Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-22T16:50:01.332Z Has data issue: false hasContentIssue false

Propranolol in Schizophrenia: A Double Blind, Placebo Controlled Trial of Propranolol as an Adjunct to Neuroleptic Medication

Published online by Cambridge University Press:  29 January 2018

C. R. Pugh
Affiliation:
Shenley Hospital, Radlett, Hertfordshire
J. Steinert
Affiliation:
St Bernard's Hospital, Uxbridge Road, Southall, Middlesex, UB1 3EU
R. G. Priest
Affiliation:
Academic Department of Psychiatry, St Mary's Hospital, Harrow Road, London, W9 3RL

Summary

A double blind, placebo controlled trial was carried out to examine the contribution of propranolol as an adjunct to neuroleptic medication in the treatment of chronic schizophrenic patients whose florid symptoms had not remitted with neuroleptic medication alone. Propranolol was shown to have a more beneficial effect than placebo, but the results were much less dramatic than those which have been described in previous studies. Recent work has shown that there may be a pharmacokinetic interaction between propranolol and neuroleptics, and this should be considered as one possible explanation of our findings.

Type
Research Article
Copyright
Copyright © 1983 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Asberg, M., Montgomery, S. A., Perris, C., Schalling, D. & Sedvall, G. (1978) The Comprehensive Psycho-pathological Rating Scale. Acta Psychiatrica Scandinavica, 271 (Suppl), 5.CrossRefGoogle Scholar
Atsmon, A., Blum, I., Wijsenbeek, H., Maoz, B., Steiner, M. & Ziegelman, G. (1971) The short term effects of adrenergic blocking agents in a small group of psychotic patients. Psychiatrica Neurologia Neurochirurgia, 74, 251–8.Google Scholar
Conway, J., Greenwood, D. T. & Middlemiss, D. M. (1978) Central nervous actions of beta-adrenoreceptor antagonists. Clinical Science and Molecular Medicine, 54, 18.Google ScholarPubMed
Elizure, A., Segal, Z., Yeret, A., Davidson, S. & Ben-David, M. (1978) Antipsychotic activity and mode of action of propranolol versus neuroleptic drugs. Israel Journal of Medical Science, 14, 493–4.Google Scholar
Feighner, J. P., Robins, E., Guze, S. B., Woodruff, R. A., Winokur, G. & Munoz, R. (1972) Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry, 26, 5763.CrossRefGoogle ScholarPubMed
Gardos, G. (1973) CNS effects of propranolol in man. Psychopharmacologia, 29, 299306.Google Scholar
Gershon, E. S., Goldstein, R. E., Moss, A. J. & Kammen, D. P. (1979) Psychosis with ordinary doses of propranolol. Annals of Internal Medicine, 90, 938–9.CrossRefGoogle ScholarPubMed
Gruzeuer, J., Thornton, S., Staniforth, D., Zaki, S. & Yorkston, N. (1980) Active and passive avoidance learning in controls and schizophrenic patients on racemic propranolol and neuroleptics. British Journal of Psychiatry, 137, 131–7.Google Scholar
Honigfeld, D. G. (1973) NOSIE 30: history and current status of its use in pharmacopsychiatric research. In Modern Problems in Pharmacopsychiatry: Psychological Measurement (ed. Pichot, P.). Basle: Karger.Google Scholar
Honigfeld, D. 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, 6571.3.0.CO;2-I>CrossRefGoogle Scholar
Kendall, M. G. (1962) Rank Correlation Methods. London: Griffin.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, 458–68.CrossRefGoogle ScholarPubMed
Laverty, R. & Taylor, K. M. (1968) Propranolol uptake into the central nervous system and the effect on rat behaviour and amine metabolism. Journal of Pharmacy and Pharmacology, 20, 605–9.Google ScholarPubMed
Lindström, L. H. & Persson, E. (1980) Propranolol in chronic schizophrenia: a controlled study in neuroleptic treated patients. British Journal of Psychiatry, 137, 126–30.CrossRefGoogle ScholarPubMed
Middlemiss, D. N., Blakeborough, L. & Leather, S. R. (1977) Direct evidence for an interaction of beta-adrenergic blockers with the 5 HT receptor. Nature, 267, 289–90.CrossRefGoogle Scholar
Montgomery, S. A. & Montgomery, D. B. (1980) Measurement of change in psychiatric illness: new obsessional, schizophrenia, and depression scales. Postgraduate Medical Journal, 56 (Suppl 1), 50–2.Google ScholarPubMed
Myers, D. H., Campbell, P. L., Cocks, N. M., Flowerdew, J. A. & Muir, A. (1981) A trial of propranolol in chronic schizophrenia. British Journal of Psychiatry, 139, 118–21.CrossRefGoogle ScholarPubMed
Overall, J. E. & Gorham, D. R. (1962) The Brief Psychiatric Rating Scale (BPRS). Psychological Reports, 10, 799812.CrossRefGoogle Scholar
Peet, M., Middlemiss, D. N. & Yates, R. A. (1980) Pharmacokinetic interaction between propranolol and chlorpromazine in schizophrenic patients. Lancet, 2, 978.CrossRefGoogle ScholarPubMed
Peet, M., Bethell, M. S., Coates, A., Khamnee, A. K., Hall, P., Cooper, S. J., King, D. J. & Yates, R. A. (1981) Propranolol in schizophrenia: I. Comparison of propranolol, chlorpromazine, and placebo. British Journal of Psychiatry, 139, 105–11.CrossRefGoogle ScholarPubMed
Peet, M., Middlemiss, D. N. & Yates, R. A. (1981) Propranolol in schizophrenia: II. Clinical and biochemical aspects of combining propranolol with chlorpromazine. British Journal of Psychiatry, 139, 112–17.CrossRefGoogle ScholarPubMed
Philip, A. E. (1979) Prediction of successful rehabilitation by nurse rating scale. British Journal of Psychiatry, 134, 422–6.CrossRefGoogle ScholarPubMed
Shepherd, G. P. (1979) High dose propranolol in schizophrenia. British Journal of Psychiatry, 134, 470–6.Google Scholar
Steinert, J. & Pugh, C. R. (1979) Two patients with schizophrenic-like psychosis after treatment with beta-adrenergic blockers. British Medical Journal, i, 790.CrossRefGoogle Scholar
Van Zerssen, D. (1976) Beta-adrenergic blocking agents in the treatment of psychoses. Advances in Clinical Pharmacology, 12, 105–14.Google Scholar
Whitlock, F. A. & Bonfield, A. R. (1980) Propranolol psychosis. Medical Journal of Australia, 1, 184–5.Google ScholarPubMed
Wing, J. R., Cooper, J. E. & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms. London: Cambridge University Press.Google Scholar
Yorkston, N. Z., Zaki, S. A., Malik, M. K. U., Morrison, R. C. & Havard, C. W. H. (1974) Propranolol and the control of schizophrenic symptoms. British Medical Journal, iv, 633–5.Google Scholar
Yorkston, N. Z., Zaki, S. A., Themen, J. F. A. & Havard, C. W. H. (1976) Propranolol to control schizophrenic symptoms: 55 patients. Advances in Clinical Pharmacology, 12, 91104.Google Scholar
Yorkston, N. Z., Gruzelier, J. H., Zaki, S. A., Hollander, D., Pitcher, D. & Sergeant, H. S. (1977) Propranolol as an adjunct to the treatment of schizophrenia. Lancet, i, 575–8.Google Scholar
Yorkston, N. Z., Zaki, S. A., Weller, M. P., Gruzelier, J. H. & Hirsch, S. R. (1981) DL-propranolol and chlorpromazine following admission for schizophrenia. Acta Psychiatrica Scandinavica, 63, 1327.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.