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

J Psychopharmacol. 2016 Feb;30(2):128-39. doi: 10.1177/0269881115612236. Epub 2015 Oct 20.

Abstract

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.

Keywords: Propranolol; anxiety disorders; meta-analysis; panic disorder.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Administration, Oral
  • Adrenergic beta-Antagonists / therapeutic use*
  • Anti-Anxiety Agents / therapeutic use
  • Anxiety Disorders / drug therapy*
  • Anxiety Disorders / physiopathology
  • Humans
  • Propranolol / therapeutic use*
  • Randomized Controlled Trials as Topic
  • Severity of Illness Index

Substances

  • Adrenergic beta-Antagonists
  • Anti-Anxiety Agents
  • Propranolol