BP medication may reduce anxiety symptoms in children, young adults with autism
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Key takeaways:
- Treatment with a common BP medication may reduce symptoms of anxiety in young people with autism.
- There was no association between propranolol treatment and improvements in social interaction and language.
Children and young adults with autism spectrum disorder experienced reduced anxiety symptoms after 12 weeks of treatment with the BP medication propranolol vs. placebo, though it did not improve scores for social interaction and language.
Data from single-dose, psychopharmacology challenge studies, reported previously by Healio, have demonstrated that the beta-blocker propranolol could potentially be beneficial for people with autism spectrum disorder, with improved scores for verbal problem solving and social interaction tasks, David Q. Beversdorf, MD, professor in the departments of radiology, neurology and psychological sciences at the University of Missouri, said during an interview. Additionally, a literature review suggests propranolol is a promising agent for emotional, behavioral and autonomic dysregulation in autism spectrum disorder, though randomized controlled trials are lacking, Beversdorf said.
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“We were hoping to see those benefits in a clinical trial,” Beversdorf told Healio. “The trial did not reveal those outcomes, but [treatment] did show an improvement in anxiety.”
Beversdorf and colleagues analyzed data from 69 children and young adults with autism spectrum disorder aged 7 to 24 years, recruited from the Thompson Center for Autism and Neurodevelopment at the University of Missouri (average age of participants, 14 years). Researchers randomly assigned participants to propranolol or placebo for 12 weeks. Masked assessments took place at baseline, 6 and 12 weeks. The primary outcome was the General Social Outcome Measure-2 (GSOM-2) for social interaction; secondary outcomes were the Clinician Global Clinical Impression-Improvement (CGI-I) ratings independently conducted for social interaction, anxiety and language at 6 and 12 weeks.
The findings were published in Psychopharmacology.
The researchers did not observe any effects of propranolol for GSOM-2 or CGI-I scales for social interaction or language. However, scores for CGI-I for anxiety showed greater improvement with propranolol at the 12-week time point (OR = 2.58; 95% CI, 1.02-6.52; P = .045).
Beversdorf said there are plans to assess biomarkers, such as heart rate variability and imaging markers, to determine who might respond better to propranolol therapy, including social domain scores.
“With those biomarkers, we want to see if we can parse out who those best responders are,” Beversdorf told Healio. “A larger trial can also help us to us better determine that. We are also looking at nonpharmaceutical approaches, including vagal nerve stimulation. We have some pilot data suggesting that might be beneficial.”
The researchers also observed small but expected decreases in heart rate and BP with propranolol, noting any adverse effects were uncommon. There was one psychiatric event requiring treatment in both the propranolol and the placebo arms.
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