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May 19, 2021
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Propranolol is ‘quite promising’ in treating some autism symptoms

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The beta-blocker propranolol showed potential in treating certain autism symptoms, according to an initial analysis of a small, double-blinded, placebo-controlled trial.

Propranolol has been used to treat certain anxiety-related conditions “for many years,” Kristin Sohl, MD, FAAP, the executive director of ECHO Autism, told Healio Primary Care.

Change in Clinician Global Clinical Impression-Severity Scale scores: Social interaction, -0.26; Anxiety: -0.52, Verbal communication: -0.18, Overall ASD severity: -0.33
Beversdorf D, et al. Open label extension findings for a trial of propranolol in Autism Spectrum Disorder.

“Therefore, it was important to determine if this longstanding medicine is useful for the reduction of the common symptom of anxiety in autism,” she said. “There is much that can be learned even from relatively small sample sizes.”

Kristin Sohl

Sohl and colleagues, based on body weight, titrated 47 patients with autism spectrum disorder aged 7 to 24 years up to 100 mg of propranolol daily in divided doses over 12 weeks. The researchers used the Clinician Global Clinical Impression-Severity Scale, which ranks symptoms in ascending order from one to seven, to interpret results.

Sohl and colleagues reported that the score for social interaction — the trial’s primary outcome — was 4.01 (± 0.8 standard deviation) at baseline and dropped to 3.75 (± 0.82 standard deviation; P < .001) at week 12. Regarding secondary outcomes, the score for anxiety was 3.92 (± 0.89 standard deviation) at baseline and 3.4 (± 1.01 standard deviation; P < .001) at week 12, verbal communication was 3.22 (± 0.81 standard deviation) at baseline and 3.04 (± 0.78 standard deviation; P =.005) at week 12, and overall ASD severity was 3.9 (± 0.54 standard deviation) at baseline and 3.57 (± 0.68 standard deviation; P =.003) at week 12.

The data provide “critical support” for creating tailored approaches to treating autism, according to study coauthor David Beversdorf, MD, a physician and professor in the departments of radiology, neurology and psychology at MU Health Care and the University of Missouri.

David Beversdorf

Although the results are also “quite promising,” they need further analysis, the researchers wrote.

“We do not propose this as a definitive study,” Beverdorf said. “Many clinical trials in autism have a very high placebo response, and in an open-label study, we cannot differentiate the effect of drug from placebo response. Therefore, we are awaiting final analysis of the double‐blind, placebo-controlled data before coming to a conclusion.”