Evaluation of the Efficacy of Propranolol in the Treatment of Patients with Anxiety and Post-traumatic Stress Disorder

Summary

Here, we present a clinical study to investigate how propranolol performs clinically in treating anxiety and post-traumatic stress disorder (PTSD).

Abstract

Patients with anxiety and post-traumatic stress disorder (PTSD) require combined psychological and pharmacological treatment, but evidence on propranolol's efficacy in these conditions remains insufficient.

A retrospective analysis was conducted on 211 eligible patients (after exclusion) with anxiety-related disorders or PTSD (per ICD-11 criteria) admitted to Ganzhou Third People's Hospital from January 2022 to December 2024. Patients were divided into the control group (conventional treatment, n = 105) and the experimental group (propranolol treatment, n = 106). Main outcomes included heart rate (HR), systolic/diastolic blood pressure (SBP/DBP), and Hamilton Anxiety Scale (HAMA) score. Secondary outcomes covered respiratory rate (RR), Beck Depression Inventory-II (BDI-II), Clinical Global Impression (CGI), Post-Traumatic Stress Disorder Checklist-Specific (PCL-S) scores, and adverse reaction incidence.

Baseline characteristics were comparable between groups (P > 0.05). Post-treatment, the experimental group showed significant reductions in HR, SBP, DBP, and RR (all P ≤ 0.003), as well as lower HAMA, BDI-II, and PCL-S scores (all P ≤ 0.004) compared with the control group. CGI score and adverse reaction incidence were also decreased in the experimental group (P = 0.004 and P = 0.037, respectively).

Propranolol effectively relieves anxiety and depression in patients with anxiety and PTSD, reduces adverse reactions, and improves treatment efficacy, providing a scientific basis for clinical medication optimization.

Introduction

Emotions influence cognition and behavior and mediate the different needs of organisms to adapt to their environment¹. Anxiety is characterized by excessive fear and worry-related behavioral disruptions. The manifestations of anxiety include internalizing and externalizing features, which are related to different types of situations and objects². As outlined in the 4th Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-4), PTSD was regarded as a type of AD. However, since PTSD shows a connection with specific events, PTSD was classified as a trauma stress-related disorder in DSM-5^....

Protocol

This clinical study complied with relevant ethical regulations, such as the Declaration of Helsinki, was reviewed and approved by Ganzhou Third People's Hospital Ethics Committee (ethics approval number: gzsyy2024076), and detailed explanations of the research purpose, procedures, and potential risks were provided to the subjects or their agents, with written informed consent obtained.

General information
This study retrospectively selected 221 patients with AD and PTSD admitted to Ganzhou Third People's Hospital from January 2022 to December 2024 as the research subjects, aiming to evaluate the therapeutic ef....

Results

Comparison of baseline data between the two groups
In this retrospective cohort study, statistical analysis was performed on the baseline data characteristics of patients, including age, body mass index (BMI), gender, height, weight, and disease type. No significant differences were observed between the control group and the experimental group (P = 0.793, 0.053, 0.827, 0.275, 0.992, 0.99), indicating comparability. There were no statistical differences in the previous medical histories of pa.......

Discussion

Propranolol has a highly selective blocking effect on β receptors and can competitively bind to the receptors, thereby counteracting the β receptor effects of neurotransmitters and adrenergic agonists. It can slow down the HR, reduce cardiac output, and cardiac oxygen consumption. For blood vessels, it can increase peripheral resistance, resulting in a decrease in blood flow to the liver, kidneys, intestines, and coronary arteries, and inhibit renin activity, so it can lower BP. It is also capable of crossing t.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Digital twelve-channel electrocardiograph	Shenzhen Mindray Precision Medical Electronics Co., Ltd.	SE-1202
Electronic BP monitor	OMRON	HEM-1026
General stethoscope	3M Company	3m Littmann
Hydrochloride propranolol	Jiangsu Yabang Aipusen Pharmaceutical Co., Ltd.	H32020133