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Psychopharmacology Bulletin Jun 2021Akathisia is a movement disorder affecting the trunk and limbs, characterized by subjective and objective restlessness. Key signs include continual, repetitive rocking,... (Review)
Review
Akathisia is a movement disorder affecting the trunk and limbs, characterized by subjective and objective restlessness. Key signs include continual, repetitive rocking, leg shuffling, and fidgeting. Antipsychotic-induced akathisia is optimally managed by reducing the medication dose or switching to a second generation antipsychotic that is less prone to inducing akathisia. However, since medication changes are often not feasible, we review the available classes of rescue agents for akathisia symptoms. The fitting acronym, "B-CALM", which stands for Beta-blockers, Clonazepam, Anticholinergics, cLonidine and Mirtazapine, will assist prescribers in facile recall of evidence-based treatment options for akathisia. Pharmacological agents such as mianserin, trazodone, Vit B6, amantadine, gabapentin, and pregabalin have also been examined as treatment options for antipsychotic-induced akathisia. Although initial exploratory reports on these agents have been promising, the current evidence is insufficient. Akathisia has a good prognosis when managed early in the course of treatment. A variety of safe rescue agents are available for the management of this condition, however, current evidence best supports the use of propranolol and mirtazapine.
Topics: Akathisia, Drug-Induced; Antipsychotic Agents; Humans; Mirtazapine; Propranolol; Psychomotor Agitation
PubMed: 34421146
DOI: No ID Found -
The Cochrane Database of Systematic... Feb 2017Propranolol is one of the most commonly prescribed drugs for migraine prophylaxis. (Review)
Review
BACKGROUND
Propranolol is one of the most commonly prescribed drugs for migraine prophylaxis.
OBJECTIVES
We aimed to determine whether there is evidence that propranolol is more effective than placebo and as effective as other drugs for the interval (prophylactic) treatment of patients with migraine.
SEARCH METHODS
Potentially eligible studies were identified by searching MEDLINE/PubMed (1966 to May 2003) and the Cochrane Central Register of Controlled Trials (Issue 2, 2003), and by screening bibliographies of reviews and identified articles.
SELECTION CRITERIA
We included randomised and quasi-randomised clinical trials of at least 4 weeks duration comparing clinical effects of propranolol with placebo or another drug in adult migraine sufferers.
DATA COLLECTION AND ANALYSIS
Two reviewers extracted information on patients, methods, interventions, outcomes measured, and results using a pre-tested form. Study quality was assessed using two checklists (Jadad scale and Delphi list). Due to the heterogeneity of outcome measures and insufficient reporting of the data, only selective quantitative meta-analyses were performed. As far as possible, effect size estimates were calculated for single trials. In addition, results were summarised descriptively and by a vote count among the reviewers.
MAIN RESULTS
A total of 58 trials with 5072 participants met the inclusion criteria. The 58 selected trials included 26 comparisons with placebo and 47 comparisons with other drugs. The methodological quality of the majority of trials was unsatisfactory. The principal shortcomings were high dropout rates and insufficient reporting and handling of this problem in the analysis. Overall, the 26 placebo-controlled trials showed clear short-term effects of propranolol over placebo. Due to the lack of studies with long-term follow up, it is unclear whether these effects are stable after stopping propranolol. The 47 comparisons with calcium antagonists, other beta-blockers, and a variety of other drugs did not yield any clear-cut differences. Sample size was, however, insufficient in most trials to establish equivalence.
AUTHORS' CONCLUSIONS
Although many trials have relevant methodological shortcomings, there is clear evidence that propranolol is more effective than placebo in the short-term interval treatment of migraine. Evidence on long-term effects is lacking. Propranolol seems to be as effective and safe as a variety of other drugs used for migraine prophylaxis.
Topics: Adrenergic beta-Antagonists; Adult; Calcium Channel Blockers; Humans; Migraine Disorders; Propranolol; Randomized Controlled Trials as Topic; Treatment Refusal
PubMed: 28212466
DOI: 10.1002/14651858.CD003225.pub3 -
Biomedical Journal Jun 2019In this issue of the Biomedical Journal we discover how alternative splicing might modulate the cell-type specificity and exact function of a ubiquitous purinergic...
In this issue of the Biomedical Journal we discover how alternative splicing might modulate the cell-type specificity and exact function of a ubiquitous purinergic receptor and how the beta blocker propanolol can contribute to breast cancer therapy. Moreover, we learn which culture conditions generate the best vascularisation of tissue engineered bone and which are the clinical features of acute necrotising encephalopathy in adults. Other studies reveal, how laser irradiation can fix fractured all-ceramic dental restorations in situ, and finally that nuclear magnetic resonance holds great potential for the rapid detection of pathogens.
Topics: Alternative Splicing; Animals; Humans; Propranolol; RNA, Messenger
PubMed: 31466707
DOI: 10.1016/j.bj.2019.06.001 -
Ugeskrift For Laeger Aug 2014Subglottic haemangioma (SGH) is the rare condition of an infantile haemangioma in the subglottic space. The diagnostics is complicated due to the clinical symptoms...
Subglottic haemangioma (SGH) is the rare condition of an infantile haemangioma in the subglottic space. The diagnostics is complicated due to the clinical symptoms mimicking pseudocroup, and difficulties in visualization of the subglottic space. A two-month-old girl with a cycle of repeated hospitalizations due to recurrent and progressive croupal cough and stridor was diagnosed with SGH by laryngoscopy and initiated propranolol treatment with effect after 48 hours. SGH is rare but should be kept in mind in infants with recurrent croupal cough and stridor.
Topics: Female; Glottis; Hemangioma; Humans; Infant; Laryngeal Neoplasms; Laryngoscopy; Propranolol; Rare Diseases; Vasodilator Agents
PubMed: 25292478
DOI: No ID Found -
World Journal of Emergency Surgery :... 2017The objective of this systematic review was to determine the effectiveness and safety of propranolol compared to placebo or usual care for improving clinical relevant... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The objective of this systematic review was to determine the effectiveness and safety of propranolol compared to placebo or usual care for improving clinical relevant outcomes in severely burned patients (TBSA >20%).
METHODS
Relevant articles from randomized controlled trials were identified by a literature search in MEDLINE, EMBASE, and CENTRAL. We included trials involving patients with a severe burn (>20% of total body surface area affected). Trials were eligible if they evaluated propranolol and compared to usual care or placebo. Two investigators independently assessed articles for inclusion and exclusion criteria and selected studies for the final analysis. We conducted a meta-analysis using a random-effects model.
RESULTS
We included ten studies in our systematic review. These studies randomized a total of 1236 participants. There were no significant differences between propranolol and placebo with respect to mortality (RD -0.02 [95% CI -0.06 to 0.02]), sepsis (RD -0.03 [95% CI -0.09 to 0.04]), and the overall hospital stay (MD -0.37 [-4.52 to 3.78]). Propranolol-treated adults had a decrease in requirements of blood transfusions (MD -185.64 [95% CI -331.06 to -40.43]) and a decreased heart rate (MD -26.85 [95% CI -39.95 to -13.75]).
CONCLUSIONS
Our analysis indicates that there were no differences in mortality or sepsis in severely burned patients treated with propranolol compared with those who had usual care or placebo. However, the use of propranolol in these patients resulted in lower requirements of blood transfusion and lower values of heart rate. The evidence synthesized in this systematic review is limited to conclude that propranolol reduces the length of hospital stay among severely burned patients. Future trials should assess the impact of propranolol on clinically relevant outcomes such as mortality and adverse events.
Topics: Adrenergic beta-Antagonists; Burns; Humans; Patient Safety; Propranolol
PubMed: 28265298
DOI: 10.1186/s13017-017-0124-7 -
Molecules (Basel, Switzerland) Jul 2017Our research to discover potential new multitarget agents led to the synthesis of 10 novel derivatives of cinnamic acids and propranolol, atenolol, 1-adamantanol,...
Our research to discover potential new multitarget agents led to the synthesis of 10 novel derivatives of cinnamic acids and propranolol, atenolol, 1-adamantanol, naphth-1-ol, and (benzylamino) ethan-1-ol. The synthesized molecules were evaluated as trypsin, lipoxygenase and lipid peroxidation inhibitors and for their cytotoxicity. Compound derived from phenoxyphenyl cinnamic acid and propranolol showed the highest lipoxygenase (LOX) inhibition (IC = 6 μΜ) and antiproteolytic activity (IC = 0.425 μΜ). The conjugate of simple cinnamic acid with propranolol showed the higher antiproteolytic activity (IC = 0.315 μΜ) and good LOX inhibitory activity (IC = 66 μΜ). Compounds and , derived from methoxylated caffeic acid present a promising combination of in vitro inhibitory and antioxidative activities. The isomer of also presented an interesting multitarget biological profile in vitro Molecular docking studies point to the fact that the theoretical results for LOX-inhibitor binding are identical to those from preliminary in vitro study.
Topics: Animals; Cell Line; Cinnamates; Lipoxygenase; Lipoxygenase Inhibitors; Mice; Propranolol; Protease Inhibitors; Soybean Proteins; Glycine max
PubMed: 28757554
DOI: 10.3390/molecules22081247 -
Skin Research and Technology : Official... Apr 2023The most frequent benign vascular tumor in children is infantile hemangioma (IH). For severe IHs, propranolol has become the first-line Treatment. Despite the fact that...
BACKGROUND/OBJECTIVES
The most frequent benign vascular tumor in children is infantile hemangioma (IH). For severe IHs, propranolol has become the first-line Treatment. Despite the fact that several studies have comprehensive therapy regimens, including the best time to start Treatment, dosage, visit frequency, and treatment duration, there is still controversy about the best time to start and stop propranolol medication.
METHODS
Between January 2016 and February 2019, dermatologists experienced hemangioma treatment and recommended propranolol treatment for 232 IHs. A total of 90 patients completed the treatment process after undergoing a color Doppler ultrasound test.
RESULTS
Propranolol uniquely affects each IH. Ninety patients were divided into two groups in this study: entire regression (n = 40) and partial regression (n = 50). The entire regression group's initial treatment period (4.3 ± 2.97 months) was substantially shorter than the partial regression group's (5.2 ± 4.57 months) (p < 0.05). Between the entire regression group (23.4 ± 12.8 months) and the partial regression group (24.5 ± 16.6 months), there was no significant difference in time to reduce propranolol. The partial regression group (32.9 ± 25.3month) had a lengthier treatment course than the entire regression group (23.4 ± 13.7 months) (p < 0.05). The partial regression group (22%), like the entire regression group, had a higher recurrence rate (5%). The overall proportion of hemangiomas on the face (particularly periocular hemangioma) in the regression group was greater than in the control group.
CONCLUSION
The entire regression group's initial treatment time was significantly shorter than the partial regression group's. As a result, as soon as a hemangioma is discovered, it should be treated. To determine the appropriate time to reduce propranolol, we must evaluate the patient's age and the percentage of tumor regression. Periocular hemangioma may have a better prognosis than other types. Given the small number of patients in our study, we will need to do more research in the future to confirm our findings.
Topics: Child; Humans; Infant; Propranolol; Treatment Outcome; Hemangioma; Administration, Oral; Skin Neoplasms
PubMed: 37113082
DOI: 10.1111/srt.13310 -
JACC. Clinical Electrophysiology May 2020
Topics: Arrhythmias, Cardiac; Autonomic Nerve Block; Humans; Propranolol; Stellate Ganglion; Tachycardia, Ventricular
PubMed: 32439043
DOI: 10.1016/j.jacep.2020.01.010 -
Neurobiology of Learning and Memory Apr 2016Posttraumatic stress disorder (PTSD) has been described as the only neuropsychiatric disorder with a known cause, yet effective behavioral and pharmacotherapies remain... (Review)
Review
Posttraumatic stress disorder (PTSD) has been described as the only neuropsychiatric disorder with a known cause, yet effective behavioral and pharmacotherapies remain elusive for many afflicted individuals. PTSD is characterized by heightened noradrenergic signaling, as well as a resistance to extinction learning. Research aimed at promoting more effective treatment of PTSD has focused on memory erasure (disrupting reconsolidation) and/or enhancing extinction retention through pharmacological manipulations. Propranolol, a β-adrenoceptor antagonist, has received considerable attention for its therapeutic potential in PTSD, although its impact on patients is not always effective. In this review, we briefly examine the consequences of β-noradrenergic manipulations on both reconsolidation and extinction learning in rodents and in humans. We suggest that propranolol is effective as a fear-reducing agent when paired with behavioral therapy soon after trauma when psychological stress is high, possibly preventing or dampening the later development of PTSD. In individuals who have already suffered from PTSD for a significant period of time, propranolol may be less effective at disrupting reconsolidation of strong fear memories. Also, when PTSD has already developed, chronic treatment with propranolol may be more effective than acute intervention, given that individuals with PTSD tend to experience long-term, elevated noradrenergic hyperarousal.
Topics: Adrenergic beta-Antagonists; Animals; Behavior, Animal; Disease Models, Animal; Extinction, Psychological; Fear; Humans; Memory; Propranolol; Rats; Stress Disorders, Post-Traumatic
PubMed: 26808441
DOI: 10.1016/j.nlm.2016.01.009 -
Cells Dec 2022Tremor is the most common movement disorder. Several drugs reduce tremor severity, but no cures are available. Propranolol, a β-adrenergic receptor blocker, is the...
Tremor is the most common movement disorder. Several drugs reduce tremor severity, but no cures are available. Propranolol, a β-adrenergic receptor blocker, is the leading treatment for tremor. However, the in vivo circuit mechanisms by which propranolol decreases tremor remain unclear. Here, we test whether propranolol modulates activity in the cerebellum, a key node in the tremor network. We investigated the effects of propranolol in healthy control mice and mice, which exhibit pathophysiological tremor and ataxia due to cerebellar dysfunction. Propranolol reduced physiological tremor in control mice and reduced pathophysiological tremor in mice to control levels. Open field and footprinting assays showed that propranolol did not correct ataxia in mice. In vivo recordings in awake mice revealed that propranolol modulates the spiking activity of control and Purkinje cells. Recordings in cerebellar nuclei neurons, the targets of Purkinje cells, also revealed altered activity in propranolol-treated control and mice. Next, we tested whether propranolol reduces tremor through β and β adrenergic receptors. Propranolol did not change tremor amplitude or cerebellar nuclei activity in β and β null mice or mice lacking β and β receptor function. These data show that propranolol can modulate cerebellar circuit activity through β-adrenergic receptors and may contribute to tremor therapeutics.
Topics: Mice; Animals; Propranolol; Cerebellum; Purkinje Cells; Ataxia; Neurons; Adrenergic beta-Antagonists; Mice, Knockout; Nerve Tissue Proteins; Biomarkers, Tumor
PubMed: 36497147
DOI: 10.3390/cells11233889