Effects of selective beta-adrenoceptor blockade on anxiety associated with flight phobia

The present study is aimed at studying the effects of selective beta-adrenoceptor blockade on anxiety in subjects with flight phobia. Using an incomplete block design subjects received a beta-1 (atenolol 2 x 50 mg), a beta-2 (ICI 118 551 3 x 50 mg) selective blocking drug, or placebo on three occasions over a 16 h period under double-blind conditions prior to a 1/2 h flight. The same procedure was repeated 4 weeks later. Thirty-four subjects completed this double-blind, two-period crossover study. Self-reporting by the Alderley Park State Anxiety Questionnaire, Global Flight Anxiety and Treatment Preference showed a moderate but significant effect of atenolol in alleviating especially somatic symptoms of flight anxiety in addition to an overall effect in the treatment of this entity (p<0.01). ICI 118 551 was ineffective in alleviating any of the important symptoms of flight phobia. These results may imply that the effect of beta-adrenoceptor blockade in reducing phobic anxiety may be more a result of beta-1 than of beta-2 blockade. Beta-1 adrenoceptor blockade may be an alternative treatment of flight phobia, particularly when the symptoms are of somatic character and when intellectual performance is expected shortly after the flight.