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Can low-dose propranolol induce a manic syndrome? Case report of an unexpected side effect

Published online by Cambridge University Press:  11 March 2013

Mahin Eslami Shahrbabaki ,
Fariborz Estilaee  and
Amir Eslami Shahrbabaki
Mahin Eslami Shahrbabaki
Affiliation:
Psychiatry Department, Beheshti Hospital, Kerman University of Medical Sciences and Health Services, Kerman, Iran
Fariborz Estilaee*
Affiliation:
Psychiatry Department, Beheshti Hospital, Kerman University of Medical Sciences and Health Services, Kerman, Iran
Amir Eslami Shahrbabaki
Affiliation:
Sports Medicine Research Center, Tehran University of Medical Science, Tehran, Iran
*
Fariborz Estilaee, Psychiatry Department, Beheshti Hospital, Kerman University of Medical Sciences and Health Services, Kerman, Iran. Tel: +98 341 2116328; Fax: +98 341 2110856; E-mail: farest01@gmail.com
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Abstract

Objectives

Propranolol, the first discovered b-adrenergic receptor antagonist, has been prescribed by physicians in various fields for more than three decades. It has been applied for treating psychiatric disorders including schizophrenia, mania and anxiety disorders, as well as for controlling withdrawal symptoms or other side effects.

Methods

We describe the case of an 11-year-old boy with bipolar-I disorder comorbid with panic disorder who developed manic symptoms with a single dose of 10 mg of propranolol.

Results and Conclusion

Although depression is a better-known side effect of b-adrenergic antagonists, clinicians should take mania as a rare side effect into consideration as well.

Keywords

propranololbipolarside effectmania

Information

Type
Case Report
Information
Acta Neuropsychiatrica , Volume 25 , Issue 3 , June 2013 , pp. 184 - 186
Copyright
Copyright © Scandinavian College of Neuropsychopharmacology 2013 

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References

1.Fletcher, S, Creamer, M, Forbes, D. Preventing post traumatic stress disorder: are drugs the answer? Aust N Z J Psychiatry 2010;44:1064–1071.Google Scholar
2.Pastrana Jiménez, JI, Catalina Romero, C, García Diéguez, N, Lopez-Ibor Aliño, JJ. Pharmacological treatment of acute stress disorder with propranolol and hypnotics. Actas Esp Psiquiatr 2007;35:351–358.Google Scholar
3.Goyal, R, Chandrasekaran, R, Nanda, MR. Propranolol-responsive akathisia following acute encephalitis. Gen Hosp Psychiatry 2007;29:273–274.CrossRefGoogle ScholarPubMed
4.Hawken, ER, Delva, NJ, Lawson, JS. Successful use of propranolol in migraine associated with electroconvulsive therapy. Headache 2001;41:92–96.CrossRefGoogle ScholarPubMed
5.Weber, RB, Reinmuth, OM. The treatment of migraine with propranolol. Neurology 2011;77:865.Google Scholar
6.Wohleb, ES, Hanke, ML, Corona, AWet al. β-Adrenergic receptor antagonism prevents anxiety-like behavior and microglial reactivity induced by repeated social defeat. J Neurosci 2011;31:6277–6288.Google Scholar
7.Kampman, KM, Dackis, C, Lynch, KGet al. A double-blind, placebo-controlled trial of amantadine, propranolol, and their combination for the treatment of cocaine dependence in patients with severe cocaine withdrawal symptoms. Drug Alcohol Depend 2006;85:129–137.Google Scholar
8.Bruijnzeel, AW, Bishnoi, M, van Tuijl, IAet al. Effects of prazosin, clonidine, and propranolol on the elevations in brain reward thresholds and somatic signs associated with nicotine withdrawal in rats. Psychopharmacology (Berl) 2010;212:485–499.Google Scholar
9.Serrano-Duenas, M. Clonidine versus propranolol in the treatment of essential tremor. A double-blind trial with a one-year follow-up. Neurologia 2003;18:248–254.Google Scholar
10.Ahmed, AI, van Mierlo, P, Jansen, P. Sleep disorders, nightmares, depression and anxiety in an elderly patient treated with low-dose metoprolol. Gen Hosp Psychiatry 2010;32:646.Google Scholar
11.Fernandez, A, Crowther, TR, Vieweg, WV. Musical hallucinations induced by propranolol. J Nerv Ment Dis 1998;186:192–194.Google Scholar
12.Bali, SJ, Parmar, T, Arora, V, Ichhpujani, P, Sagar, R, Dada, T. Evaluation of major depressive disorder in patients receiving chronic treatment with topical timolol. Ophthalmologica 2011;226:157–160.Google Scholar
13.Schweitzer, I, Maguire, K, Ng, CH. A case of melancholic depression induced by beta-blocker antiglaucoma agents. Med J Aust 2008;189:406–407.Google Scholar
14.Verbeek, DE, van Riezen, J, de Boer, RA, van Melle, JP, de Jonge, P. A review on the putative association between beta-blockers and depression. Heart Fail Clin 2011;7:89–99.Google Scholar
15.Jouvent, R, Baruch, P, Simon, P. Manic episode after propranolol withdrawal. Am J Psychiatry 1986;143:1633.Google Scholar
16.Kornischka, J, Cordes, J, Agelink, MW. 40 years beta-adrenoceptor blockers in psychiatry. Fortschr Neurol Psychiatr 2007;75:199–210Google Scholar
17.Portella, MJ, de Diego-Adeliño, J, Puigdemont, Det al. Pindolol augmentation enhances response outcomes in first depressive episodes. Eur Neuropsychopharmacol 2009;19:516–519.Google Scholar
18.Carvalho, AF, Cavalcante, JL, Castelo, MS, Lima, MC. Augmentation strategies for treatment-resistant depression: a literature review. J Clin Pharm Ther 2007;32:415–428.Google Scholar
19.Ali, S, Milev, R. Switch to mania upon discontinuation of antidepressants in patients with mood disorders: a review of literature. Can J Psychiatry 2003;48:258–264.Google Scholar