Effects of propranolol on conversational reciprocity in autism spectrum disorder: a pilot, double-blind, single-dose psychopharmacological challenge study
Pharmacological intervention for autism spectrum disorder (ASD) is an important addition to treatment, yet currently available agents target co-morbid psychiatric concerns, such as aggression and irritability. Propranolol, a beta-adrenergic antagonist with anxiolytic effects, has been shown to improve verbal fluency and working memory in adults and adolescents with ASD in single-dose challenges.
The present pilot study explores the acute effects of propranolol on a measure of conversational reciprocity in this population. We also examined whether autonomic activity and anxiety moderate or mediate response to the drug, given relationships between these variables and ASD, as well as the drug’s effects.
In a within-subject crossover design, 20 individuals with ASD received a single dose of propranolol or placebo during two sessions in a double-blinded, counterbalanced manner. After drug administration, participants performed a conversational reciprocity task by engaging in a short conversation with the researcher. Measurements of autonomic activity and anxiety were obtained before and after drug administration.
Propranolol significantly improved performance on the conversational reciprocity task total [d = 0.40] and nonverbal communication domain scores when compared to the placebo condition. However, neither autonomic activity nor anxiety was significantly associated with drug response.
Acute propranolol administration improved conversational reciprocity in ASD. Further exploration of these preliminary findings, as well as other potential treatment response predictors, with serial doses is warranted.
KeywordsAutism Propranolol Conversational reciprocity Noradrenergic Autonomic Anxiety
The study was supported by a grant from the Health Resources and Services Administration (1R40MC19926). We thank our many research assistants for their help with data collection and Nicole Takahashi and Jill Akers at the University of Missouri Thompson Center for Autism and Neurodevelopmental Disorders for their assistance with recruitment. We are grateful to all participants and their families who participated in this study. The experiments presented in this manuscript comply with the current US laws. This study was supported in part by the Center for Cognitive Aging and Memory at the University of Florida, the McKnight Brain Research Foundation.
Compliance with ethical standards
Conflict of interest
All authors declare no conflict of interest related to the present study.
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