Propranolol and alcohol
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Propranolol and Alcohol: Interactions and Effects
Propranolol and Acute Alcohol Intoxication
Research has shown that propranolol does not mitigate the effects of acute alcohol intoxication. In a study involving healthy male volunteers, propranolol was administered after alcohol ingestion. The results indicated that propranolol did not antagonize any of the effects of alcohol, such as reduced motor coordination, memory impairment, and altered mood. In fact, propranolol increased the effects of alcohol on divided attention and inebriation ratings without altering blood alcohol concentrations1. Another study with chronic alcoholic addicts also found that propranolol pretreatment did not block or attenuate cognitive, perceptual, motor, and affective changes induced by acute alcohol intoxication7.
Propranolol and Alcohol Withdrawal
Propranolol has been studied for its effects on alcohol withdrawal symptoms. In a double-blind controlled trial comparing propranolol to diazepam, both drugs showed improvement in blood pressure, pulse, and withdrawal tremor. However, propranolol was associated with a higher incidence of withdrawal seizures and increasing withdrawal symptoms requiring additional treatment, suggesting that minor tranquilizers like diazepam remain the preferred treatment for alcohol withdrawal syndrome2. Another study found that propranolol was not significantly effective in reducing withdrawal tremor compared to a placebo10.
Propranolol and Alcohol Consumption
The impact of propranolol on alcohol consumption has been explored in animal models. Studies on rats indicated that propranolol alone was not effective in reducing alcohol intake. However, when combined with prazosin, an α1-adrenergic receptor antagonist, the combination was more effective in reducing alcohol drinking during both withdrawal and prolonged abstinence periods4. This suggests that a combination therapy targeting multiple adrenergic receptors may be more beneficial in managing alcohol consumption and preventing relapse.
Propranolol and Alcohol Metabolism
Propranolol has been found to inhibit alcohol and aldehyde dehydrogenases, enzymes involved in alcohol metabolism. This inhibition is reversible and suggests that propranolol could potentially slow ethanol oxidation and modify the metabolism of deaminated biogenic amines5. However, the clinical significance of this inhibition in humans remains to be fully understood.
Propranolol and Alcohol-Related Cardiac Issues
During alcohol withdrawal, cardiac arrhythmias can be a concern. Propranolol has been shown to be effective in controlling arrhythmias during the first 48 hours of alcohol withdrawal. However, its use was limited due to the association with hallucinations. The combination of propranolol and chlordiazepoxide was found to be the most effective in reducing arrhythmias with the fewest treatment failures6.
Propranolol and Alcohol Hangover
A study assessing the effect of propranolol on hangover symptoms found that while beta blockade was achieved, there was no clinically significant reduction in hangover symptoms. This suggests that propranolol is not effective in preventing the symptoms of an alcohol hangover9.
Conclusion
Propranolol has varied effects when used in conjunction with alcohol. It does not mitigate the acute effects of alcohol intoxication and is not particularly effective in managing alcohol withdrawal symptoms or reducing alcohol consumption when used alone. However, it may have some utility in combination therapies for reducing alcohol intake and managing withdrawal-related cardiac arrhythmias. Further research is needed to fully understand the potential benefits and limitations of propranolol in the context of alcohol use and withdrawal.
Sources and full results
Most relevant research papers on this topic
Reversal of ethanol intoxication in humans: An assessment of the efficacy of propranolol
Propranolol increases ethanol's effects on divided attention, inebriation ratings, and electroencephalogram without significantly altering blood alcohol concentrations, suggesting central catecholamine-stimulating drugs may reverse some of ethanol's effects.
RCTPropranolol versus diazepam in the management of the alcohol withdrawal syndrome: double-blind controlled trial.
Minor tranquilizers, such as diazepam, are the "gold standard" for managing alcohol withdrawal symptoms in most patients, while propranolol may cause seizures.
RCTPropranolol and alcohol consumption in the rat.
Propranolol does not effectively reduce alcohol consumption in rats, contrary to previous reports suggesting its potential use in reducing opiate cravings.
Non-RCT
Animal StudyCombining the α1 -adrenergic receptor antagonist, prazosin, with the β-adrenergic receptor antagonist, propranolol, reduces alcohol drinking more effectively than either drug alone.
Combining prazosin and propranolol effectively reduces alcohol drinking in rats, potentially aiding in preventing alcohol relapse in some individuals.
Non-RCTAnimal Study
Rigorous JournalThe inhibition of alcohol and aldehyde dehydrogenases by propranolol.
Propranolol can slow ethanol oxidation and modify biogenic amine metabolism by inhibiting alcohol and aldehyde dehydrogenases.
In Vitro StudyPropranolol and chlordiazepoxide effects on cardiac arrhythmias during alcohol withdrawal.
Propranolol and chlordiazepoxide combination effectively reduces cardiac arrhythmias during alcohol withdrawal, with few treatment failures and minimal side effects.
Observational StudyPropranolol and behavior of alcohol addicts after acute alcohol ingestion
Propranolol pretreatment did not prevent cognitive, perceptual, motor, and affective changes induced by acute alcohol intoxication in chronic alcoholic addicts.
Non-RCTPrevention of recurrent variceal bleeding in alcoholic cirrhotic patients: prospective controlled trial of propranolol and sclerotherapy.
Propranolol shows a tendency to prevent rebleeding and increase survival in alcoholic cirrhotic patients, but its effectiveness remains unresolved due to poor statistical power.
RCTPropranolol for the treatment of the alcoholic hangover.
Propranolol does not significantly reduce the symptoms of alcoholic hangover.
RCTEffect of propranolol on acute withdrawal tremor in alcoholic patients.
Propranolol does not significantly reduce acute alcohol withdrawal tremor compared to placebo.
RCT