Propranolol in schizophrenia. Clinical, metabolic, and pharmacological findings

Six schizophrenic patients received propranolol hydrochloride to evaluate pharmacological, endocrinological, and antipsychotic properties of the drug. They had previously been unsuccessfully treated with phenothiazines. After a drug-free period of two weeks, propranolol was administered in gradually increasing doses. After two to four weeks, a low dose of phenothiazines was added. The clinical effect was evaluated using the Comprehensive Psychopathological Rating Scale. Three of the six patients showed a definite improvement with propranolol therapy given as a sole treatment. Propranolol in plasma was positively correlated to dosage. The proportion of its major metabolite, 4-hydroxy-propranolol, decreased with increasing drug dose. Melatonin and prolactin levels in serum decreased noticeably with propranolol treatment. When phenothiazines were added, prolactin increased above drug-free levels. These results support the view that propranolol has an antipsychotic potential that needs further evaluation in clinical trials.