Propranolol for the treatment of anxiety disorders: Systematic review and meta-analysis

• Published in: Journal of Psychopharmacology Vol. 30; no. 2; pp. 128 - 139
• Main Authors: Steenen, Serge A, van Wijk, Arjen J, van der Heijden, Geert JMG, van Westrhenen, Roos, de Lange, Jan, de Jongh, Ad
• Format: Book Review Journal Article
• Language: English
• Published: London, England SAGE Publications 01-02-2016; Sage Publications Ltd
• Subjects: Administration, Oral; Adrenergic beta-Antagonists - therapeutic use; Anti-Anxiety Agents - therapeutic use; Anxiety; Anxiety Disorders - drug therapy; Anxiety Disorders - physiopathology; Humans; Mental health care; Meta-analysis; Panic attacks; Post traumatic stress disorder; Propranolol - therapeutic use; Randomized Controlled Trials as Topic; Reviews; Severity of Illness Index; Systematic review; meta-analysis; anxiety disorders; Propranolol; panic disorder
• ISSN: 0269-8811; 1461-7285
• DOI: 10.1177/0269881115612236

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.