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Low-Dose Propranolol Reduces Aggression and Agitation Resembling That Associated with Orbitofrontal Dysfunction in Elderly Demented Patients

1995; Lippincott Williams & Wilkins; Volume: 9; Issue: 4 Linguagem: Inglês

10.1097/00002093-199509040-00010

1546-4156

William R. Shankle, Kristy A. Nielson, Carl W. Cotman,

Dementia and Cognitive Impairment Research

Summary Although several reports suggest that intermediate to high doses of propranolol (80–160 and 200–600 mg/day) can effectively treat aggressive behavior in dementia, significant side effects can occur at these doses. To minimize these side effects, we treated and followed-up a series of 12 demented patients, whose caregivers sought medical help for their disruptive, aggressive behavior, with low-dose propranolol monotherapy (10–80 mg/day). Assessment measures obtained at baseline and during treatment by caregiver interview included ordinal ratings of aggression severity, the Cohen-Mansfield Agitation Inventory (CMAI), and the California Behavior Questionnaire (CBQ). The aggression ratings showed that low-dose propranolol effectively reduced aggression in eight of 12 patients (67%) within 2 weeks of treatment and remained effective for the duration of follow-up (1 to 14 months). Subscales of the CMAI showed responders to have significant reductions in physical and verbal aggression/agitation and in pacing/wandering. These results suggest that low-dose propranolol should be further studied for treating aggression or agitation in demented patients.