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Propranolol

TRIGGER WARNING: The following article contains references to sex and sexual activities. Care should be taken when reading the information below.

Propranolol, sold under the brand name Inderal among others, is a medication of the beta blocker class. It is used to treat high blood pressure, a number of types of irregular heart rate, thyrotoxicosis, capillary hemangiomas, performance anxiety, and essential tremors. It is used to prevent migraine headaches, and to prevent further heart problems in those with angina or previous heart attacks. It can be taken by mouth or by injection into a vein. The formulation that is taken by mouth comes in short-acting and long-acting versions. Propranolol appears in the blood after 30 minutes and has a maximum effect between 60 and 90 minutes when taken by mouth.

Psychiatric
Propranolol is occasionally used to treat performance anxiety, although evidence to support its use in any anxiety disorders is poor. Its benefits appear similar to benzodiazepines in panic disorder with potentially fewer side effects such as addiction. Some experimentation has been conducted in other psychiatric areas:
  • Post-traumatic stress disorder (PTSD) and specific phobias (see subsection below)
  • Aggressive behavior of patients with brain injuries
  • Treating the excessive drinking of fluids in psychogenic polydipsia
PTSD and phobias
Propranolol is being investigated as a potential treatment for PTSD. Propranolol works to inhibit the actions of norepinephrine, a neurotransmitter that enhances memory consolidation. In one small study individuals given propranolol immediately after trauma experienced fewer stress-related symptoms and lower rates of PTSD than respective control groups who did not receive the drug. Due to the fact that memories and their emotional content are reconsolidated in the hours after they are recalled/re-experienced, propranolol can also diminish the emotional impact of already formed memories; for this reason, it is also being studied in the treatment of specific phobias, such as arachnophobia, dental fear, and social phobia.

Ethical and legal questions have been raised surrounding the use of propranolol-based medications for use as a "memory damper", including: altering memory-recalled evidence during an investigation, modifying behavioral response to past (albeit traumatic) experiences, the regulation of these drugs, and others. However, Hall and Carter have argued that many such objections are "based on wildly exaggerated and unrealistic scenarios that ignore the limited action of propranolol in affecting memory, underplay the debilitating impact that PTSD has on those who suffer from it, and fail to acknowledge the extent to which drugs like alcohol are already used for this purpose."

Adverse effects
Propranolol should be used with caution in people with:
  • Diabetes mellitus or hyperthyroidism, since signs and symptoms of hypoglycaemia may be masked
  • Peripheral artery disease and Raynaud's syndrome, which may be exacerbated
  • Phaeochromocytoma, as hypertension may be aggravated without prior alpha blocker therapy
  • Myasthenia gravis, which may be worsened
  • Other drugs with bradycardic effects

Pregnancy and lactation
Propranolol, like other beta blockers, is classified as pregnancy category C in the United States and ADEC category C in Australia. β-blocking agents in general reduce perfusion of the placenta, which may lead to adverse outcomes for the neonate, including lung or heart complications, or premature birth. The newborn may experience additional adverse effects such as low blood sugar and a slower than normal heart rate.

Most β-blocking agents appear in the milk of lactating women. However, propranolol is highly bound to proteins in the bloodstream and is distributed into breast milk at very low levels. These low levels are not expected to pose any risk to the breastfeeding infant, and the American Academy of Pediatrics considers propranolol therapy "generally compatible with breastfeeding".



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Information taken from Wikipedia under the Creative Commons Attribution-ShareAlike License.

Content should be used for information only. The information located above was accurate from Wikipedia at the time of publish. The information above does not replace advice from a trained medical professional. If in any doubt, seek immediate medical assistance.
 

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