Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA.
Department of Psychiatry, Inova Fairfax Hospital, Falls Church, VA.
J Acad Consult Liaison Psychiatry. 2021 Jul-Aug;62(4):404-412. doi: 10.1016/j.jaclp.2020.12.009. Epub 2021 Jan 11.
β-Blockers (BBs) are a widely used class of medications with a number of medical indications. Their ability to suppress the adrenergic response has made them a target of investigation for treating a variety of psychiatric symptoms.
The aim of this review is to identify evidence regarding the use of BBs for various psychiatric disorders including anxiety disorders, mood disorders, psychosis, and posttraumatic stress disorder. We also review the evidence for use for aggression and agitation and for extrapyramidal side effects of psychiatric medications.
A search of PubMed and Google Scholar was conducted with search terms relevant to the use of BBs for psychiatric conditions. Studies were selected based on relevance to the review objective, focusing on systematic reviews and meta-analyses. Case reports were included and are clearly identified when referenced in this review.
A total of 44 publications were included that examined the use of BBs as treatment for the following psychiatric symptoms and conditions: anxiety disorders, depression and mood disorders, acute stress disorder and postraumatic stress disorder, psychotic disorders and extrapyramidal symptoms, as well as aggression and agitation. Additionally, adverse effects and drug-drug interactions were reviewed.
Well-characterized psychiatric uses of BBs include treating symptoms of performance anxiety and akathisia. Some positive evidence exists for BB therapy in other disorders such as specific phobia, panic disorder, and for aggression in patients with psychosis, acquired brain injury, or intellectual disability. Most of the evidence on the role of BBs in psychiatry is as adjunctive treatment for management of somatic symptoms rather than as monotherapy. Outside of performance anxiety and akathisia, the role of BBs in psychiatry has not been subjected to careful study, and further investigative trials are needed.
β受体阻滞剂（BBs）是一类广泛应用的药物，具有多种医学适应证。它们抑制肾上腺素能反应的能力使它们成为治疗各种精神症状的研究目标。
本综述旨在确定 BBs 用于各种精神障碍的证据，包括焦虑障碍、心境障碍、精神病和创伤后应激障碍。我们还综述了 BBs 用于攻击和激越以及精神药物的锥体外系副作用的证据。
通过与 BBs 用于精神状况相关的检索词在 PubMed 和 Google Scholar 上进行检索。根据与综述目的的相关性选择研究，重点关注系统评价和荟萃分析。纳入病例报告，并在本综述中明确标识。
共纳入 44 篇研究，研究了 BBs 作为以下精神症状和疾病的治疗方法：焦虑障碍、抑郁和心境障碍、急性应激障碍和创伤后应激障碍、精神病和锥体外系症状，以及攻击和激越。此外，还审查了不良反应和药物相互作用。
BBs 的明确的精神科用途包括治疗表演焦虑和静坐不能的症状。一些证据表明 BB 治疗在其他疾病中是有效的，如特定恐惧症、恐慌症，以及在精神病、获得性脑损伤或智力残疾患者中用于治疗攻击。BBs 在精神病学中的作用的大部分证据是作为躯体症状管理的辅助治疗，而不是作为单一疗法。除了表演焦虑和静坐不能之外，BBs 在精神病学中的作用尚未经过仔细研究，需要进一步的研究试验。
