Propranolol for the treatment of anxiety disorders: Systematic review and meta-analysis.
The effects of propranolol in the treatment of anxiety disorders have not been systematically evaluated previously. The aim was to conduct a systematic review and meta-analysis of randomised controlled trials, addressing the efficacy of oral propranolol versus placebo or other medication as a treatment for alleviating either state or trait anxiety in patients suffering from anxiety disorders. Eight studies met the inclusion criteria. These studies concerned panic disorder with or without agoraphobia (four studies, total n = 130), specific phobia (two studies, total n = 37), social phobia (one study, n = 16), and posttraumatic stress disorder (PTSD) (one study, n = 19). Three out of four panic disorder trials qualified for pooled analyses. These meta-analyses found no statistically significant differences between the efficacy of propranolol and benzodiazepines regarding the short-term treatment of panic disorder with or without agoraphobia. Also, no evidence was found for effects of propranolol on PTSD symptom severity through inhibition of memory reconsolidation. In conclusion, the quality of evidence for the efficacy of propranolol at present is insufficient to support the routine use of propranolol in the treatment of any of the anxiety disorders.
Department of Oral and Maxillofacial Surgery, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands s.a.steenen@amc.uva.nl.
Serge A
SA
Steenen
Department of Social Dentistry and Behavioural Sciences, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, the Netherlands.
Arjen J
AJ
van Wijk
Department of Social Dentistry and Behavioural Sciences, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, the Netherlands.
Geert J M G
GJ
van der Heijden
Department of Psychiatry, Erasmus University Medical Centre, Rotterdam, the Netherlands.
Roos
R
van Westrhenen
Department of Oral and Maxillofacial Surgery, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands.
Jan
J
de Lange
Department of Social Dentistry and Behavioural Sciences, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, the Netherlands School of Health Sciences, Salford University, Manchester, UK.
Ad
A
de Jongh
D000284:Administration, Oral; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D011433:Propranolol / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index
D000319:Adrenergic beta-Antagonists; D014151:Anti-Anxiety Agents; D011433:Propranolol
Propranolol; anxiety disorders; meta-analysis; panic disorder