Treatment of infantile haemangiomas with atenolol: Comparison with a historical propranolol group

Psychopharmacological interventions for managing aggression in schizophrenia have thus far yielded inconsistent results. This study evaluates the antiaggressive efficacy of combined haloperidol-propranolol treatment. Thirty-four newly admitted schizophrenic patients were studied in a controlled double-blind trial. Following a 3-day drug-free period and 7 days of haloperidol treatment, patients were randomly assigned to receive either haloperidol-propranolol or haloperidol-placebo for eight consecutive weeks. Doses of medications were adjusted as necessary; biperiden was administered if required. Rating scales were applied to assess aggression, anger, psychosis, depression, anxiety and extrapyramidal symptoms. The mean daily dose of haloperidol was 21 mg (SD = 6.4) in the research group and 29 mg (SD = 6.9) in the controls. Mean and maximal daily doses of propranolol were 159 mg (SD = 61) and 192 mg (SD = 83), and of placebo, 145 mg (SD = 50) and 180 mg (SD = 70), respectively. Compared with the controls, the scores for the research patients decreased significantly from baseline, particularly after 4 weeks of treatment, for some dimensions of anger, psychosis, anxiety, and neuroleptic-induced parkinsonism. A tendency for reduced aggression was shown in the combined haloperidol-propranolol group for some dimensions but not others. These patients also required significantly less biperiden. The tendency toward elevated antiaggressive effect of combined haloperidol-propranolol treatment compared to haloperidol alone may be explained by a simultaneous decrease in aggression, psychotic symptomatology, and anxiety.

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Infantile haemangioma: 5-year experience at the vascular anomaly clinic

Egyptian Pediatric Association Gazette ◽

10.1186/s43054-021-00062-2 ◽

2021 ◽

Vol 69 (1) ◽

Author(s):

Amr Abdelhamid AbouZeid ◽

Iman A. Ragab ◽

Shaimaa Abdelsattar Mohammad ◽

Wael Ahmed Ghanem ◽

Haytham Mohamed Nasser ◽

...

Keyword(s):

Neck Region ◽

Vascular Anomaly ◽

Paediatric Population ◽

Favourable Outcome ◽

Tumour Regression ◽

Main Body ◽

Female Predominance ◽

The Face ◽

Spontaneous Involution ◽

Infantile Haemangiomas

Abstract Background Infantile haemangiomas (IH) represent a common benign vascular tumour affecting the paediatric population. Infantile haemangiomas are characterised by a natural history differentiating it from other vascular anomalies. After a transient proliferative phase in early infancy, the tumour passes through a plateau phase before going into spontaneous involution. In this report, we tried to share our experience over the last 5 years in managing cases presenting with IH at a specialised vascular anomaly clinic. Main body of abstract This report included cases of IH who were attending the vascular anomaly clinic during the period 2015 through 2019. Data of all patients attending the clinic were retrospectively examined. Files of 103 cases with IH were available for review. The diagnosis of IH was usually straight forward owing to the typical history and characteristic findings at clinical examination. A significant female predominance was noticed. Generally, IH were more common in the head and neck region (70%). Active intervention was necessary in specific situations (eye occlusion, airway involvement, large lesions with skin ulcerations). Whenever intervention proved to be necessary, propranolol was chosen as the first line of treatment with a favourable response detected in about 90% of cases. Surgery was still a valid option (6%) for lesions amenable to resection; however, we must put in consideration that most lesions will spontaneously regress. Conclusion Infantile haemangiomas are common benign vascular tumours of infancy with relatively few complications. Cosmesis is a major concern especially for lesions affecting the face. Propranolol can induce tumour regression in most cases, and generally, a favourable outcome can be anticipated.

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Neural substrates of propranolol-induced impairments in the reconsolidation of nicotine-associated memories in smokers

Translational Psychiatry ◽

10.1038/s41398-021-01566-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Xiao Lin ◽

Jiahui Deng ◽

Kai Yuan ◽

Qiandong Wang ◽

Lin Liu ◽

...

Keyword(s):

Neural Activity ◽

Neural Substrates ◽

Brain Regions ◽

Reward Processing ◽

Memory Reconsolidation ◽

Functional Magnetic Resonance ◽

Resonance Imaging ◽

Postcentral Gyrus ◽

Propranolol Group ◽

Propranolol Administration

AbstractThe majority of smokers relapse even after successfully quitting because of the craving to smoking after unexpectedly re-exposed to smoking-related cues. This conditioned craving is mediated by reward memories that are frequently experienced and stubbornly resistant to treatment. Reconsolidation theory posits that well-consolidated memories are destabilized after retrieval, and this process renders memories labile and vulnerable to amnestic intervention. This study tests the retrieval reconsolidation procedure to decrease nicotine craving among people who smoke. In this study, 52 male smokers received a single dose of propranolol (n = 27) or placebo (n = 25) before the reactivation of nicotine-associated memories to impair the reconsolidation process. Craving for smoking and neural activity in response to smoking-related cues served as primary outcomes. Functional magnetic resonance imaging was performed during the memory reconsolidation process. The disruption of reconsolidation by propranolol decreased craving for smoking. Reactivity of the postcentral gyrus in response to smoking-related cues also decreased in the propranolol group after the reconsolidation manipulation. Functional connectivity between the hippocampus and striatum was higher during memory reconsolidation in the propranolol group. Furthermore, the increase in coupling between the hippocampus and striatum positively correlated with the decrease in craving after the reconsolidation manipulation in the propranolol group. Propranolol administration before memory reactivation disrupted the reconsolidation of smoking-related memories in smokers by mediating brain regions that are involved in memory and reward processing. These findings demonstrate the noradrenergic regulation of memory reconsolidation in humans and suggest that adjunct propranolol administration can facilitate the treatment of nicotine dependence. The present study was pre-registered at ClinicalTrials.gov (registration no. ChiCTR1900024412).

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Printing of cutaneous patches loaded with propranolol for the treatment of infantile haemangiomas

Journal of Drug Delivery Science and Technology ◽

10.1016/j.jddst.2021.102767 ◽

2021 ◽

pp. 102767

Author(s):

Umberto M. Musazzi ◽

Chiara G.M. Gennari ◽

Silvia Franzè ◽

Paola Minghetti ◽

Francesco Cilurzo

Keyword(s):

Infantile Haemangiomas

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Propranolol versus topiramate in prophylaxis of migraines among children and adolescents: a randomized, double-blind clinical trial

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20174480 ◽

2017 ◽

Vol 5 (10) ◽

pp. 4307 ◽

Cited By ~ 1

Author(s):

Ramakant Yadav ◽

S. K. Shukla

Keyword(s):

Clinical Trial ◽

Children And Adolescents ◽

International Headache Society ◽

Primary Outcome Measure ◽

Secondary Outcome ◽

Relative Reduction ◽

Double Blind ◽

Double Blind Clinical Trial ◽

Significant Difference ◽

Propranolol Group

Background: Migraine is a common health problem in children and adolescents. This study compares the efficacy and safety of propranolol and topiramate in preventing migraine among children and adolescents.Methods: Seventy-six patients (10-18 years of age) with migraine without auras defined by the 2004 International Headache society criteria were included in a prospective double blind clinical trial were allocated to receive propranolol (0.5-2mg/kg per day) or topiramate (1-2mg/kg per day). The primary outcome measure was reduction in 50 % or more headache days in comparison to baseline headache frequency per month. Secondary outcome measures were headache related disability, migraine intensity and duration. Efficacy measures were recorded at the baseline and at 12 weeks of prophylactic treatment.Results: In this study total of 76 patients with mean age of 12.43 years were evaluated, 40 in the propranolol group and 36 in the topiramate group. At the 12-week, the percentage of patients who had a relative reduction of 50% or more in the number of headache days were 67.5% patients in the propranolol group and 75.0% patients in the topiramate group. The monthly migraine frequency, headache related disability, intensity and duration were significantly decreased in both the propranolol and topiramate groups when compared to the baseline. No significant difference was observed between these two groups in term of reduction of frequency, headache related disability, severity and duration of attack. Fatigue, hypotension and exercise induced asthma were main side effects in propranolol group and weight loss, fatigue and loss of appetite, paresthesias in topiramate group.Conclusions: Propranolol and topiramate were found effective and safe for the prevention of paediatric migraines.

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Controversies in the Treatment of Infantile Haemangiomas with β-Blockers

Practical Pediatric Dermatology ◽

10.1007/978-3-319-32159-2_8 ◽

2016 ◽

pp. 69-78

Author(s):

Sherief R. Janmohamed ◽

Nisha Suyien Chandran ◽

Arnold P. Oranje

Keyword(s):

Β Blockers ◽

Infantile Haemangiomas

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Propranolol as an effective therapy for infantile haemangioma of the urinary bladder

BMJ Case Reports ◽

10.1136/bcr-2018-226929 ◽

2019 ◽

Vol 12 (2) ◽

pp. e226929

Author(s):

Taha Anwar ◽

Elizabeth Malm-Buatsi

Keyword(s):

Surgical Treatment ◽

Urinary Bladder ◽

Medical Therapy ◽

Potential Role ◽

Marked Decrease ◽

Surgical Techniques ◽

Cutaneous Lesions ◽

Infantile Haemangiomas

Infantile haemangiomas are one of the most common tumours in infancy, but typically present as cutaneous lesions; haemangiomas of the urinary bladder are incredibly rare. Although benign, these can sometimes ulcerate and bleed, causing haematuria in the case of bladder lesions. Propranolol is a well-documented medical therapy for cutaneous lesions, but surgical treatment dominates the literature on bladder haemangiomas. We present the case of a child with infantile haemangiomas of the urinary bladder, as well as internal and cutaneous lesions, treated with propranolol. At 6-week follow-up cystoscopy and MRI, there was a significant improvement in both bladder and internal lesions, respectively. Follow-up with dermatology 9 months after initiation of propranolol demonstrated excellent regression of the cutaneous lesions with a marked decrease in both size and prominence. This case demonstrates the potential role of propranolol in the treatment of bladder haemangiomas in lieu of more invasive surgical techniques.

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Topical Propranolol Improves Epistaxis Control in Hereditary Hemorrhagic Telangiectasia (HHT): A Randomized Double-Blind Placebo-Controlled Trial

Journal of Clinical Medicine ◽

10.3390/jcm9103130 ◽

2020 ◽

Vol 9 (10) ◽

pp. 3130

Author(s):

Meir Mei-Zahav ◽

Yulia Gendler ◽

Elchanan Bruckheimer ◽

Dario Prais ◽

Einat Birk ◽

...

Keyword(s):

Placebo Group ◽

Hereditary Hemorrhagic Telangiectasia ◽

Controlled Trial ◽

Intravenous Iron ◽

Common Adverse Event ◽

Open Label ◽

Two Phase ◽

Double Blind ◽

Double Blind Placebo ◽

Propranolol Group

Epistaxis is a common debilitating manifestation in hereditary hemorrhagic telangiectasia (HHT), due to mucocutaneous telangiectases. The epistaxis can be difficult to control despite available treatments. Dysregulated angiogenesis has been shown to be associated with telangiectases formation. Topical propranolol has demonstrated antiangiogenic properties. We performed a two-phase study, i.e., a double-blind placebo-controlled phase, followed by an open-label phase. The aim of the study was assessment of safety and efficacy of nasal propranolol gel in HHT-related epistaxis. Twenty participants with moderate-severe HHT-related epistaxis were randomized to eight weeks of propranolol gel 1.5%, or placebo 0.5 cc, applied to each nostril twice daily; and continued propranolol for eight weeks in an open-label study. For the propranolol group, the epistaxis severity score (ESS) improved significantly (−2.03 ± 1.7 as compared with −0.35 ± 0.68 for the placebo group, p = 0.009); hemoglobin levels improved significantly (10.5 ± 2.6 to 11.4 ± 2.02 g/dL, p = 0.009); and intravenous iron and blood transfusion requirement decreased. The change in nasal endoscopy findings was not significant. During the open-label period, the ESS score improved significantly in the former placebo group (−1.99 ± 1.41, p = 0.005). The most common adverse event was nasal mucosa burning sensation. No cardiovascular events were reported. Our results suggest that topical propranolol gel is safe and effective in HHT-related epistaxis.

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