Skip to main content
SpringerLink
Log in

Use of β-Adrenergic Receptor Blocking Drugs in Psychiatry

  • Review Article
  • Published:
Drugs Aims and scope Submit manuscript

Summary

On the evidence surveyed it is difficult to reach clear-cut conclusions about the value of propranolol or other β-blocking drugs in psychiatry. Studies on anxiety for the most part have been of relatively short duration and, although some workers have claimed benefits for propranolol administration, more recent and better controlled trials have failed to demonstrate advantages over placebo treatment. The possibility remains that control of the autonomic symptoms associated with anxiety to some degree diminishes the patient’s distress in the face of an unpleasant affect. Hence there may be merit in the opinion that the autonomic symptoms appear to act as signals which are interpreted as warnings of impending danger. Such activation in its turn results in the psychological experience of anxiety. Hence, in this group of patients at least, control of the autonomie 1 See subject index in each issue for further indexing terms. symptoms should minimise the extent to which anxiety, as a psychological disturbance, is felt.

In other forms of psychiatric disorder, the evidence is less convincing. There is no reason to believe that patients with chronic psychoses will benefit and the effects of propranolol in the treatment of alcoholism appear to be short-lived, although longer trials are clearly warranted. The finding that the drug appears to block the actions of opiates is of considerable interest and one can but hope that more extensive testing of propranolol with narcotic-dependent patients will be carried out. In healthy subjects, propranolol appears to be a relatively safe drug, but its use for the control of hypertension and cardiac symptoms in patients who have experienced former depressive illnesses should probably be strictly limited. Transitory hallucinosis and toxic confusional states have been recorded. They appear to be dose-related and subside when the drug is withdrawn. There appears to be a use for propranolol in the treatment of. lithium-induced tremor and overdosage with tricyclic antidepressants.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Ahlquist, R.P.: A study of the adrenotropic receptors. American Journal of Physiology 153: 568 (1948).

    Google Scholar 

  • Atsmon, A.; Blum, I.; Steiner, M.; Latz, A. and Wijsen-biek, H.: Further studies with propranolol in psychotic patients. Psychopharmacologia 27: 249 (1972).

    Article  PubMed  CAS  Google Scholar 

  • Balla, J.I.: Treatment of essential tremor with propranolol. Lancet 7: 205 (1973).

    Article  Google Scholar 

  • Black, J.W.; Crowther, A.F.; Shanks, R.G., Smith, L.H. and Dornhorst, A.C.: A new adrenergic beta-receptor antagonist. Lancet 7: 1080 (1964).

    Article  Google Scholar 

  • Boakes, A.J. and Boeree, B.H.: Suicidal attempts with beta-adrenoceptor blocking agents. British Medical Journal 4: 675(1973).

    Article  PubMed  CAS  Google Scholar 

  • Bonn, J.A. and Turner, P.: D-Propranolol and anxiety. Lancet 7: 1355(1971).

    Article  Google Scholar 

  • Bonn, J.A.; Turner, P. and Hicks, D.C.: Beta-adrenergic receptor blockade with proctolol in treatment of anxiety. Lancet 1: 814 (1972).

    Article  PubMed  CAS  Google Scholar 

  • Breggin, P.B.: The psychophysiology of anxiety. Journal of Nervous and Mental Disease 139: 558 (1964).

    Article  PubMed  CAS  Google Scholar 

  • Brewer, C.: Beneficial effect of beta-adrenergic blockade on examination nerves. Lancet 2: 435 (1972).

    Article  PubMed  CAS  Google Scholar 

  • Cannon, W.B.: The James-Lange theory of emotions: a critical examination and an alternative theory. American Journal of Psychology 39: 106 (1927).

    Article  Google Scholar 

  • Carlsson, C. and Johansson, T.: The psychological effects of propranolol in the abstinence phase of chronic alcoholics. British Journal of Psychiatry 119: 605 (1971).

    Article  PubMed  CAS  Google Scholar 

  • Geghorn, J.M.; Peterfy, G.; Pinter, E.G. and Patteen, C.J.: Verbal anxiety and beta-adrenergic receptors: A facilitating mechanism? Journal of Nervous & Mental Disease 151: 266 (1970).

    Article  Google Scholar 

  • Corbett, J.L.; Eidelman, B.H. and Debarge, O.: Modification of cerebral vasoconstriction with hyperventilation in normal man with thymoxamine. Lancet 2: 461 (1972).

    Article  PubMed  CAS  Google Scholar 

  • Crown, S. and Crisp, A.H.: A short clinical self-rating scale for psychoneurotic patients. British Journal of Psychiatry 112:917(1966).

    Article  PubMed  CAS  Google Scholar 

  • Dale, H.H.: On some physiological actions of ergot. Journal of Physiology 34: 163 (1906).

    PubMed  Google Scholar 

  • Davis, J.N.: Increased beta-receptor responsiveness, central or peripheral? Archives of Internal Medicine 123: 101 (1969).

    Article  PubMed  CAS  Google Scholar 

  • De Fudis, F. V. and Grosz, H.J.: Effects of propranolol on the binding of (14C) morphine to particulate fractions in mouse brain. Brain Research 47: 510 (1972).

    Article  Google Scholar 

  • Drew, L.R.H.; Moon, J.R. and Buchanan, F.H.: Inderal (propranolol) in the treatment of alocholism. Medical Journal of Australia 2: 282 (1973).

    PubMed  CAS  Google Scholar 

  • Drew, W.G.; Kiplinger, C.L.; Miller, L.L. and Marx, M.: Effects of propranolol on marihuana-induced cognitive dysfunctioning. Clinical Pharmacology and Therapeutics 13: 526(1972).

    PubMed  CAS  Google Scholar 

  • Duncan, R.J.S.: The inhibition of alcohol and aldehyde dehydrogenases by propranolol. Molecular Pharmacology 9: 191 (1973).

    PubMed  CAS  Google Scholar 

  • Editorial: Benign essential tremor. Lancet 2: 471 (1972).

  • Editorial: Beta-blockade for withdrawal symptoms? Lancet 2: 650 (1973).

  • Fitzgerald, J.D.: Propranolol-induced depression. British Medical Journal 2: 372 (1967).

    Article  PubMed  CAS  Google Scholar 

  • Floru, L.: Clinical attempts at treating lithium-induced tremor by administration of beta-receptor blockers — propranolol. International Pharmacopsychiatry 6: 197(1971).

    PubMed  CAS  Google Scholar 

  • Freeman, J.W. and Loughead, M.G.: Beta-blockade in the treatment of tricyclic antidepressant overdose. Medical Journal of Australia 1: 1233 (1973).

    PubMed  CAS  Google Scholar 

  • Frohlich, E.D.; Dunstan, H.P. and Page, I.H.: Hyperdynamic beta-adrenergic circulatory state. Archives of Internal Medicine 117: 614 (1966).

    Article  PubMed  CAS  Google Scholar 

  • Frohlich, E.D.; Tarazi, R.C. and Dunstan, H.P.: Hyperdynamic beta-adrenergic circulatory state. Archives of Internal Medicine 123: 1 (1969).

    Article  PubMed  CAS  Google Scholar 

  • Gallant, D.M.; Swanson, W.C. and Guerrero-Figueroa, R.: A controlled evaluation of propranolol in chronic alcoholic patients presenting with symptomatology of anxiety and tension. Journal of Clinical Pharmacology and Journal of New Drugs 13: 41 (1973).

    CAS  Google Scholar 

  • Gardos, G.; Cole, J.O.; Volicer, L.; Orzack, M.H. and Oliff, A.C.: A dose-response study of propranolol in chronic schizophrenics. Current Therapeutic Research 15: 314 (1973).

    PubMed  CAS  Google Scholar 

  • Granville-Grossman, K.L. and Turner, P.: The effect of propranolol on anxiety. Lancet 7: 788 (1966).

    Article  Google Scholar 

  • Grosz, H.J.: Narcotic withdrawal symptoms in heroin users treated with propranolol. Lancet 2: 564 (1972).

    Article  PubMed  CAS  Google Scholar 

  • Grosz, H.J.: Effect of propranolol on active users of heroin. Lancet 2: 612 (1973).

    Article  PubMed  CAS  Google Scholar 

  • Herman, Z.S.: Influence of some psychotropic and adrenergic-blocking agents upon amphetamine stereotyped behaviour in white rats. Psychopharmacologia 77: 136(1967).

    Article  Google Scholar 

  • Hinsheiwood, R.D.: Hallucinations and propranolol. British Medical Journal 2: 445 (1969).

    Article  Google Scholar 

  • Jönsson, L.E.: Pharmacological blockade of amphetamine effects in amphetamine dependent subjects. European Journal of Clinical Pharmacology 4: 206 (1972).

    Article  Google Scholar 

  • Kirk, L.; Baastrup, P.C. and Schou, M.: Propranolol and lithium-induced tremor. Lancet 7: 839 (1972).

    Article  Google Scholar 

  • Kirk, L.; Baastrup, P.C. and Schou, M.: Propranolol treatment of lithium-induced tremor. Lancet 2: 1086 (1973).

    Article  PubMed  CAS  Google Scholar 

  • Lader, M.H. and Tyrer, P.: Central and peripheral effects of propranolol and sotalol in normal human subjects. British Journal of Pharmacology 45: 557 (1972).

    Article  PubMed  CAS  Google Scholar 

  • Lader, M.H. and Wing, L.: Physiological measures, sedative drugs and morbid anxiety. Maudsley Monograph 14 (Oxford University Press, London 1966).

    Google Scholar 

  • Lange, C.G. and James, W.: The Emotions (Williams and Wilkins, Baltimore 1922).

    Google Scholar 

  • Langley, J.N.: On the reaction of cells and of nerve-endings to certain poisons, chiefly as regards the reaction of striated muscle to nicotine and curare. Journal of Physiology 33: 374 (1905).

    PubMed  Google Scholar 

  • Laverty, R. and Taylor, K.M.: Propranolol uptake into the central nervous system and the effect on rate behaviour and amine metabolism. Journal of Pharmacy and Pharmacology 20: 605 (1968).

    Article  PubMed  CAS  Google Scholar 

  • Leszkovszky, G. and Tardos, L.: Some effects of propranolol on the central nervous system. Journal of Pharmacy and Pharmacology 17: 518 (1965).

    Article  PubMed  CAS  Google Scholar 

  • Linken, A.: Propranolol for L.S.D.-induced anxiety states. Lancet 2: 1039(1971).

    Article  PubMed  CAS  Google Scholar 

  • Lowenstein, H.: Propranolol as a psychotropic agent. Lancet 7: 559 (1973).

    Article  Google Scholar 

  • McMillin, W.P.: Oxprenolol in anxiety. Lancet 7: 1193 (1973).

    Article  Google Scholar 

  • Morgan, M.H.; Hewer, R.L. and Cooper, R.: Effect of the beta adrenergic blocking agent propranolol on essential tremor. Journal of Neurology, Neurosurgery and Psychiatry 36: 618 (1973).

    Article  CAS  Google Scholar 

  • Mortz, R.; Brown, DJ.; Forney, R.B.; Bright, T.P.; Kiplinger, G.F. and Rodda, B.E.: Propranolol antagonism of marihuana-induced tachycardia. Life Science 11:999(1972).

    Article  Google Scholar 

  • Orzack, M.H. and Branconnier, R.: CNS effects of propranolol in man. Psychopharmacologia 29: 299 (1973).

    Article  PubMed  CAS  Google Scholar 

  • Prichard, B.N.C. and Gillam, P.M.S.: Use of propranolol (Inderal) in the treatment of hypertension. British Medical Journal 2: 725 (1964).

    Article  PubMed  CAS  Google Scholar 

  • Ramsay, I.; Greer, S. and Bagley, C.: Propranolol in neurotic and thyrotoxic anxiety. British Journal of Psychiatry 122: 555 (1973).

    Article  PubMed  CAS  Google Scholar 

  • Scales, B. and Cosgrove, M.B.: The metabolism and distribution of the selective adrenergic beta blocking agent, practolol. Journal of Pharmacology and Experimental Therapeutics 175: 338 (1970).

    PubMed  CAS  Google Scholar 

  • Shee, J.C. and Rajput, AM.: Propranolol in essential tremor. Lancet 1: 1117 (1972).

    Article  Google Scholar 

  • Simon, P.; Chermat, R.; Fosset, M.T. and Boissier, J.R.: Beta-adrenergic blocking agents and amphetamine or apomorphine induced stereotyped behaviour in rats. Psychopharmacologia 23: 357 (1972).

    Article  PubMed  CAS  Google Scholar 

  • Stephen, S.A.: Unwanted effects of propranolol. American Journal of Cardiology 18: 463 (1966).

    Article  PubMed  CAS  Google Scholar 

  • Sullivan, J.L.; Segal, D.S.; Kuczenski, R.T. and Mandell, A.J.: Propranolol-induced rapid activation of rat striatal tyrosine hydroxylase concomitant with behavioural depression. Biological Psychiatry 4: 193 (1972).

    PubMed  CAS  Google Scholar 

  • Suzman, M.M.: The use of beta-adrenergic blockade with Propranolol in anxiety syndromes. Postgraduate Medical Journal 47 (Suppl.): 104 (1971).

    Google Scholar 

  • Tyrer, P.J.: Propranolol in alcohol addiction. Lancet 2: 707(1972).

    Article  PubMed  CAS  Google Scholar 

  • Tyrer, P.J. and Lader, M.H.: Beta-adrenergic blockade in the treatment of anxiety. Lancet 2: 542 (1972).

    Article  PubMed  CAS  Google Scholar 

  • Tyrer, P.J. and Lader, MM.: Effect of beta-adrenergic blockade with sotalol in chronic anxiety. Clinical Pharmacology and Therapeutics 14: 418 (1973).

    PubMed  CAS  Google Scholar 

  • Voltolina, E.J.; Thompson, S.I. and Tissue, J.: Acute organic brain syndrome with propranolol. Clinical Toxicology 4:357 (1971).

    Article  PubMed  CAS  Google Scholar 

  • Waal, H.J.: Propranolol-induced depression. British Medical Journal 2: 50 (1967).

    Article  PubMed  CAS  Google Scholar 

  • Wheatley, D.: Comparative effect of propranolol and chlordiazepoxide in anxiety states. British Journal of Psychiatry 775: 1411 (1969).

    Article  Google Scholar 

  • Zeft, H.J.; Patterson, S. and Orgain, E.S.: The effect of propranolol on the long-term treatment of angina pectoris. Archives of Internal Medicine 124: 578 (1969).

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry, University of Queensland, Clinical Sciences Building, Royal Brisbane Hospital, Brisbane, Qld, 4029, Australia

    F. A. Whitlock &  J. Price

Authors
  1. F. A. Whitlock
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. Price
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

See subject index in this issue for further indexing terms.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Whitlock, F.A., Price, J. Use of β-Adrenergic Receptor Blocking Drugs in Psychiatry. Drugs 8, 109–124 (1974). https://doi.org/10.2165/00003495-197408020-00004

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00003495-197408020-00004

Key Words

Search

Navigation