Randomized comparison of atenolol and placebo in the treatment of anxiety: A double-blind study

Saúl, Pablo; Jones, B. P.; Edwards, Karlie; Tweed, Jefferson

doi:10.1007/bf00543722

Cited by 10 publications

(4 citation statements)

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“…In conclusion, bisoprolol was as effective as diazepam in the treatment of cardiac neurosis, but with a more pronounced effect on somatic symptoms related to the beta-adrenergic-mediated hyperdynamic state, which confirms previous observations with other beta blockers, both betal-selective and nonselective [13][14][15][16][17][18][19][20][21][22][23][24][25][28][29][30]. As a result of several reports in the literature, the presence of betal-selectivity, ISA, and lipophilicity do not appear to substantially affect the neuropsychiatric use of beta blockers [18,[28][29][30]41,42].…”

Section: Hamilton Rating Scalessupporting

confidence: 76%

“…As a result of several reports in the literature, the presence of betal-selectivity, ISA, and lipophilicity do not appear to substantially affect the neuropsychiatric use of beta blockers [18,[28][29][30]41,42]. However, the value of betal-selective agents in patients with peripheral vascular disease, obstructive airways disease, diabetes, and hyperlipidemia is well established [43,44].…”

Section: Hamilton Rating Scalesmentioning

confidence: 99%

“…The introduction of beta blockers with a selective action on beta1 receptors can, in addition, allow a safer treatment of patients with cardiac neurosis in the presence of concomitant diseases for which nonselective beta blockers are contraindicated [28][29][30]. Bisoprolol is a new betal-selective beta-blocking agent that is devoid of intrinsic sympathomimetic activity, with high oral bioavailability, that is effective for once-aday administration [31][32][33].…”

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confidence: 99%

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Comparison of bisoprolol and diazepam in the treatment of cardiac neurosis

Fogari

Zoppi

Corradi

et al. 1992

Cardiovasc Drug Ther

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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.

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Section: Hamilton Rating Scalessupporting

confidence: 76%

Section: Hamilton Rating Scalesmentioning

confidence: 99%

mentioning

confidence: 99%

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Comparison of bisoprolol and diazepam in the treatment of cardiac neurosis

Fogari

Zoppi

Corradi

et al. 1992

Cardiovasc Drug Ther

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“…Propranolol(non-cardioselective) did not reduce BZD withdrawal symptoms in BZD-dependent patients over ten weeks (40). Atenolol(cardioselective) ameliorated both the affective and somatic symptoms of anxiety (41). The b-blockers showed a small effect size benefit to lessen somatic symptoms during BZD withdrawal (d 0.107), with a high degree of imprecision (95% CI −0.347-0.562,p= 0.644).…”

Section: Resultsmentioning

confidence: 99%

Pharmacological class interventions for benzodiazepine withdrawal discontinuation: a meta-analysis

Fluyau

Revadigar

Mitra³

et al. 2020

Preprint

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Background Long-term benzodiazepine (BZD) use may lead to dependence, addiction, and neuropsychiatric disturbances. BZD discontinuation can cause severe withdrawal symptoms and resurgence of premorbid conditions. There are guidelines on how to stop BZD if it is necessary. Pharmacological management is an option among several other recommendations, but its benefit remains unclear. The current meta-analysis aims to supplement the existing literature by dividing the pharmacological agents studied for the management of BZD discontinuation into pharmacological classes according to the Neuroscience-based Nomenclature and to investigate whether these classes (e.g., BZD receptor antagonist) are efficient in managing and facilitating BZD withdrawal discontinuation. Methods Data collected from (1985 to 2018) in Google Scholar, Medline Ovid, Scopus, PsychInfo, ClinicalTrials.gov, Cochrane Review Database, Embase, Scopus, Pubmed, and Proquest databases; involved controlled clinical trials on drugs studied for BZD withdrawal discontinuation. Single drugs were clustered into their pharmacological class (domain). The Oxford Quality Scoring System assessed the quality of a trial. The GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) was used for clinical practice recommendations. For publication bias, we visually inspected the Funnel plot. We adopted the Cochrane Risk of Bias Tool to assess biases inherent to individual trials. The standardized mean difference measured the magnitude of the benefit of a pharmacological class. Results We analyzed forty-nine controlled trials of 2815 assigned participants. Of fourteen classes, the BZD receptor antagonist class (d 0.671, CI 0.199 -1.143, p=0.005, I2=0),5-HT1A receptor partial agonist, and the glutamate class seemed to have the potentiality to manage BZD withdrawal discontinuation clinically. Around 61 % of the trials received an Oxford Quality score of three, 86% of the trials were granted a GRADE recommendation low. About 29 trials were at low risk of bias in general. Conclusions Even though we could not prove that the pharmacological classes of drugs we analyzed for the clinical management of BZD withdrawal discontinuation were efficacious, our investigation showed that some of these classes have the potentiality to manage BZD withdrawal discontinuation and clinically facilitate the process when it is necessary, relevant, and recommended based on established guidelines. Further investigations are warranted to support our findings. Keywords: benzodiazepine withdrawal, benzodiazepine discontinuation, benzodiazepine cessation, benzodiazepine dependence.

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Beta-adrenergic blockers in mental retardation and developmental disabilities

Ruedrich

Erhardt

1999

Ment. Retard. Dev. Disabil. Res. Rev.

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Randomized comparison of atenolol and placebo in the treatment of anxiety: A double-blind study

Cited by 10 publications

References 2 publications

Comparison of bisoprolol and diazepam in the treatment of cardiac neurosis

Comparison of bisoprolol and diazepam in the treatment of cardiac neurosis

Pharmacological class interventions for benzodiazepine withdrawal discontinuation: a meta-analysis

Beta-adrenergic blockers in mental retardation and developmental disabilities

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