Clinical psychopharmacology of beta-adrenoceptor antagonism in treatment of anxiety.

beta-adrenoceptor antagonists such as propranolol have been shown to produce improvement in the symptoms of patients with anxiety states, particularly the somatic or autonomically mediated features of their condition. It is not yet certain whether this is a central or peripheral action of beta-blocking drugs, and whether it is due to beta-adrenoceptor blockade or to another pharmacological action which these drugs possess, such as 5HT receptor blockade. There is experimental evidence that abrupt discontinuation of treatment with beta-blocking drugs is not associated with a central nervous withdrawal syndrome, but the implications are limited because of the lack of agonist models of central nervous beta-adrenoceptor function in man. The original observations on the anti-anxiety effects of propranolol were serendipitous, and illustrate the importance of designing clinical pharmacological studies so that unexpected and unsought information can be recorded.