity of schizophrenia, there is some evidence supporting non-neuroleptic drug treatment for specific schizophrenic subtypes. The various stages of this usually life-long disorder, together with the possible mutability of the underlying etiological factors over time, requires the utmost care in clinical trials.

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Section: Beta-adrenergic Receptor Blockerssupporting

confidence: 79%

Novel approaches to the pharmacotherapy of schizophrenia

Meltzer

1986

Drug Development Research

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“…Does evidence exist that any adjunctive medication will reduce overt aggression or hostility in persons with schizophrenia spectrum disorders? [70][71][72]88,[132][133][134][135][136][137][138][139][140][141][142] (Table 4) Fifteen articles were identified that reported relevant data. One paper 137 was also reported in Table 5 because the subjects were preselected for aggressiveness.…”

Section: Resultsmentioning

confidence: 99%

Pharmacological Management of Persistent Hostility and Aggression in Persons With Schizophrenia Spectrum Disorders: A Systematic Review

Victoroff

Coburn

Reeve

et al. 2014

JNP

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The incidence of aggressive behaviors is higher among persons with schizophrenia spectrum disorders (SSDs) than among persons without such disorders. This phenomenon represents a risk to the well-being of patients, their families, and society. The authors undertook a systematic review of the English language literature to determine the efficacy of neuropharmacological agents for the management of hostility and aggression among persons with SSDs. The search combined findings from the Medline, EMBASE, and PsycINFO databases. Ninety-two full text articles were identified that reported relevant findings. The American Academy of Neurology criteria were used to determine levels of evidence. Paliperidone-extended release is probably effective for the management of hostility among inpatients with SSDs who have not been preselected for aggression (Level B). Clozapine is possibly more effective than haloperidol for the management of overt aggression and possibly more effective than chlorpromazine for the management of hostility among inpatients with SSDs who have not been preselected for aggression (Level C). Clozapine is also possibly more effective than olanzapine or haloperidol for reducing aggression among selected physically assaultive inpatients (Level C). Adjunctive propranolol, valproic acid, and famotidine are possibly effective for reducing some aspects of hostility or aggression among inpatients with SSDs (Level C). Paliperidone-extended release currently appears to be the agent for the management of hostility among inpatients with SSDs for which there is the strongest evidence of efficacy.

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“…In the psychiatric literature, it is recognized that placebo effect rates are low in patients with obsessive-compulsive disorder as compared with patients with other anxiety-based Axis I disorders [22]. Most studies suggest that placebo response rates in attention-deficit/ hyperactivity disorder and schizophrenia are also substantially lower than those seen in anxiety and depressive disorders [23]. The reasons for these differences are not clear.…”

Section: Placebo Responses Differ Based On Diseasementioning

confidence: 98%

Placebo Response: A Consideration of its Role in Therapeutics

Kradin

2010

Curr Psychiatry Rep

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Placebo effects are a potentially inherent element in all treatment responses, and as such, they play a critical role in determining what is "therapeutic." However, the placebo response is also an area of substantial controversy. In the present review, the scientific issues that influence placebo effects are elucidated. The evolution of the concept of placebo and how this has affected its historical importance in therapeutics is considered. The importance of placebo responses in psychiatry and psychotherapy is specifically examined, and recent progress in determining the cognitive and neurobiological bases of placebo effects is reviewed. Finally, it is argued that the placebo response is a cardinal mind-body pathway that promotes salutogenesis and that evidence suggests its relationship to central nervous system activities that are responsible for the concomitant development of positive affects and somatic procedural memories that govern states of mind/body well-being during maternal-infant attachment.

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Propranolol in Schizophrenia: A Double Blind, Placebo Controlled Trial of Propranolol as an Adjunct to Neuroleptic Medication

Cited by 38 publications

References 18 publications

Novel approaches to the pharmacotherapy of schizophrenia

Novel approaches to the pharmacotherapy of schizophrenia

Pharmacological Management of Persistent Hostility and Aggression in Persons With Schizophrenia Spectrum Disorders: A Systematic Review

Placebo Response: A Consideration of its Role in Therapeutics

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