A comparison of a ß2-adrenoceptor antagonist (ICI 118,551), diazepam and placebo in the treatment of acute anxiety.

The effect of ß( 2)-adrenoceptor antagonism in acute anxiety neurosis was investigated by comparing the effects of ICI 118,551, a specific ß(2)-adrenoceptor antagonist, diazepam and placebo in a double-blind, parallel group study. Sixty-three patients, who fulfilled criteria for Anxiety Disorder (DSM III) and were psychotropic drug- free (apart from six using hypnotics), were entered. Anxiety symptoms were rated using the Hamilton Anxiety Scale (HAS) and Spielberger State Anxiety Scale. Assessments were made at entry and following a 7-day single-blind placebo treatment phase, at the end of which only 51 wished to continue and had sufficient symptoms (HAS score >16 or reduction <25% on placebo) for entry to the next phase. Following a double- blind, random allocation they then received ICI 118,551 (50 mg), diazepam (2 mg) or placebo thrice daily for 4 weeks. Symptoms were assessed after 2 and 4 weeks in this active treatment phase (i.e. at weeks 3 and 5 of the study). Thirty-five patients completed the study. A statistically significant improvement in HAS score was seen for all patients but there were no significant differences between treatments. Treatments did not differ in their effects on blood pressure or heart rate. ß(2)-Adrenoceptor antagonism does not seem to have important effects on anxiety symptoms in anxiety neurosis.