Randomized controlled trial of propranolol on social communication and anxiety in children and young adults with autism spectrum disorder.

Autor: Beversdorf DQ; Thompson Center for Autism & Neurodevelopmental Disorders, University of Missouri, One Hospital Drive, Columbia, MO, DC069.1065212, USA. beversdorfd@health.missouri.edu.; Departments of Radiology, Neurology, and Psychological Sciences, University of Missouri, Columbia, USA. beversdorfd@health.missouri.edu.; William and Nancy Thompson Endowed Chair in Radiology, University of Missouri, Columbia, USA. beversdorfd@health.missouri.edu., Ferguson B; Thompson Center for Autism & Neurodevelopmental Disorders, University of Missouri, One Hospital Drive, Columbia, MO, DC069.1065212, USA.; Department of Neurology, University of Missouri, Columbia, USA., Hunter S; Thompson Center for Autism & Neurodevelopmental Disorders, University of Missouri, One Hospital Drive, Columbia, MO, DC069.1065212, USA., Hirst K; Thompson Center for Autism & Neurodevelopmental Disorders, University of Missouri, One Hospital Drive, Columbia, MO, DC069.1065212, USA., Lolli B; Thompson Center for Autism & Neurodevelopmental Disorders, University of Missouri, One Hospital Drive, Columbia, MO, DC069.1065212, USA., Bellesheim KR; University of Michigan, Ann Arbor, USA., Barton AU; Northwest Missouri State University, Maryville, USA., Muckerman J; Thompson Center for Autism & Neurodevelopmental Disorders, University of Missouri, One Hospital Drive, Columbia, MO, DC069.1065212, USA., Takahashi N; Thompson Center for Autism & Neurodevelopmental Disorders, University of Missouri, One Hospital Drive, Columbia, MO, DC069.1065212, USA., Selders K; Thompson Center for Autism & Neurodevelopmental Disorders, University of Missouri, One Hospital Drive, Columbia, MO, DC069.1065212, USA., Holem R; Thompson Center for Autism & Neurodevelopmental Disorders, University of Missouri, One Hospital Drive, Columbia, MO, DC069.1065212, USA.; University of Missouri School of Medicine, Columbia, USA., Sohl K; Deparment of Child Health, University of Missouri, Columbia, USA., Dyke P; Deparment of Child Health, University of Missouri, Columbia, USA., Stichter J; Department of Special Education, University of Missouri, Columbia, USA., Mazurek M; University of Virginia, Charlottesville, USA., Kanne S; Weill-Cornell Medical College, NY, USA.
Jazyk: angličtina
Zdroj: Psychopharmacology [Psychopharmacology (Berl)] 2024 Jan; Vol. 241 (1), pp. 19-32. Date of Electronic Publication: 2023 Dec 13.
DOI: 10.1007/s00213-023-06452-1
Abstrakt: Rationale: Autism spectrum disorder (ASD) is characterized by impaired social communication and is also frequently characterized by co-occurring anxiety. Propranolol is widely utilized to treat performance and public speaking anxiety. Single-dose psychopharmacological challenge studies suggested benefits using propranolol for verbal tasks and social interaction.
Objective: We conducted a double-blinded, placebo-controlled trial of the β-adrenergic antagonist propranolol in ASD for social interaction, anxiety, and language.
Methods: Seventy-four participants with ASD, age 7-24 years, were enrolled and randomized to a 12-week course of propranolol or placebo, with blinded assessments at baseline, 6 weeks, and 12 weeks. The primary outcome was the General Social Outcome Measure-2 (GSOM-2) for social interaction, and secondary outcomes were the Clinician Global Clinical Impression-Improvement (CGI-I) ratings independently conducted for social interaction, anxiety, and language at 6 weeks and 12 weeks.
Results: Sixty-nine participants completed the 12-week visit. No significant effect of drug was found for the GSOM-2 or the CGI-I for social interaction or language. CGI-I for anxiety showed greater improvement with propranolol at the 12-week time point (p = 0.045, odds ratio = 2.58 (95% CI = 1.02-6.52). Expected decreases in heart rate and blood pressure were observed with propranolol, and side effects were uncommon.
Conclusions: Propranolol did not impact social interaction measures or language, but there were indications of a beneficial effect for anxiety. This will need confirmation in a larger multicenter trial, monitoring markers or characteristics to identify those participants most likely to respond to propranolol for anxiety, and determine whether there is a subset of participants that are responsive for other previously reported outcomes.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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