The Role of ??-Adrenoceptor Blockers in the Treatment of Psychiatric Disorders

Abstract

Although β-adrenoceptor blockers (in particular, propranolol) have been used in the treatment of psychiatric disorders for many years, their indications, extent of efficacy and place in therapy remain unclear. This overview assess the published reports on the use of these drugs in psychiatric disorders. It can be concluded that β-adrenoceptor blockers may be helpful in the management of some forms of anxiety disorders, including performance anxiety and other types of situational anxiety, especially when somatic symptoms are prominent. In the same way, alcohol (ethanol) withdrawal syndrome of moderate severity, antipsychotic-induced akathisia and lithium-induced tremor seem to be responsive to this drug class. Because of the fact that they are well tolerated, the use of β-adrenoceptor blockers in these disorders should be considered whenever drug treatment is being contemplated. In contrast, the efficacy of high doses of β-adrenoceptor blockers in schizophrenia remains unestablished. However, they may be of benefit in some patients presenting with aggressive behaviour due to organic brain disease. Studies have shown a high rate of improvement in this condition, especially in patients who have previously failed to respond to other treatments. Finally, preliminary results suggest that β-adrenoceptor blockers may be useful as adjunctive medication in the treatment of depression and chronic anxiety, but further investigations are needed in these areas of patient management.