Beta blockers for aggression: a review of the pediatrie experience.
ABSTRACT beta-Adrenergic blocking agents have been used successfully to treat intractable aggression in adult psychiatric patients. A review of the adult literature and a summary of the pediatrie treatment experience are presented. There are no double-blind placebo-controlled studies in child or adolescent psychiatric patients. Open studies have reported high improvement rates (75-85%), but actual improvement rates may be lower than the generally uncontrolled reports in the literature suggest to date. Future controlled studies should take advantage of statistical methods that allow determination of meaningful changes within subjects in addition to the more typically analyzed changes within groups. Though these medications may be effective as adjunctive treatments in a multidisciplinary approach to aggression, beta blockers cannot at present be considered to be indicated in the treatment of any child or adolescent psychiatric disorder. There is not enough available information to know whether aggression that is associated with any specific psychiatric diagnosis is predictive of response to beta blockers in children or adolescents, and no other predictors of treatment response have been consistently identified. Judging from the experience in adults, treatment duration may be more important than dose level in attaining a therapeutic response with beta blockers. Empirical clinical and research trials of beta blockers for psychiatric symptoms or disorders should probably be run for a minimum of 12 weeks.
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