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Does Propranolol have an Antipsychotic Effect?

A Placebo-Controlled Study in Acute Schizophrenia

Published online by Cambridge University Press:  29 January 2018

Rahul Manchanda
Affiliation:
Academic Department of Psychiatry at Charing Cross & Westminster Medical School; University of Western Ontario; St. Thomas Psychiatric Hospital, P.O. Box 2004, St. Thomas, Ontario, Canada, 1ND5 3V9
Steven R. Hirsch*
Affiliation:
Charing Cross Hospital Medical School, Fulham Palace Road, London, W6 8RF
*
Correspondence.

Abstract

Thirty-six acute schizophrenics were randomly assigned to dextro (d)-propranolol or placebo in a double blind trial lasting four weeks. All patients had a fixed dose of haloperidol during the first week, which resulted in an initial improvement in both groups. Thereafter, a deterioration towards base-line was seen. Six patients on placebo, but none on propranolol were treatment failures at the end of three weeks (P < 0.001). Comparison of change in scores from week 2 to 4 showed significantly greater deterioration in the placebo group; d-propranolol thus had a better effect than placebo in sustaining the initial improvement with haloperidol. The overall magnitude of clinical change from pre-treatment scores is small, the majority of the patients showing little or no overall improvement. It is concluded that d-propranolol has a detectable therapeutic effect, which by inference must have a novel pharmacological basis, but this is not as potent as standard neuroleptics.

Type
Papers
Copyright
Copyright © 1986 The Royal College of Psychiatrists 

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References

Åsberg, M., Montgomery, S. A., Perris, C., Schalung, D. & Sedvall, G. (1978) The comprehensive psychopathological rating scale. Acta Psychiatrica Scandinavica Supplement, 271, 527.Google Scholar
Atsmon, A. & Blum, J. (1970) Treatment of acute porphyria variegata with propranolol. Lancet, i, 196197.Google Scholar
Atsmon, A., Blum, I., Wusenbeck, H., Maoz, B., Steiner, M. & Ztegelman, G. (1971) The short term effects of adrenergic blocking agents in a small group of psychotic patients. Preliminary clinical observations. Psychiatria, Neurologica, Neurochirurgia. 74, 251258.Google Scholar
Creese, I., Burt, D. R. & Snyder, S. H. (1978) Neuroleptics and schizophrenia. In Handbook of Psychopharmacology. Vol. 10 (eds.) Iverson, L. L., Iverson, S. D. & Snyder, S. H., New York: Plenum.Google Scholar
Davis, J. M. & Garver, D. L. (1978) Neuroleptics: clinical use in psychiatry. In Handbook of Psychopharmacology, Vol. 10 (eds). Iverson, L. L., New York: Plenum.Google Scholar
Emrich, H. M., Zerssen, D. V., Moller, H. J., Kissling, W., Cording, C., Schtetsch, E. & Riedel, J. (1979) Action of propranol in mania: comparison of effects of the d- and the 1-stereoisomer. Pharmakopsychiatry and Neuropsychopharmacology, 12, 295304.Google Scholar
Green, A. R. & Grahame-Smith, D. G. (1976) Propranolol inhibits the behavioural responses of rats to increase 5HT in the central nervous system. Nature, 262, 594596.Google Scholar
Gruzelier, J. H., Hirsch, S. R., Weller, M. P. I. & Murphy, C. (1979) Influence of d- or dl-propranolol and chlorpramzine on habituation of phasic electrodermal responses in schizophrenia. Acta Psychiatrica Scandinavica, 60, 241248.Google Scholar
Hanssen, T., Heyden, T., Sundberg, I., Alfredsson, G., Nyback, H. & Wetterberg, L. (1980) Propranolol in Schizophrenia: clinical, metabolic and pharmacological findings. Archives of General Psychiatry, 37, 685690.Google Scholar
Hirsch, S. R., Manchanda, R. & Weller, M. P. I. (1980) Dextro-propranolol in schizophrenia. Progress in Neuro-Psychopharmacology, 4, 633637.Google Scholar
Honigfeld, G. & Klett, C. (1965) The nurses observation scale for inpatient evaluation (NOSIE): a new scale for measuring improvement in chronic schizophrenia. Journal of Clinical Psychology, 21, 6571.Google Scholar
King, D. J., Turkson, S. M., Liddle, J. & Kinney, C. D. (1980) Some clinical and metabolic aspects of propranolol in chronic schizophrenia. British Journal of Psychiatry, 137, 458468.Google Scholar
Krawiecka, M., Goldberg, D. & Vaughan, M. (1977) A standardized psychiatric assessment scale for rating chronic psychotic patients. Acta Psychiatrica Scandinavica, 55, 299308.Google Scholar
Lindstrom, L. H. & Persson, E. (1980) Propranolol in chronic schizophrenia: a controlled study in neuroleptic treated patients. British Journal of Psychiatry, 137, 126130.Google Scholar
Manchanda, R. & Hirsch, S. R. (1981) (Des-Tyr1)-endorphin in the treatment of schizophrenia. Psychological Medicine, 11, 401404.Google Scholar
Manchanda, R. & Hirsch, S. R. (1986) Rating scales for clinical studies in schizophrenia. In The Pharmacology and Drug Treatment of Schizophrenia. Oxford University Press.Google Scholar
Moller, H. J., Zerssen, D. V., Emrich, H. M., Kissung, W., Cording, C., Schtetsch, H. J. & Riedel, E. (1979) Action of d-propranolol in manic psychoses. Archives of Psychiatry and Neurological Sciences, 227, 301317.Google ScholarPubMed
Myers, D. H., Campbell, P. L., Cocks, N. M., Flowerdew, J. A. Mum, A. (1981) A trial of propranolol in chronic schizophrenia. British Journal of Psychiatry, 139, 118121, 1981.Google Scholar
Overall, J. E. & Gorham, D. R. (1962) The brief psychiatric rating scale. Psychological Reports, 10, 799812.Google Scholar
Peet, M., Bethell, M. S., Coates, A., Khamnee, A. K., Hall, P., Cooper, S. J., King, D. J. & Yates, R. A. (1981a) Propranolol in schizophrenia: comparison of propranolol, chlorpromazine and placebo. British Journal of Psychiatry, 139, 105111.Google Scholar
Hall, P., Middlemiss, D. N. & Yates, R. A. (1981b) Propranolol in schizophrenia: clinical and biochemical aspects of combining propranolol with chlorpramazine. British Journal of Psychiatry, 139, 112117.Google Scholar
Pugh, C. R., Steinart, J. & Priest, R. G. (1983) Propranolol in schizophrenia: a double blind, placebo controlled trial of propranolol as an adjunct to neuroleptic medication. British Journal of Psychiatry, 143, 151155.CrossRefGoogle ScholarPubMed
Shanks, R. C. (1976) The properties of beta adrenoreceptor antagonists. Post Graduate Medical Journal. Supplement (4), 52, 1420.Google Scholar
Sheppard, G. P. (1979) High dose propranolol in schizophrenia. British Journal of Psychiatry, 134, 470476.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms. London: Cambridge University Press.Google Scholar
Yorkston, N. J., Zakl, S. A., Malik, M. K. U., Morrison, R. C. & Havard, C. W. H. (1974) Propranolol in the control of schizophrenic symptoms. British Medical Journal. 4, 633635.Google Scholar
Yorkston, N. J., Zakl, S. A., Theven, J. F. A., & Havard, C. W. H. (1976) Early observations on the effect of propranolol on psychotic patients. Advances in Clinical Pharmacology, 12, 91104.Google Scholar
Havard, C. W. H., Gruzelier, J. H., Zakl, S. A., Hollander, D., Pitcher, D. R. & Sergeant, H. G. (1977) Propranolol as an adjunct to the treatment of schizophrenia. The Lancet ii, 575578.Google Scholar
Hollander, D., Zakl, S. A., Weller, M. P., Gruzelier, J. H. & Hirsch, S. R. (1981) Dl-propranolol and chlorpromazine following admission for schizophrenia. A controlled comparison. Acta Psychiatrica Scandinavica, 63, 1327.Google Scholar
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