TY - JOUR
T1 - Propranolol for treating emotional, behavioural, autonomic dysregulation in children and adolescents with autism spectrum disorders
AU - Sagar-Ouriaghli, Ilyas
AU - Lievesley, Kate
AU - Santosh, Paramala J.
PY - 2018/6/1
Y1 - 2018/6/1
N2 - Objectives: To date, there is no single medication prescribed to alleviate all the core symptoms of Autism Spectrum Disorder (ASD; National Institute of Health and Care Excellence, 2016). Both serotonin reuptake inhibitors and drugs for psychosis possess therapeutic drawbacks when managing anxiety and aggression in ASD. This review sought to appraise the use of propranolol as a pharmacological alternative when managing emotional, behavioural and autonomic dysregulation (EBAD) and other symptoms. Materials and methods: Sixteen reports examined the administration of propranolol in the context of ASD. Results: Sixteen reports broadly covered cognitive domains, neural correlates, and behavioural domains. From the eight single-dose clinical trials, propranolol led to significant improvements in cognitive performance – verbal problem solving, social skills, mouth fixation, and conversation reciprocity; and changes in neural correlates – improvement in semantic networks and functional connectivity. The remaining eight case series and single case reports showed improvements in EBAD, anxiety, aggressive, self-injurious and hypersexual behaviours. Additionally, propranolol significantly improved similar behavioural domains (aggression and self-injury) for those with acquired brain injury. Conclusion: This review indicates that propranolol holds promise for EBAD and cognitive performance in ASD. Given the lack of good quality clinical trials, randomised controlled trials are warranted to explore the efficacy of propranolol in managing EBAD in ASD.
AB - Objectives: To date, there is no single medication prescribed to alleviate all the core symptoms of Autism Spectrum Disorder (ASD; National Institute of Health and Care Excellence, 2016). Both serotonin reuptake inhibitors and drugs for psychosis possess therapeutic drawbacks when managing anxiety and aggression in ASD. This review sought to appraise the use of propranolol as a pharmacological alternative when managing emotional, behavioural and autonomic dysregulation (EBAD) and other symptoms. Materials and methods: Sixteen reports examined the administration of propranolol in the context of ASD. Results: Sixteen reports broadly covered cognitive domains, neural correlates, and behavioural domains. From the eight single-dose clinical trials, propranolol led to significant improvements in cognitive performance – verbal problem solving, social skills, mouth fixation, and conversation reciprocity; and changes in neural correlates – improvement in semantic networks and functional connectivity. The remaining eight case series and single case reports showed improvements in EBAD, anxiety, aggressive, self-injurious and hypersexual behaviours. Additionally, propranolol significantly improved similar behavioural domains (aggression and self-injury) for those with acquired brain injury. Conclusion: This review indicates that propranolol holds promise for EBAD and cognitive performance in ASD. Given the lack of good quality clinical trials, randomised controlled trials are warranted to explore the efficacy of propranolol in managing EBAD in ASD.
KW - aggression
KW - anxiety
KW - ASD
KW - Autism Spectrum Disorder
KW - beta-blockers
KW - EBAD
KW - propranolol
UR - http://www.scopus.com/inward/record.url?scp=85049030032&partnerID=8YFLogxK
U2 - 10.1177/0269881118756245
DO - 10.1177/0269881118756245
M3 - Review article
AN - SCOPUS:85049030032
SN - 0269-8811
VL - 32
SP - 641
EP - 653
JO - Journal of Psychopharmacology
JF - Journal of Psychopharmacology
IS - 6
ER -
