Propranolol and central nervous system function: potential implications for paediatric patients with infantile...

Area of Science:

• Pharmacology
• Developmental Pediatrics
• Neurology

Background:

• Propranolol is the primary treatment for infantile haemangioma (IH) due to its favorable safety profile over systemic corticosteroids.
• Evidence suggests propranolol may cause central nervous system (CNS) effects, including impacts on memory, psychomotor function, sleep, and mood, even at low doses.
• The full extent and developmental impact of these CNS effects from propranolol, particularly with prolonged use, remain unclear.

Purpose of the Study:

• To review existing evidence on the central nervous system (CNS) effects of propranolol, with a focus on its use in infantile haemangioma (IH).
• To highlight the potential for subtle or delayed cognitive impairments associated with propranolol therapy.
• To inform clinical practice regarding the cautious and indicated use of propranolol for IH.

Main Methods:

• This is a narrative review synthesizing data from volunteer and patient studies.
• The review examines evidence regarding propranolol's impact on cognitive function, memory, psychomotor skills, sleep, and mood.
• Focus is placed on studies involving propranolol use for infantile haemangioma (IH).

Main Results:

• Propranolol use has been linked to impairments in short- and long-term memory, psychomotor function, sleep quality, and mood.
• These CNS effects can occur with relatively low doses and short treatment durations.
• The magnitude and long-term consequences of these effects, especially in developing infants, are not fully understood and may require specialized cognitive assessments.

Conclusions:

• The potential for central nervous system (CNS) adverse effects necessitates a cautious approach to propranolol treatment for infantile haemangioma (IH).
• Propranolol should be reserved for cases with clear indications such as ulceration, vital function impairment, or risk of disfigurement.
• Treatment duration should be limited, and a careful risk-benefit analysis is crucial before initiating propranolol therapy, considering potential cognitive impacts.