Diazepam, propranolol and their combination in the management of chronic anxiety.

The therapeutic benefit of combining propranolol with diazepam over either of these drugs given alone was tested in a placebo-controlled crossover study with twenty-four chronically anxious out-patients. The combination was generally more effective than diazepam. Diazepam was more effective than placebo or propranolol. A reduction in the resting pulse rate by propranolol of more than 7.5 beats per minute resulted in a greater therapeutic response to this drug, alone and in combination. Lesser degrees of pathology responded better to treatment. Psychological factors in treatment showed themselves to be important in moderating pharmacological response. Chronically anxious patients generally derived little benefit from continued anti-anxiety treatment.