Propranolol in Ataxia and in Aggression: Central Actions

To the Editor. —A recent letter1reports treatment of ataxia with propranolol hydrochloride, seeks other reports of trials with ataxia, and asks if there is evidence for a central or cerebellar effect of the drug. Its use with familial, senile, and essential tremor2and subsequent extension to action tremor following head injury3has been followed by one other report of use with ataxia.4Let us hope that citing these two reports together will encourage further study. We have used propranolol to reduce disinhibited aggression after head injury, and this use has been extensively studied elsewhere.5-8These positive findings suggest, without proving, central action. Also suggestive are reports of use against florid psychoses,9some types of panic,10and narcolepsy.11One should also consider the evidence that reduction of heightened urinary adrenaline with propranolol in alcohol withdrawal12is mediated by action on brain