Propranolol for Post-Traumatic Stress Disorder: A Review of Clinical Effectiveness

Key Message

This report included four systematic reviews (that summarized nine unique relevant primary studies), three randomized controlled trials, and one non-randomized study regarding the clinical effectiveness of propranolol for the treatment and prevention of post-traumatic stress disorder (PTSD).

Based on the findings from the included literature, propranolol administered prior to trauma memory reactivation decreased the severity of PTSD symptoms, reduced physiological responses (e.g., heart rate, skin conductance, blood pressure), and improved cognitive performance in individuals with PTSD. Although these findings were largely consistent, one included study did not show a significant difference between treatment with propranolol and placebo with respect to severity of PTSD symptoms.

When used as a preventative measure following trauma, propranolol did not significantly reduce the risk for subsequent PTSD or acute stress disorder compared to placebo or no treatment. In addition, those who received propranolol did not consistently demonstrate improvements to PTSD symptom severity scores compared to those who received placebo or no treatment.

Regardless of the indication, individuals treated with propranolol experienced similar side effects to those who received placebo (when adverse events were reported); however, the included studies were not designed to thoroughly investigate the harms associated with the use of propranolol and these findings are indeterminate.