Propranolol + Sertraline: New Evidence in Treating Panic Disorder in Women
Want the latest research insights delivered straight to your inbox?
Published: July 2025 in BMC Psychiatry
Study: The effect of sertraline with or without propranolol on panic attacks in women: a controlled clinical trial
📌 Context Within Existing Research:
- This study addresses a significant gap in the literature as the first to investigate the combination of sertraline with propranolol specifically for treating panic attacks in women.
📌 Study Summary
This double-blind, randomized, controlled clinical trial explored whether adding propranolol to sertraline improves treatment outcomes in women with panic disorder, compared to sertraline alone.
Study Design:
- Participants: 60 women aged 18–45 with DSM-5–defined panic disorder
Groups:
- Sertraline + Propranolol (20 mg/day)
- Sertraline + Placebo
Primary Outcomes:
- Number of panic attacks (weekly)
- Hamilton Anxiety Rating Scale (HAM-A)
- Panic Disorder Severity Scale (PDSS)
Key Results:
- Both groups showed significant reductions in panic attacks and anxiety scores from baseline.
- Propranolol augmentation group had greater reduction in number of weekly panic attacks compared to the placebo group (p < 0.05).
- No significant differences were observed between groups for HAM-A or PDSS scores at week 8.
- Tolerability: No major adverse effects; propranolol was well tolerated.
💬 Clinical Commentary
This trial contributes meaningful insight into the role of beta-blockers as augmentation agents in panic disorder, particularly in female patients. While SSRIs remain first-line, propranolol may offer added benefit in reducing frequency of panic attacks, possibly by blunting the physiological “fear response” driven by adrenergic overactivation.
Key Clinical Implications:
- Targeted symptom relief: Propranolol may specifically reduce somatic symptoms of panic (e.g., palpitations, tremors) rather than overall anxiety severity.
- Augmentation strategy: Consider propranolol (10–20 mg/day) in patients with partial response to SSRIs—especially when autonomic hyperactivity dominates.
- Gender relevance: All participants were women; extrapolation to male patients requires caution.
✅ Key Conclusions
- Anxiety Relief: Combining propranolol with sertraline significantly reduces panic attack severity compared to sertraline alone
- Depression Relief: The combination therapy also provides greater improvement in depression symptoms
- Augmentation strategy: Consider propranolol (10–20 mg/day) in patients with partial response to SSRIs—especially when autonomic hyperactivity dominates.
- Safety: No adverse effects were reported, suggesting good tolerability
- Gender relevance: All participants were women; extrapolation to male patients requires caution.
📚 References
Rouhzendeh S, Mousavi Z, Mashayekh-Amiri S, Shaseb E, Mirmolaei ST, Mirghafourvand M. The effect of sertraline with or without propranolol on panic attacks in women: a controlled clinical trial. J Pharm Health Care Sci. 2025 Jul 4;11(1):57. doi: 10.1186/s40780-025-00466-x. PMID: 40615929; PMCID: PMC12228203. (Pubmed)
FOR ACADEMY MEMBERS:
ANXIETY & RELATED DISORDERS
Want the latest research insights delivered straight to your inbox?
We continue to review and summarize clinically relevant research to support your daily practice.
INTERESTED IN ACCESS TO THIS & OTHER CLINICALLY RELEVANT LECTURE SERIES?
JOIN ACADEMY MEMBERSHIP:
This is a closed membership for medical professionals only.
- 400+ Clinically Relevant Chapters: Each chapter within these sections is of direct clinical relevance for your daily practice. (Table of Content)
- Journal Club: we will post the most recently published psychiatry articles relevant to your daily clinical practice. (Read Content)
- Clinical Case Discussion: Dr. Singh (Psychiatry) and Dr. Kaur (Family Medicine) discuss clinical cases to integrate the clinical cases from Psychiatry and Medicine. (Read Content)
- Monthly Insights: Gain access to our monthly sessions featuring the latest on recent publications, new medication approvals, FDA updates, and more. (Monthly Insights)
- Discussion Forum & Community: Connect with other medical professionals and discuss your difficult-to-treat clinical cases. (Academy Network)
- Goal: is to have all important clinically relevant topics in one place for ease of access.
DISCOUNTS AVAILABLE FOR: Residents & Students ONLY.
Email us your student information (program information and way to confirm your student status) to: HSingh@PsychiatryEducationForum.com
© 2025 All Rights Reserved.
