The effects of timolol maleate on subjective and physiological components of air travel phobia.

Twenty-one monophobic patients with moderately severe fear of flying were exposed to two 40 minute challenge flights after taking either Timolol 20 mg/day or placebo. Heart rate, blood pressure, subjective ratings of anxiety, fear and palpitation and Hamilton Anxiety Scale ratings were made at the predetermined assessment intervals. Post-treatment global ratings of improvement were provided by patients and the attending psychiatrist. Results showed that heart rate significantly increased from baseline with placebo while Timolol successfully inhibited tachycardia during the challenge flights. Subjective ratings of anxiety, fear and palpitations did not show any drug group differences. These variables, however, showed a non-significant decrease from outgoing to return flight assessments after an initial significant increase from baseline scores. Hamilton Anxiety Scale ratings showed a significant decrease from baseline to post-treatment assessments, irrespective of drug group. Global improvement ratings revealed no significant differences between drug groups. Overall ratings by the psychiatrist were generally more positive than patients' ratings, with the difference between the two sources of assessment reaching significance only in the placebo group. Disregarding group membership, heart rate was positively and significantly correlated with subjective ratings of fear, but not with palpitations or ratings of overall anxiety.