Which medications in the drug class Antihypertensive Agent are used in the treatment of Anxiety Disorders?

Updated: Mar 27, 2019
  • Author: Nita V Bhatt, MD, MPH; Chief Editor: David Bienenfeld, MD  more...
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Antihypertensive Agent

Agents in this class may have a positive effect on the physiological symptoms of anxiety. Beta-blockers such as atenolol, nadolol, or propranolol may be useful for the circumscribed treatment of situational/performance anxiety on an as-needed basis. A pilot study revealed propranolol is effective in decreasing physiological signs of hyperarousal for up to 1 week when used shortly after patients with PTSD re-experience their traumatic event. [17]

Clonidine (Catapres)

Investigational agent. Central alpha-adrenergic agonist that stimulates alpha2-adrenoreceptors in brain stem and activates an inhibitory neuron, resulting in a decrease in vasomotor tone and heart rate. Available in tab or transdermal skin patches. Frequently given to children. Affects alpha1-, alpha2-, and alpha3-adrenergic receptors.

Propranolol (Inderal, Betachron E-R, InnoPran XL)

Investigational agent. Blocks the physiological symptoms of anxiety and may be helpful for decreasing the severity of the somatic symptoms of anxiety. May cause unpleasant cardiovascular and GI adverse effects and is not the DOC especially as hypotension and/or cardiac block can occur. Initiation of therapy should be performed with close monitoring of blood pressure to prevent hypotensive crisis. Do not discontinue abruptly as this may precipitate hypertensive crisis. Available as tablets, sustained release, and liquid preparations.

Nadolol (Corgard)

Competitively blocks beta1 and beta2-receptors. Does not exhibit membrane stabilizing activity or intrinsic sympathomimetic activity.

Atenolol (Tenormin)

Used to treat hypertension. Selectively blocks beta1-receptors with little or no affect on beta2 types. Beta-adrenergic blocking agents affect blood pressure via multiple mechanisms. Actions include negative chronotropic effect that decreases heart rate at rest and after exercise, negative inotropic effect that decreases cardiac output, reduction of sympathetic outflow from the CNS, and suppression of renin release from the kidneys. Used to improve and preserve hemodynamic status by acting on myocardial contractility, reducing congestion, and decreasing myocardial energy expenditure.

Beta-adrenergic blockers reduce inotropic state of left ventricle, decrease diastolic dysfunction, and increase LV compliance, thereby reducing pressure gradient across LV outflow tract. Decreases myocardial oxygen consumption, thereby reducing myocardial ischemia potential. Decreases heart rate, thus reducing myocardial oxygen consumption and reducing myocardial ischemia potential. During IV administration, carefully monitor blood pressure, heart rate, and ECG

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