Steenen Serge A, van Wijk Arjen J, van der Heijden Geert J M G, van Westrhenen Roos, de Lange Jan, de Jongh Ad
Department of Oral and Maxillofacial Surgery, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
Department of Social Dentistry and Behavioural Sciences, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, the Netherlands.
J Psychopharmacol. 2016 Feb;30(2):128-39. doi: 10.1177/0269881115612236. Epub 2015 Oct 20.
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.
此前尚未对普萘洛尔治疗焦虑症的效果进行系统评估。目的是对随机对照试验进行系统评价和荟萃分析,探讨口服普萘洛尔与安慰剂或其他药物相比,在缓解焦虑症患者的状态焦虑或特质焦虑方面的疗效。八项研究符合纳入标准。这些研究涉及伴或不伴广场恐惧症的惊恐障碍(四项研究,共130例)、特定恐惧症(两项研究,共37例)、社交恐惧症(一项研究,16例)和创伤后应激障碍(PTSD)(一项研究,19例)。四项惊恐障碍试验中有三项符合汇总分析条件。这些荟萃分析发现,在伴或不伴广场恐惧症的惊恐障碍的短期治疗中,普萘洛尔和苯二氮䓬类药物的疗效在统计学上无显著差异。此外,未发现普萘洛尔通过抑制记忆再巩固对PTSD症状严重程度有影响。总之,目前关于普萘洛尔疗效的证据质量不足以支持在治疗任何焦虑症时常规使用普萘洛尔。