Violent behavior in psychiatric patients may result in long-term hospitaliz
ation. There is no FDA-approved psychopharmacologic treatment for aggressio
n. In this study, 20 chronically aggressive hospitalized patients were admi
nistered 1 week of placebo followed by an open trial of increasing doses of
propranolol. Patients who had an equivocal or definite clinical response w
ere entered into art open add-on double-blind discontinuation study phase.
Aggressive behavior was objectively documented throughout the study. After
the open phase of the study, 7 patients had a greater than 50% decrease in
aggressive behavior. Four patients entered the double-blind discontinuation
phase. The clinical course of 3 of those patients was consistent with the
positive response to propranolol. The results of this study are consistent
with a therapeutic effect of propranolol in some patients with aggressive b
ehavior. Further studies are indicated.