title: Effects of propranolol on conversational reciprocity in autism spectrum disorder: a pilot, double-blind, single-dose psychopharmacological challenge study.
abstract: BACKGROUND
  Pharmacological intervention for autism spectrum disorder (ASD) is an important addition to treatment, yet currently available agents target co-morbid psychiatric concerns, such as aggression and irritability. Propranolol, a beta-adrenergic antagonist with anxiolytic effects, has been shown to improve verbal fluency and working memory in adults and adolescents with ASD in single-dose challenges.
  
  
  OBJECTIVE
  The present pilot study explores the acute effects of propranolol on a measure of conversational reciprocity in this population. We also examined whether autonomic activity and anxiety moderate or mediate response to the drug, given relationships between these variables and ASD, as well as the drug's effects.
  
  
  METHODS
  In a within-subject crossover design, 20 individuals with ASD received a single dose of propranolol or placebo during two sessions in a double-blinded, counterbalanced manner. After drug administration, participants performed a conversational reciprocity task by engaging in a short conversation with the researcher. Measurements of autonomic activity and anxiety were obtained before and after drug administration.
  
  
  RESULTS
  Propranolol significantly improved performance on the conversational reciprocity task total [d = 0.40] and nonverbal communication domain scores when compared to the placebo condition. However, neither autonomic activity nor anxiety was significantly associated with drug response.
  
  
  CONCLUSIONS
  Acute propranolol administration improved conversational reciprocity in ASD. Further exploration of these preliminary findings, as well as other potential treatment response predictors, with serial doses is warranted.
authors.affiliation: Interdisciplinary Neuroscience Program, University of Missouri, Columbia, MO, USA.
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Zamzow
authors.affiliation: Interdisciplinary Neuroscience Program, University of Missouri, Columbia, MO, USA.
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: Ferguson
authors.affiliation: Department of Special Education, University of Missouri, Columbia, MO, USA.
authors.forename: Janine P
authors.initials: JP
authors.lastname: Stichter
authors.affiliation: Center for Cognitive Aging and Memory (CAM), Institute on Aging, McKnight Brain Institute, Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, 32608, USA.
authors.forename: Eric C
authors.initials: EC
authors.lastname: Porges
authors.affiliation: Department of Biological Sciences, University of Missouri, Columbia, MO, USA.
authors.forename: Alexandra S
authors.initials: AS
authors.lastname: Ragsdale
authors.affiliation: Department of Biological Sciences, University of Missouri, Columbia, MO, USA.|Department of Psychological Sciences, University of Missouri, Columbia, MO, USA.
authors.forename: Morgan L
authors.initials: ML
authors.lastname: Lewis
authors.affiliation: Department of Psychological Sciences, University of Missouri, Columbia, MO, USA. beversdorfd@health.missouri.edu.|William and Nancy Thompson Endowed Chair in Radiology, Departments of Radiology and Neurology, and the Thompson Center for Autism and Neurodevelopmental Disorders, University of Missouri, Columbia, MO, USA. beversdorfd@health.missouri.edu.|Department of Radiology, DC069.10, University of Missouri Health Care, One Hospital Dr, Columbia, MO, 65212, USA. beversdorfd@health.missouri.edu.
authors.forename: David Q
authors.identifier: http://orcid.org/0000-0002-0298-0634
authors.initials: DQ
authors.lastname: Beversdorf
mesh_terms: D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000494:pharmacology* / Q000627:therapeutic use; D000328:Adult; D000374:Aggression / Q000187:drug effects; D001007:Anxiety / Q000188:drug therapy; D000067877:Autism Spectrum Disorder / Q000188:drug therapy / Q000523:psychology*; D001341:Autonomic Nervous System / Q000187:drug effects; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011433:Propranolol / Q000494:pharmacology* / Q000627:therapeutic use; D012919:Social Behavior; D055815:Young Adult
chemical_list: D000319:Adrenergic beta-Antagonists; D011433:Propranolol
keywords: Anxiety; Autism; Autonomic; Conversational reciprocity; Noradrenergic; Propranolol