beta-adrenergic blocking drugs in psychiatry: present status, future approaches and research

Clinical trials with propranolol were performed in 44 carefully selected psychiatric patients. Propranolol was administered in 8 equal doses over 24 hours and increased at a daily rate of 400 mg. Treatment was monitored by patient's reactions and by periodic examination of pulse rate and blood pressure. Results showed marked to moderate improvement, often within 24 to 48 hours, in two-thirds of the patients treated. Concurrent with stabilization of heart rate and blood pressure at about 60/min and 90/60 mm Hg respectively, improvement was noted in anxiety, psychomotor hyperactivity, thought process disturbance, hallucinations, and disturbances in affect. Our studies and those of other investigators indicate that propranolol and oxprenolol, and possibly other beta-adrenoceptor blocking drugs, may have a beneficial influence on psychotic syndromes. Further well-controlled clinical trials seem warranted. Indications for use, dosages, and combinations with other drugs, mainly phenothiazines, must be delineated. Laboratory investigations may add considerably in these respects ans may lead to safe treatment regimes with minimal side effects.