Beta-adrenergic blockers in mental retardation and developmental disabilities

Beta-adrenergic-blocking medications have been hypothesized to benefit persons with a wide variety of neuropsychiatric disorders. Research supports their use in only three areas, however: anxiety disorders with prominent physiological signs, impulsive aggression, and neuroleptic-induced akathisia (NIA). Except for NIA, beta blockers are best used adjunctively, and cannot be considered treatments of choice as monotherapy. These guidelines are applicable to individuals with intellectual disability and psychiatric illness as well, and beta blockers are generally effective and well tolerated in these persons. Nadolol, a hydrophilic beta blocker, may be preferable for anxiety, whereas propranolol and metoprolol (lipophilic) are more beneficial in treating aggression and NIA. MRDD Research Reviews 1999;5:290–298.