Propranolol in Schizophrenia

Abstract

Fifty-three hospitalized chronic schizophrenic patients were treated with either propranolol, chlorpromazine or placebo in a double-blind randomized trials for up to three months. Propranolol in a usual dose of 640 mg/day, produced marked cardiovascular effects but no improvement in schizophrenic symptomatology relative to placebo. The effects of chlorpromazine were small and inconsistent.

The effect of propranolol on CSF amine metabolites in psychiatric patients.

“…Myers et al (1981), however, failed to find any significant beneficial effect in a similar study. It has been shown to have no value when given alone in a double-blind controlled study of placebo, chlorpromazine or propranolol in 53 chronic schizophrenics (Peet et al, 1981a). Peet et al (1980Peet et al ( , 1981b have further shown that any beneficial effect of propranolol/neuroleptic combinations can be accounted for by a pharmacokinetic interaction leading to elevated neuroleptic plasma levels.…”

The Ethics of Placebo-Controlled Trials

“…That is, although the established drug has been proven to work in other studies, the investigators may have chosen outcome measures that are relatively insensitive, or had them administered by poorly trained staff, or may not have had enough subjects in the trial to demonstrate the difference, or for anyone ofmany other reasons. For example, Peet et al (2) failed to show that either propranolol or chlorpromazine had any effect on symptoms, a result which most probably was the result of insufficient sample size (3). Because only with the use of a placebo control group could we differentiate among these reasons, the Health Protection Branch of Health Canada and the Food and Drug Administration in the US have mandated placebo-controlled trails in testing the effectiveness of any new drug (except when the established drug can prevent death or irreversible injury).…”