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Psychosis with propranolol: still not recognized?

J G Cunnane1, G W Blackwood

  • 1Department of Psychiatry, St. James' University Hospital, Leeds, UK.

Postgraduate Medical Journal
|January 1, 1987
PubMed
Summary

Propranolol, a common beta-blocker, can cause psychiatric side effects like hallucinations and depression, even at recommended doses. Careful monitoring is crucial after discontinuing propranolol due to potential for recurring symptoms.

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Area of Science:

  • Psychiatry
  • Pharmacology
  • Neuroscience

Background:

  • Propranolol is a widely prescribed beta-adrenergic receptor antagonist.
  • Its known side effects include central nervous system effects.
  • Psychiatric adverse events necessitate careful consideration in clinical practice.

Observation:

  • A 21-year-old male experienced hallucinations, personality changes, and severe depression after an increase in oral propranolol dosage.
  • Symptoms significantly improved upon drug discontinuation.
  • Recurrent depressive symptoms and suicidal impulses emerged later, resolving spontaneously.

Findings:

  • The case highlights a potential link between propranolol use and significant psychiatric disturbances.
  • Psychiatric symptoms may manifest or recur even after the drug is stopped.
  • Recommended dosage levels did not preclude adverse psychiatric reactions.

Implications:

  • Clinicians must maintain vigilance for psychiatric side effects associated with propranolol.
  • Extended observation post-discontinuation is warranted to detect potential symptom recurrence.
  • This case underscores the importance of individualized patient monitoring for beta-blocker therapy.

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