Can low-dose propranolol induce a manic syndrome? Case report of an unexpected side effect

Objectives Propranolol, the first discovered b-adrenergic receptor antagonist, has been prescribed by physicians in various fields for more than three decades. It has been applied for treating psychiatric disorders including schizophrenia, mania and anxiety disorders, as well as for controlling withdrawal symptoms or other side effects. Methods We describe the case of an 11-year-old boy with bipolar-I disorder comorbid with panic disorder who developed manic symptoms with a single dose of 10 mg of propranolol. Results and Conclusion Although depression is a better-known side effect of b-adrenergic antagonists, clinicians should take mania as a rare side effect into consideration as well.