New Uses of Propranolol, June 25, 1986

New Uses of Propranolol, June 25, 1986

1. Treatment of hyperthyroidism

This drug can quickly control hyperthyroid symptoms, but it does not affect thyroid enlargement, exophthalmos, or biochemical parameters such as serum T3, T4, and iodine uptake. Propranolol is ideal for preoperative preparation for hyperthyroidism, typically 20 mg three times daily by mouth. If a crisis is discovered during surgery, 10 mg can be administered intravenously, often turning danger into safety.

2. Treatment of migraine

Migraine is a type of headache caused by episodic vasoconstriction. Propranolol can inhibit small arterial spasms and platelet aggregation around cerebral blood vessels. Currently, propranolol is considered the best drug for treating migraines, 20 mg three times daily by mouth.

3. Treatment of schizophrenia

In recent years, the dopamine theory of the onset of this disease has been proposed, suggesting that the cerebral cortex is particularly sensitive to dopamine. Propranolol can inhibit the action of dopamine, thereby treating schizophrenia.

4. Treatment of essential tremor

Also known as tremor paralysis or Parkinson’s disease, taking 120 mg of propranolol daily can bring about a certain degree of improvement.

5. Treatment of portal hypertension

It can lower heart rate and reduce hepatic venous wedge pressure. In patients with cirrhosis, the hepatic venous wedge pressure directly reflects portal vein pressure; therefore, reducing the wedge pressure with propranolol is equivalent to reducing portal vein pressure. At the same time, since propranolol reduces cardiac output, visceral arterial blood flow correspondingly decreases, thus lowering portal vein pressure as well. Lebrec first used propranolol at doses of 40–180 mg twice daily by mouth to treat eight patients with portal hypertension-related variceal bleeding for one month, confirming that the reduction in cardiac index leads to decreased visceral arterial blood flow, thereby lowering portal vein pressure.

6. Anxiety state

Patients with this condition often experience varying degrees of combined psychological and physical symptoms, such as palpitations, tremors, and sweating. These symptoms are all caused by increased sympathetic nervous system excitability, so the use of propranolol often yields satisfactory results.