Propranolol in the treatment of alchoholism: a review

In the withdrawal phase of chronic alcoholism, hyperkinetic circulation, characterized by increased cardiac output, is the rule. Even in alcoholics who have been sober for a long time, increased cardiac output is very common and these changes are similar to those seen in some patients with labile hypertension. This could be caused by psychic tension. In the withdrawal phase propranolol was found to normalize the circulation and to reverse the decreased peripheral vascular resistance. We observed that the patients seemed to be calm after 40 mg of propranolol by mouth. In a double blind study of propranolol and placebo this effect was confirmed and in another study 120 mg of propranolol a day was compared to 30 mg of diazepam a day (double-blind, crossover). Using different psychological methods all significant differences are in favour of propranolol. The findings are in agreement with other reports. It is our clinical impression that propranolol is a useful drug for psychic tension symptoms in chronic alcoholism. Very few side effects have been found.