A 53-year-old black male with no history of neuropsychiatric behavioral problems was treated successfully with propranolol, furosemide, and minoxidil for previously uncontrolled hypertension. However, paranoid ideations, illusions, severe combativeness, and visual hallucinations developed shortly after initiation of the listed therapy. When atenolol was substituted for propranolol, all psychotic behavior resolved.
RemickRAO'KaneJSparlingTG. A case report of toxic psychosis with low-dose propranolol therapy. Am J Psychiatry1981; 138: 850–1.
4.
FlemingPDDrachmanDA. Propranolol, hallucinations, and sleep disturbance (letters). Am J Psychiatry1982; 139: 540–1.
5.
GershonESGoldsteinREMossAJPsychosis with ordinary doses of propranolol. Ann Intern Med1979; 90: 938–9.
6.
MayerSEMelmonKLGilmanAG. Introduction; the dynamics of drug absorption, distribution, and elimination. In: GilmanAGGoodmanLSGilmanA, eds. The pharmacological basis of therapeutics. 6th ed.New York: MacMillan, 1980: 10.
7.
CruickshankJM. The clinical importance of cardioselectivity and lipophilicity in beta-blockers. Am Heart J1980; 100: 160–78.
8.
MattiassonIHenningsonNC. Side effects during treatment with lipid soluble beta-blockers, beta-adrenergic blocking substances. Proceedings of the 8th World Congress of Cardiology, Tokyo, 1978.
9.
McLeanAJSkewsHBobikAInteraction between oral propranolol and hydralazine. Clin Pharmacol Ther1980; 27: 726–32.
10.
WilliamsJB. Diagnostic and statistical manual of mental disorders. 3rd ed.Washington, DC: American Psychiatric Association, 1980: 107–10, 127–8.
11.
KaplanHIFreedmanAMSadockBJ. Comprehensive textbook of psychiatry/III. 3rd ed.Baltimore, MD: Williams & Wilkins Co, 1980; 1: 319–20.
