Alcohol and beta blockers

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The Role of Beta Blockers in Alcohol Withdrawal Syndrome

Introduction to Alcohol Withdrawal Syndrome and Beta Blockers

Alcohol withdrawal syndrome (AWS) is a potentially life-threatening condition that occurs when individuals with chronic alcohol use suddenly stop drinking. Symptoms can range from mild anxiety and tremors to severe complications like seizures and delirium tremens. Beta blockers, commonly used to manage cardiovascular conditions, have been investigated for their potential benefits in treating AWS.

Efficacy of Beta Blockers in Alcohol Withdrawal Syndrome

Clinical Trial Findings on Atenolol

A randomized, double-blind clinical trial evaluated the effectiveness of atenolol, a beta blocker, in patients hospitalized with AWS. The study included 120 patients who were randomly assigned to receive either atenolol or a placebo, in addition to standard therapy. The results demonstrated that patients treated with atenolol experienced a more rapid normalization of vital signs and a quicker resolution of abnormal behaviors and clinical symptoms such as tremors and agitation compared to those receiving the placebo. Additionally, fewer patients in the atenolol group required additional medication (oxazepam) for agitation, and those who did need it required lower doses .

Systematic Review and Meta-Analysis Insights

A systematic review and meta-analysis assessed the efficacy of drugs acting on adrenergic receptors, including beta blockers, in treating alcohol use disorders. The analysis included six studies focused on alcohol use disorder. While the review found that alpha-1 antagonists like prazosin and doxazosin were effective in reducing alcohol consumption, beta blockers did not show a significant impact on abstinence or heavy drinking days (HDD) .

Conclusion

The evidence suggests that beta blockers, particularly atenolol, can be beneficial in managing the symptoms of alcohol withdrawal syndrome by stabilizing vital signs and reducing agitation and tremors. However, their role in long-term alcohol use disorder treatment, particularly in achieving abstinence or reducing heavy drinking days, appears limited. Further research is needed to fully understand the potential benefits and limitations of beta blockers in the broader context of alcohol use disorder treatment.

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Most relevant research papers on this topic

The role of beta blockers in alcohol withdrawal syndrome.

Atenolol is effective in treating alcohol withdrawal syndrome, reducing agitation and requiring less oxazepam therapy than placebo patients.

RCT

1988·

8citations

·L. Gottlieb

Effectiveness of drugs acting on adrenergic receptors in the treatment for tobacco or alcohol use disorders: systematic review and meta-analysis.

Clonidine, an alpha-2 agonist, effectively increased smoking abstinence in tobacco use disorder patients, while beta-blockers showed no significant effect.

Meta-AnalysisRigorous Journal

2020·

11citations

·P. Vanderkam et al.

Treatment with non-selective beta blockers is associated with reduced severity of systemic inflammation and improved survival of patients with acute-on-chronic liver failure.

Ongoing treatment with non-selective beta blockers in cirrhotic patients is safe and reduces mortality when they develop acute-on-chronic liver failure.

Observational StudyRigorous JournalHighly Cited

2016·

221citations

·R. Mookerjee et al.

Beta 2 Adrenergic Receptor Antagonist Propranolol and Opioidergic Receptor Antagonist Naltrexone Produce Synergistic Effects on Breast Cancer Growth Prevention by Acting on Cancer Cells and Immune Environment in a Preclinical Model of Breast Cancer

Propranolol and naltrexone combined show promising antitumor effects in preclinical breast cancer models, improving survival rates and reducing inflammatory cytokine levels.

Non-RCTAnimal StudyRigorous Journal

2021·

14citations

·Sengottuvelan Murugan et al.

Renal effects of beta-adrenoceptor blockade.

Beta-blockers may reduce renal function through changes in sodium and water balance, renin-angiotensin system activity, and possibly acting within the kidney itself.

1980·

57citations

·M. Weber et al.

Beta‐blockers for hypertension

Beta-blockers show no significant difference in all-cause mortality between them and other first-line therapies for hypertension in adults.

Systematic ReviewVery Rigorous JournalHighly Cited

2017·

99citations

·C. Wiysonge et al.

Beta-blockers in hypertension.

Beta blockers, particularly those with vasodilatory actions, are an appropriate treatment option for hypertension in certain patients, despite recent concerns about their effectiveness and co-morbidity effects.

Meta-AnalysisHighly Cited

2010·

89citations

·C. Ram

Beta-blockers and Traumatic Brain Injury: A Systematic Review, Meta-analysis, and Eastern Association for the Surgery of Trauma Guideline.

Beta-blockers show a significant mortality advantage in adults with acute traumatic brain injury, but more high-quality trials are needed to confirm their effectiveness and functional outcomes.

Meta-AnalysisHighly Cited

2017·

70citations

·Aziz S. Alali et al.

Beta-blockers in hypertension: overview and meta-analysis of randomized outcome trials.

Beta-blockers can reduce the risk of major cardiovascular events and all-cause death when prescribed to lower blood pressure in patients with modest or clear BP elevations, but are less protective against stroke and overall mortality compared to other antihypertensive agents.

Meta-AnalysisVery Rigorous Journal

2020·

37citations

·C. Thomopoulos et al.

Current and Future Status of Beta‐blockers in the Treatment of Hypertension

Beta-blockers are effective and safe antihypertensive drugs, and should remain as first-line therapy for most uncomplicated hypertensive patients, with reservations for diabetic and older patients.

Systematic Review

2008·

33citations

·S. Chrysant et al.

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