Which beta-blocker is commonly used for alcohol withdrawal management?

Which beta-blocker is commonly used for alcohol withdrawal management?

• A. Metoprolol
• B. Propranolol
• C. Atenolol
• D. Nadolol

Answer: (B)

Managing alcohol withdrawal focuses on reducing autonomic hyperactivity such as tachycardia, tremor, anxiety, and sweating. Propranolol is commonly used because it is a nonselective beta-blocker that crosses into the brain. By blocking both beta-1 and beta-2 receptors, it diminishes the peripheral symptoms (heart rate rise, tremors) and also helps blunt the anxious, adrenergic component driven by CNS signaling. This CNS penetration makes it particularly effective for tremor and anxiety during withdrawal. The other options are less ideal in this context: metoprolol and atenolol are beta-1 selective, so they mainly lower heart rate and blood pressure but do not address tremor and anxiety as well. Nadolol is nonselective like propranolol but has minimal CNS penetration and a long duration, making it less practical for withdrawal management. Propranolol’s combination of nonselective blockade and CNS activity is why it’s the beta-blocker of choice in this scenario.

Managing alcohol withdrawal focuses on reducing autonomic hyperactivity such as tachycardia, tremor, anxiety, and sweating. Propranolol is commonly used because it is a nonselective beta-blocker that crosses into the brain. By blocking both beta-1 and beta-2 receptors, it diminishes the peripheral symptoms (heart rate rise, tremors) and also helps blunt the anxious, adrenergic component driven by CNS signaling. This CNS penetration makes it particularly effective for tremor and anxiety during withdrawal.

The other options are less ideal in this context: metoprolol and atenolol are beta-1 selective, so they mainly lower heart rate and blood pressure but do not address tremor and anxiety as well. Nadolol is nonselective like propranolol but has minimal CNS penetration and a long duration, making it less practical for withdrawal management. Propranolol’s combination of nonselective blockade and CNS activity is why it’s the beta-blocker of choice in this scenario.