Treatment of Anxiety Prior to a Medical Procedure using an Atenolol - Scopolamine Combination Drug

Objective: Patients often experience anxiety in anticipation of medical procedures. A new class of anti-anxiety medications, PanX®, has been developed as alternatives to benzodiazepines, and is combinations of beta blockers and antimuscarinic motion sickness agents. An atenolol - scopolamine HBr drug combination was tested in an open label physician-sponsored study in patients experiencing anxiety in anticipation of a medical procedure. Methods: Eight patients were assessed in a pain management clinic. They experienced anxiety prior to an electromyography procedure and consented to a physician-sponsored study using a compounded medication of atenolol - scopolamine HBr delivered by the oral mucosal route. A pair of questionnaires assessed their overall level of anxiety and their individual symptoms of anxiety prior to the anxiolytic treatment and then during the procedure that commenced ca. 10 - 20 minutes after drug administration. Results: All eight patients remained clear minded and none reported any side effects. Seven of eight patients perceived a calming effect from the drug treatment. Six of eight patients were responders to the treatment and experienced a reduction in anxiety on a 10-point scale from an average of 6.3 points prior to the procedure to 2.7 points during the procedure. Eight individual anxiety symptoms were assessed and all six responders exhibited reductions in the number and/or severity of symptoms. Conclusion: This open label study provides proof-of-principle of a fast-acting anxiolytic effect upon patients’ overall anxiety and individual symptoms due to anticipation of a medical procedure. The atenolol – scopolamine HBr combination was well tolerated without any reported side effects. This medication may be useful in calming the anxiety of patients prior to a variety of medical and dental procedures, and as an alternative to benzodiazepines without using any addictive substances.