BB and PTSD

Q: Which of the following Beta Blockers (BB) has some indications as an adjuvant in Post-traumatic Stress Disorder (PTSD)? - Select one 

A) Atenolol 

B) Bisoprolol

C) Metoprolol

D) Propranolol

Answer: D

The hypothesis behind the use of BB in PTSD is that reducing noradrenergic activation will reduce the conditioning of trauma memories.

Propranolol is a non-selective beta blocker (BB) that blocks beta receptors in the heart and tissues. This helps reduce noradrenergic activation. At least two small studies have shown a positive impact. 

Atenolol, bisoprolol, and metoprolol (choices A, B, & C) are considered selective BBs.  

#psychiatry

#pharmacology

References:

1. Vaiva G, Ducrocq F, Jezequel K, et al. Immediate treatment with propranolol decreases posttraumatic stress disorder two months after trauma. Biol Psychiatry 2003; 54:947.

2. Pitman RK, Sanders KM, Zusman RM, et al. Pilot study of secondary prevention of posttraumatic stress disorder with propranolol. Biol Psychiatry 2002; 51:189.

3. Stein MB, Kerridge C, Dimsdale JE, Hoyt DB. Pharmacotherapy to prevent PTSD: Results from a randomized controlled proof-of-concept trial in physically injured patients. J Trauma Stress 2007; 20:923.

4. Hoge EA, Worthington JJ, Nagurney JT, et al. Effect of acute posttrauma propranolol on PTSD outcome and physiological responses during script-driven imagery. CNS Neurosci Ther 2012; 18:21.