Missouri Study Weighs in on use of Propranolol (Blood Pressure) for the Presentation of Anxiety w/in Young Adults w/ ASD

[TravelingWiki]

Background: I wanted to post this here in case it could assist anyone in any conversations with medical professionals. Dr. Temple Grandin has noted in the recent video I taped at her office at Colorado State University about ways she has opined activities of daily life can assist in making the travel experience more seamless and less stressful for The Special Needs Community.

Caveat: To be clear, my expertise is in travel, and there is no intention whatsoever to opine separately. With that being said, as one of the themes I have heard repeatedly as to considerations creating barriers to travel for the Autism community has been "anxiety" associated with the crowds, noise, stimulation, etc. as present in airports, I wanted to share this link:

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

Conclusions of Study: 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.

Link: https://link.springer.com/article/10.1007/s00213-023-06452-1

See Also (Additional Commentary): https://www.columbiamissourian.com/news/highe...1c-b3394c1aca4b.html

Best Regards,
Jonathan
My Autism Non-Profit Website: http://www.Travelingwiki.com
Special Olympics Profile on TravelingWiki Non-Profit Work (Page 9): http://alturl.com/k862b
Media / Other Coverage of TravelingWiki: https://travelingwiki.com/travelingwiki-in-the-news

 

[marc_101]

Thanks. We discussed this in other posts recently. Propranolol is a beta blocker. There are other beta blockers in the market. I use beta blockers from time to time. They are great for me. My body calms down and then my mind calms down.

This is a guess, but I suspect that they are effective among those like me who have problems recognizing/identifying emotions. I feel weird things in my body, including elevated heart rate, which beta blockers eliminate

 

[TravelingWiki]

Thank you for that feedback. As noted above, my expertise is in travel...with that being said, as this came up in my research for my writing of my second article for Autism Parenting Magazine (where Dr. Temple Grandin, during an interview, noted the impact of anxiety on air travel for the Autism community), I though it may be relevant to post. I deeply appreciate the feedback, as opinion on RX-related impact is not within my area of expertise. There is additional commentary with anecdotal reports of efficacy at https://www.dcurbanmom.com/jforum/posts/list/1191225.page (a forum for various parenting topics within the DC area...and potentially beyond..)

As discussed previously, I am deeply passionate about finding ways to augment access to air travel for the Special Needs Community. Thank you again for this opportunity to engage.

Best Regards, Jonathan My Autism Non-Profit Website: http://www.Travelingwiki.com Special Olympics Profile on TravelingWiki Non-Profit Work (Page 9): http://alturl.com/k862b Media / Other Coverage of TravelingWiki: TravelingWiki in the News

 

[Yeshuasdaughter]

I don't like the idea of a cardiovascular drug being used off label.

"Quit playing games with my heart"..

 

[marc_101]

It's very safe and has been used for many years. About 65% of adults over 60 have hypertension, and many use beta blockers and similar drugs. It has contributed greatly to the reduction in adverse cardiovascular events.

Having said that, it has contraindications so it's an individual discussion with doctors.

 

[Tom]

I was in the Air Force and Army for 27 years and also had a pretty strong fear of flying. I would of loved something like this to try as I don't like the mind altering stuff.

Medications designed for one thing found to help in another happens all the time.

I even took one of my dogs heart meds by accident one time. (Me and my dogs have a lot of pills - oldsters). I looked it up and saw it was not approved for humans in USA but! was in Japan, so I'm fine relax...
Moral of the story: Don't be an idiot like me and take your dogs drugs.

 

[Fino]

Its commonly prescribed for anxiety. I took it for a while.

 

[Neonatal RRT]

To be more clear about Propranolol: As a beta-blocker, it is used to reduce some of the cardiovascular symptoms of anxiety such as elevated blood pressure, tachycardia, and so on. It DOES NOT prevent anxiety. In other words, you still have anxiety, but you may be less aware of it, and if you go for a physician visit (which also is known to induce anxiety), your blood pressure and heart rate may not be elevated.

Beta-blockers cannot be used in patients with asthma, including anxiety-induced bronchospasm, as the common rescue drugs used to treat this condition are beta-agonists. Albuterol being one example of a common asthma rescue medication in which the mechanism of action would be blocked by a beta-blocker like Propranolol.

Beta-blockers like Propranolol also block the growth of blood vessels and can actually cause vascular regression. In fact, many years ago, some of our ophthalmologists used propranolol for the treatment of retinopathy of prematurity in some of our premature infants in the neonatal unit. We use another drug, Avastin, for this now, but this drug also causes vascular regression. If you are diabetic, if you have a healing wound, if you are involved in athletics, or any other situation where blood vessel growth and health is important, you do not want to be taking Propranolol.

Propranolol is a good medication for very specific, short-term cardiovascular (heart rate and blood pressure) and cerebral-vascular conditions (migraines, etc), and although, in very specific patients it offers an inexpensive option for managing their symptoms, over the long-term, it is not recommended. There are better medications out there.

 

[WhitewaterWoman]

I had a friend who was a jazz musician. He used beta blockers before public performances to reduce his performance anxiety. I was a little taken-aback, but apparent these drugs are used to reduce anxiety in performing musicians.

 

[marc_101]

To be more clear about Propranolol: As a beta-blocker, it is used to reduce some of the cardiovascular symptoms of anxiety such as elevated blood pressure, tachycardia, and so on. It DOES NOT alleviate anxiety. In other words, you still have anxiety, but you may be less aware of it, and if you go for a physician visit (which also is known to induce anxiety), your blood pressure and heart rate may not be elevated.

Isn't that changing the definition of anxiety, though? I can only speak for sure about my own experience. Beta blockers greatly reduce my feeling of anxiety. My mind is racing, my body feels uneasy, I can't focus, as when I drink too much coffee. 30 mins after a beta blocker, I feel calm. Because I feel calm, my thoughts change. If I was anxious about a meeting going badly, suddenly I don't have those thoughts anymore.

A dictionary definition of anxiety is "A state of uneasiness and apprehension, as about future uncertainties." So by that definition, a beta blocker greatly alleviates my anxiety -- again, this is for me, I'm sure that it doesn't have the same effect on every person.

 

[MC1Rcat]

I take a beta blocker off-label as a migraine preventative. It also helps me w/ IBS, anxiety and some of my dysautonomia symptoms. You do have to be careful with them, as they interact with a lot of other commonly used medicines, like lidocaine for instance. I have ended up in the ER with bradycardia from interactions with that because a doctor did not read my chart before injection was given. I always ask now, if something will interact with it, before taking any new medicine or letting someone give me an injection. Betas are also famous for messing with blood sugar (too hi or low), so if you are diabetic or pre-diabetic or on them for a long time, you will want to keep that on your radar.

 

[marc_101]

@MC1Rcat Agreed. It's good to ask questions and check if something is ok for you. Even the asthma warning with beta blockers comes with asterisks. I have asthma. Also, some contraindications are related to people that use beta blockers daily for hypertension, not for somebody who will take half a pill once a week for anxiety or before a musical performance.

PSA: talk to a doctor before taking any meds!

 

[Neonatal RRT]

Isn't that changing the definition of anxiety, though? I can only speak for sure about my own experience. Beta blockers greatly reduce my feeling of anxiety. My mind is racing, my body feels uneasy, I can't focus, as when I drink too much coffee. 30 mins after a beta blocker, I feel calm. Because I feel calm, my thoughts change. If I was anxious about a meeting going badly, suddenly I don't have those thoughts anymore.

A dictionary definition of anxiety is "A state of uneasiness and apprehension, as about future uncertainties." So by that definition, a beta blocker greatly alleviates my anxiety -- again, this is for me, I'm sure that it doesn't have the same effect on every person.

Think of it as "masking". Propranolol is masking the anxiety by blocking some of the cardiovascular symptoms of anxiety, but not the anxiety, per se. There is biofeedback loop where the anxiety triggers physical symptoms, a stress response, catecholamine release, then tachycardia, vasoconstriction, cool clammy hands, increased blood pressure, shaking/tremors, etc. The person recognizes all these symptoms, anxiety is further increased, and cycle can amplify itself. Now, if you take propranolol, it blocks these symptoms, the initial triggers of anxiety may come and go like a wave, and the body is none-the-wiser. The mind can then relax and go back to its baseline.

To further contribute to this is that people with varying degrees of depression are also very "in-tune" with how they are feeling. They ruminate, they typically over think. They are often "inward" thinking. They tend to socially isolate themselves. They worry a lot. This, in and of itself, can amplify the anxiety experience and often results in the mind racing on all sorts of "what if" questions, potential bad outcomes, and inhibitory or avoidance behaviors. Conversely, folks without depression are often "outward" thinkers, they don't spend much time thinking of themselves, tend not to worry, they don't hesitate to do things, they are far more social, they do a quick risk analysis and if the risks are low, they proceed. They don't pause because of all the rare "what if" scenarios. They don't make "mountains out of molehills". They certainly may have transient and occasional experiences with anxiety, but it is not a "chronic condition".

Often with autism, there is low dopamine and serotonin. Autism is known as a "low dopamine neurological condition", but with that comes varying degrees of depression, rumination, and anxiety. You don't have to spend too much time on this forum to notice that the folks most likely to be struggling with anxieties, are also experiencing depression and spend a lot of time by themselves in a self-rumination cycle.

So, this is my perspective on this topic of Propranolol. Beta-blocker pathways are treating some of the outward symptoms commonly associated with anxiety, making one feel better, but it is not treating the anxiety, per se.

 

[marc_101]

Under that definition, then, I love the ability of beta blockers to mask my anxiety!

 

[Fino]

I actually took it o counter some of the side effects of Adderall when I was taking a much too high dose of it. It wasn't an ideal situation and luckily only lasted a few months. My next doctor was shocked by the dosages I was given.

 

[TravelingWiki]

Connecting this discussion to the discussion on DC Urban Moms & Dads in case that engagement could be helpful: Missouri Study Weighs in on use of Propranolol (Blood Pressure) for the Presentation of Anxiety w/in Young Adults w/ ASD