human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: 14 phobic subjects were given propranolol ( Inderal ) , atenolol ( Tenormin ) and placebo in a double-blind fashion according to a repeated measurement design . Subjects were exposed to their source of fear while their anxiety and cardiovascular responses ( heart rate , blood pressure and peripheral temperature ) were recorded . In accordance with the Three-Systems Model of fear and phobias , the subjects were divided into two groups of high and low physiological reactors , operationalized by the cardiovascular items in their anxiety pattern from a revised version of the Autonomic Perception Question naire ( APQ ) . It was found that beta-blockade had the predicted effect on heart rate and peripheral temperature while diastolic blood pressure was unaffected . The systolic blood pressure finally was lowered for the low cardiovascular reactors . The subjectively rated anxiety rose consistently during exposure . There was no general effect of the beta-blocking drugs on subjective anxiety . For the high cardiovascular reactors propranolol was associated with a higher anxiety level The efficacy and safety of propranolol in the treatment of anxiety was compared with those of chlordiazepoxide and placebo in a 3-week , double-blind study of 212 patients . After a 1-week , single-blind placebo-washout period , patients were r and omized to receive either propranolol ( 80 , 160 , or 320 mg/day ) , chlordiazepoxide ( 30 , 45 , or 75 mg/day ) , or placebo . Patients were evaluated by three physician-rated scales -- Hamilton Rating Scale for Anxiety ( HAM-A ) , Covi Anxiety Scale ( CAS ) , and Clinical Global Impressions scale-- and two patient-rated scales -- Symptoms Checklist 90 and Profile of Mood States . Patients in all groups demonstrated significant improvement in their level of anxiety at all time points compared with their baseline level . At Week 1 propranolol and chlordiazepoxide patients were significantly better than placebo patients , as measured by the HAM-A and CAS . At Week 2 only propranolol was superior to placebo , based on HAM-A and CAS scores . Fifteen patients prematurely terminated because of adverse reactions ( 4 taking propranolol , 4 taking placebo , and 7 taking chlordiazepoxide ) . The incidence of side effects was similar for the two active drugs ; fatigue , drowsiness , and change in libido were significantly more frequent with chlordiazepoxide and drowsiness and indigestion were more frequent with propranolol compared with placebo The effect of propranolol was studied on 23 dental phobics in a double-blind , placebo-controlled clinical trial involving actual dental treatment . The subjects were selected because they showed high physiological reactivity in the dental situation . Twelve subjects received the test drug and 11 subjects received the placebo at individualized doses of either 80 or 120 mg . A significant difference in self-reported anxiety at the injection phase of treatment and less overall pain intensity and aversiveness were observed for the propranolol as compared with the placebo group . No differences were detected for behavior ratings . Beta-adrenergic blocking agents may have utility for reducing anxiety in individuals fearful of dental treatment The trial showed propranolol to be as effective as  chlordiazepoxide overall in the treatment of these cases of anxiety states , but in  depression and sleep disturbance  chlordiazepoxide was better . Nevertheless , the new drug may have some part to play in the treatment of anxiety as an alternative to tranquillizers , and it may be possible in future to define more precise indications for its use Simple tests of verbal reasoning and mental arithmetic , taken under mildly stressful conditions , have been shown to give a reproducible test of intellectual function within groups of normal subjects . Using these tests , in two separate examinations , a double-blind cross-over study was performed on 35 medical students to assess the effects of acute beta-adrenoceptor blockade with propranolol on intellectual function . With placebo treatment , students recorded an average total score of 231.3 marks , with average scores of 108.9 marks on the mental arithmetic paper and 122.4 marks on the verbal reasoning paper . Treatment with propranolol was associated with an improvement in total score of 9.2 + /- 3.9 marks ( P less than 0.05 ) , an improvement in mental arithmetic score of 5.6 + /- 2.3 marks ( P less than 0.05 ) and an improvement in verbal reasoning score of 3.6 + /- 2.4 marks ( NS ) . Eighteen out of the 35 students said that they were mildly anxious before one examination and 13 students said they were anxious before both examinations . Those students who admitted anxiety seemed to benefit the most , in terms of improved examination performance , from treatment with propranolol OBJECTIVE Performance anxiety in musicians may be severe enough to require intervention but has been the subject of relatively little clinical research . The authors ' objectives were to describe the results of a comprehensive clinical and laboratory assessment and to perform a double-blind , placebo-controlled study comparing buspirone , cognitive-behavior therapy , and the combination of these treatments for performance anxiety . METHOD Ninety-four subjects were recruited by mass media announcements and were seen in a university-based outpatient psychiatric clinic . Assessment s were 1 ) question naires for all 94 subjects , 2 ) diagnostic interview of 50 subjects , and 3 ) laboratory performance of 34 subjects . Treatment conditions were 1 ) 6 weeks of buspirone , 2 ) 6 weeks of placebo , 3 ) a five-session , group cognitive-behavior therapy program with buspirone , or 4 ) the cognitive-behavior therapy program with placebo . Treatment outcome measures included subjective anxiety ratings and heart rate measures during a laboratory performance , a question naire measure of performance confidence , and a blind rating of musical performance quality . RESULTS All subjects fulfilled criteria for DSM-III-R social phobia . Of the 15 full-time professional musicians , ten had tried propranolol and three had stopped performing . Most of the subjects had substantial anxiety and heart rate increases during laboratory speech and musical performances . Cognitive-behavior therapy result ed in statistically significant reductions in subjective anxiety , improved quality of musical performance , and improved performance confidence .  Buspirone was not an effective treatment . CONCLUSIONS Cognitive-behavior therapy is a viable treatment approach for performance anxiety in musicians BACKGROUND Although serotonin reuptake inhibitors are effective in panic disorder , questions concerning whether doses associated with antidepressant efficacy are also effective for panic disorder remain . AIMS To assess the efficacy of the usual antidepressant dose of fluoxetine in treating full panic attacks . METHOD Patients with panic disorder were r and omised to placebo or to fluoxetine initiated at 10 mg daily for 1 week and then increased to 20 mg daily . The trial lasted 12 weeks , but after 6 weeks patients who had failed to achieve a satisfactory response were eligible for dose escalation to a maximum of 60 mg of fluoxetine daily . RESULTS Fluoxetine was associated with a statistically significantly greater proportion of panic-free patients compared with placebo after 6 weeks and at end-point . CONCLUSIONS Fluoxetine at a dose of 20 mg daily is safe and efficacious in reducing symptoms of panic disorder . Patients who fail to obtain a satisfactory response at 20 mg daily may benefit from further dose increases We studied the efficacy of propranolol ( Inderal ) compared to alprazolam ( Xanax ) in 29 patients with a diagnosis of agoraphobia with panic disorder or panic disorder with or without limited phobic avoidance in a 6-week double-blind controlled experiment . Alprazolam is effective in those syndromes , whereas to date only negative or ambiguous results had been reported for propranolol .  Fourteen patients received a mean daily dose of 5.0 + /- 2.3 mg of alprazolam and 15 patients received 182.0 + /- 60.5 mg mean daily dose of propranolol . We found both drugs to be effective to suppress panic attacks and reduce avoidance behavior . The only significant between-drug difference was a more rapid onset of alprazolam 's panicolytic effect .  Propranolol merits further study . We suggest patients worthy of a clinical trial OBJECTIVE To find out if propranolol , a non-cardioselective beta-blocker , can reduce the anxiety associated with day case surgery . DESIGN Prospect i ve r and omized double blind trial . SETTING University hospital , Irel and . SUBJECTS An unselected group of 53 patients undergoing day case surgery . INTERVENTION Subjects r and omised to receive either propranolol ( 10 mg ) or placebo on the morning of operation . MAIN OUTCOME MEASURES Blood pressure ; pulse , anxiety , pain score and patient satisfaction . RESULTS Mean ( SD ) Hospital Anxiety and Depression score was significantly lower in the propranolol group than in the control group ( 2.5 ( 0.7 ) compared with 4.6 ( 0.7 ) , p < 0.0001 ) before discharge . CONCLUSION A low dose of propranolol given on the morning of day case surgery significantly reduced patients ' anxiety Sixteen socially phobic out patients underwent a 4-week course of social skills training that attempted to maximize rehearsal in real-life setting s. The therapy was largely conducted by nonprofessional volunteers after a 2-hour training workshop . It consisted of multiple role-played practice in the clinic , followed immediately by rehearsal in a real-life setting in the company of a nonprofessional therapist and a fellow patient . Subsequently , patients were r and omly paired to perform further rehearsals between sessions . Drug therapy was controlled by double blind assignment to propranolol or inert placebo throughout the course of treatment . Measures of specific fears , generalized social anxiety , self-image , and global tension and anxiety were administered 1 month before treatment , immediately before and after treatment , and at 6 months follow-up . During a 4-week drug-free period prior to active treatment no improvement was noted on any measures . After the 4-week treatment period significant improvement had occurred on all outcome measures . Propranolol and placebo subgroups showed very similar results . Treatment gains were sustained at follow-up . It was concluded that repeated behavior rehearsal , both in the clinic and in real life is a cost-effective treatment procedure for many social phobias . The approach is straightforward and can be applied by nonprofessionals , including the patients themselves , after limited training and with minimal supervision The effectiveness of propranolol , a nonsedating anxiolytic premedication , was studied by monitoring preoperative anxiety and postoperative recovery of cognitive function in 92 healthy ASA physical status 1 females aged 15–42 yr undergoing outpatient dilatation and curretage (D&C)for therapeutic abortion . In a r and omized double-blind design , patients received one of the following oral medications 1–1.5 hr preoperatively : ( 1 ) diazepam 10 mg ( n = 31 ) ; ( 2 ) propranolol 80 mg ( n = 31 ) ; ( 3 ) placebo ( n = 30 ) . Anxiety throughout the hospital stay was monitored using the State-Trait Anxiety Inventory ( STAI ) . Postoperative cognitive recovery was assessed using the digit span and Trieger tests . STAI anxiety levels were recorded on admission to hospital , immediately before entering the operating room , and two hours postoperatively . There was no difference among the anxiolytic properties of the three medications and all three patient groups showed a significant decrease in anxiety levels after administration of the medication . Tests of cognitive function after anaesthesia showed the fastest return to baseline status in patients receiving propranolol , possibly because beta adrenergic blockade blunted the autonomic signs of light anaesthesia and less anaesthetic was administered . None of the study premedications was demonstrated to have an anxiolytic advantage , but propranolol did offer a faster return of cognitive function in the postoperative period . RésuméNous avons voulu évaluer l’efficacité du propranolol à litre de prémédication anxiolytique non-sédative en mesurant le degré d’anxiété préopératoire et la rapidité de la récupération postopératoire des fonctions cognitives . Quatre-vingt douze femmes de 15 à 42 ans de classe ASA I , c and i date s à une dilatation cervicale et curetage pour avortement en externe , se sont prêtées à notre étude . Après r and omisation à double-insu , elles prenaient par la bouche soit 10 mg de diazépam ( n = 31 ) , soit 80 mg de propranolol ( n = 31 ) , soit un placebo ( n = 30 ) et ce , de 60 à 90 minutes avant l’intervention . Nous mesurions le niveau d’anxiété à l’admission , juste avant d’entrer en salle d’opération et deux heures après l’intervention en utilisant le  « State-Trait Anxiety Inventory ( STAI ) » . Le « digit span » , test mnémonique numérique et le test de Trieger nous servaient à mesurer les fonctions cognitives avant et après l’opération . Les trois médications utilisés n’ont pas démontré de propriétés anxiolytiques différentes , les niveaux d’anxiété allant décroissant dans les trois groupes à partir de l’admission 
    Output:
    
agent
These meta-analyses found no statistically significant differences between the efficacy of propranolol and benzodiazepines regarding the short-term treatment of panic disorder with or without agoraphobia .
Also , no evidence was found for effects of propranolol on PTSD symptom severity through inhibition of memory reconsolidation .
In conclusion , the quality of evidence for the efficacy of propranolol at present is insufficient to support the routine use of propranolol in the treatment of any of the anxiety disorders
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: 14 phobic subjects were given propranolol ( Inderal ) , atenolol ( Tenormin ) and placebo in a double-blind fashion according to a repeated measurement design . Subjects were exposed to their source of fear while their anxiety and cardiovascular responses ( heart rate , blood pressure and peripheral temperature ) were recorded . In accordance with the Three-Systems Model of fear and phobias , the subjects were divided into two groups of high and low physiological reactors , operationalized by the cardiovascular items in their anxiety pattern from a revised version of the Autonomic Perception Question naire ( APQ ) . It was found that beta-blockade had the predicted effect on heart rate and peripheral temperature while diastolic blood pressure was unaffected . The systolic blood pressure finally was lowered for the low cardiovascular reactors . The subjectively rated anxiety rose consistently during exposure . There was no general effect of the beta-blocking drugs on subjective anxiety . For the high cardiovascular reactors propranolol was associated with a higher anxiety level The efficacy and safety of propranolol in the treatment of anxiety was compared with those of chlordiazepoxide and placebo in a 3-week , double-blind study of 212 patients . After a 1-week , single-blind placebo-washout period , patients were r and omized to receive either propranolol ( 80 , 160 , or 320 mg/day ) , chlordiazepoxide ( 30 , 45 , or 75 mg/day ) , or placebo . Patients were evaluated by three physician-rated scales -- Hamilton Rating Scale for Anxiety ( HAM-A ) , Covi Anxiety Scale ( CAS ) , and Clinical Global Impressions scale-- and two patient-rated scales -- Symptoms Checklist 90 and Profile of Mood States . Patients in all groups demonstrated significant improvement in their level of anxiety at all time points compared with their baseline level . At Week 1 propranolol and chlordiazepoxide patients were significantly better than placebo patients , as measured by the HAM-A and CAS . At Week 2 only propranolol was superior to placebo , based on HAM-A and CAS scores . Fifteen patients prematurely terminated because of adverse reactions ( 4 taking propranolol , 4 taking placebo , and 7 taking chlordiazepoxide ) . The incidence of side effects was similar for the two active drugs ; fatigue , drowsiness , and change in libido were significantly more frequent with chlordiazepoxide and drowsiness and indigestion were more frequent with propranolol compared with placebo The effect of propranolol was studied on 23 dental phobics in a double-blind , placebo-controlled clinical trial involving actual dental treatment . The subjects were selected because they showed high physiological reactivity in the dental situation . Twelve subjects received the test drug and 11 subjects received the placebo at individualized doses of either 80 or 120 mg . A significant difference in self-reported anxiety at the injection phase of treatment and less overall pain intensity and aversiveness were observed for the propranolol as compared with the placebo group . No differences were detected for behavior ratings . Beta-adrenergic blocking agents may have utility for reducing anxiety in individuals fearful of dental treatment The trial showed propranolol to be as effective as  chlordiazepoxide overall in the treatment of these cases of anxiety states , but in  depression and sleep disturbance  chlordiazepoxide was better . Nevertheless , the new drug may have some part to play in the treatment of anxiety as an alternative to tranquillizers , and it may be possible in future to define more precise indications for its use Simple tests of verbal reasoning and mental arithmetic , taken under mildly stressful conditions , have been shown to give a reproducible test of intellectual function within groups of normal subjects . Using these tests , in two separate examinations , a double-blind cross-over study was performed on 35 medical students to assess the effects of acute beta-adrenoceptor blockade with propranolol on intellectual function . With placebo treatment , students recorded an average total score of 231.3 marks , with average scores of 108.9 marks on the mental arithmetic paper and 122.4 marks on the verbal reasoning paper . Treatment with propranolol was associated with an improvement in total score of 9.2 + /- 3.9 marks ( P less than 0.05 ) , an improvement in mental arithmetic score of 5.6 + /- 2.3 marks ( P less than 0.05 ) and an improvement in verbal reasoning score of 3.6 + /- 2.4 marks ( NS ) . Eighteen out of the 35 students said that they were mildly anxious before one examination and 13 students said they were anxious before both examinations . Those students who admitted anxiety seemed to benefit the most , in terms of improved examination performance , from treatment with propranolol OBJECTIVE Performance anxiety in musicians may be severe enough to require intervention but has been the subject of relatively little clinical research . The authors ' objectives were to describe the results of a comprehensive clinical and laboratory assessment and to perform a double-blind , placebo-controlled study comparing buspirone , cognitive-behavior therapy , and the combination of these treatments for performance anxiety . METHOD Ninety-four subjects were recruited by mass media announcements and were seen in a university-based outpatient psychiatric clinic . Assessment s were 1 ) question naires for all 94 subjects , 2 ) diagnostic interview of 50 subjects , and 3 ) laboratory performance of 34 subjects . Treatment conditions were 1 ) 6 weeks of buspirone , 2 ) 6 weeks of placebo , 3 ) a five-session , group cognitive-behavior therapy program with buspirone , or 4 ) the cognitive-behavior therapy program with placebo . Treatment outcome measures included subjective anxiety ratings and heart rate measures during a laboratory performance , a question naire measure of performance confidence , and a blind rating of musical performance quality . RESULTS All subjects fulfilled criteria for DSM-III-R social phobia . Of the 15 full-time professional musicians , ten had tried propranolol and three had stopped performing . Most of the subjects had substantial anxiety and heart rate increases during laboratory speech and musical performances . Cognitive-behavior therapy result ed in statistically significant reductions in subjective anxiety , improved quality of musical performance , and improved performance confidence .  Buspirone was not an effective treatment . CONCLUSIONS Cognitive-behavior therapy is a viable treatment approach for performance anxiety in musicians BACKGROUND Although serotonin reuptake inhibitors are effective in panic disorder , questions concerning whether doses associated with antidepressant efficacy are also effective for panic disorder remain . AIMS To assess the efficacy of the usual antidepressant dose of fluoxetine in treating full panic attacks . METHOD Patients with panic disorder were r and omised to placebo or to fluoxetine initiated at 10 mg daily for 1 week and then increased to 20 mg daily . The trial lasted 12 weeks , but after 6 weeks patients who had failed to achieve a satisfactory response were eligible for dose escalation to a maximum of 60 mg of fluoxetine daily . RESULTS Fluoxetine was associated with a statistically significantly greater proportion of panic-free patients compared with placebo after 6 weeks and at end-point . CONCLUSIONS Fluoxetine at a dose of 20 mg daily is safe and efficacious in reducing symptoms of panic disorder . Patients who fail to obtain a satisfactory response at 20 mg daily may benefit from further dose increases We studied the efficacy of propranolol ( Inderal ) compared to alprazolam ( Xanax ) in 29 patients with a diagnosis of agoraphobia with panic disorder or panic disorder with or without limited phobic avoidance in a 6-week double-blind controlled experiment . Alprazolam is effective in those syndromes , whereas to date only negative or ambiguous results had been reported for propranolol .  Fourteen patients received a mean daily dose of 5.0 + /- 2.3 mg of alprazolam and 15 patients received 182.0 + /- 60.5 mg mean daily dose of propranolol . We found both drugs to be effective to suppress panic attacks and reduce avoidance behavior . The only significant between-drug difference was a more rapid onset of alprazolam 's panicolytic effect .  Propranolol merits further study . We suggest patients worthy of a clinical trial OBJECTIVE To find out if propranolol , a non-cardioselective beta-blocker , can reduce the anxiety associated with day case surgery . DESIGN Prospect i ve r and omized double blind trial . SETTING University hospital , Irel and . SUBJECTS An unselected group of 53 patients undergoing day case surgery . INTERVENTION Subjects r and omised to receive either propranolol ( 10 mg ) or placebo on the morning of operation . MAIN OUTCOME MEASURES Blood pressure ; pulse , anxiety , pain score and patient satisfaction . RESULTS Mean ( SD ) Hospital Anxiety and Depression score was significantly lower in the propranolol group than in the control group ( 2.5 ( 0.7 ) compared with 4.6 ( 0.7 ) , p < 0.0001 ) before discharge . CONCLUSION A low dose of propranolol given on the morning of day case surgery significantly reduced patients ' anxiety Sixteen socially phobic out patients underwent a 4-week course of social skills training that attempted to maximize rehearsal in real-life setting s. The therapy was largely conducted by nonprofessional volunteers after a 2-hour training workshop . It consisted of multiple role-played practice in the clinic , followed immediately by rehearsal in a real-life setting in the company of a nonprofessional therapist and a fellow patient . Subsequently , patients were r and omly paired to perform further rehearsals between sessions . Drug therapy was controlled by double blind assignment to propranolol or inert placebo throughout the course of treatment . Measures of specific fears , generalized social anxiety , self-image , and global tension and anxiety were administered 1 month before treatment , immediately before and after treatment , and at 6 months follow-up . During a 4-week drug-free period prior to active treatment no improvement was noted on any measures . After the 4-week treatment period significant improvement had occurred on all outcome measures . Propranolol and placebo subgroups showed very similar results . Treatment gains were sustained at follow-up . It was concluded that repeated behavior rehearsal , both in the clinic and in real life is a cost-effective treatment procedure for many social phobias . The approach is straightforward and can be applied by nonprofessionals , including the patients themselves , after limited training and with minimal supervision The effectiveness of propranolol , a nonsedating anxiolytic premedication , was studied by monitoring preoperative anxiety and postoperative recovery of cognitive function in 92 healthy ASA physical status 1 females aged 15–42 yr undergoing outpatient dilatation and curretage (D&C)for therapeutic abortion . In a r and omized double-blind design , patients received one of the following oral medications 1–1.5 hr preoperatively : ( 1 ) diazepam 10 mg ( n = 31 ) ; ( 2 ) propranolol 80 mg ( n = 31 ) ; ( 3 ) placebo ( n = 30 ) . Anxiety throughout the hospital stay was monitored using the State-Trait Anxiety Inventory ( STAI ) . Postoperative cognitive recovery was assessed using the digit span and Trieger tests . STAI anxiety levels were recorded on admission to hospital , immediately before entering the operating room , and two hours postoperatively . There was no difference among the anxiolytic properties of the three medications and all three patient groups showed a significant decrease in anxiety levels after administration of the medication . Tests of cognitive function after anaesthesia showed the fastest return to baseline status in patients receiving propranolol , possibly because beta adrenergic blockade blunted the autonomic signs of light anaesthesia and less anaesthetic was administered . None of the study premedications was demonstrated to have an anxiolytic advantage , but propranolol did offer a faster return of cognitive function in the postoperative period . RésuméNous avons voulu évaluer l’efficacité du propranolol à litre de prémédication anxiolytique non-sédative en mesurant le degré d’anxiété préopératoire et la rapidité de la récupération postopératoire des fonctions cognitives . Quatre-vingt douze femmes de 15 à 42 ans de classe ASA I , c and i date s à une dilatation cervicale et curetage pour avortement en externe , se sont prêtées à notre étude . Après r and omisation à double-insu , elles prenaient par la bouche soit 10 mg de diazépam ( n = 31 ) , soit 80 mg de propranolol ( n = 31 ) , soit un placebo ( n = 30 ) et ce , de 60 à 90 minutes avant l’intervention . Nous mesurions le niveau d’anxiété à l’admission , juste avant d’entrer en salle d’opération et deux heures après l’intervention en utilisant le  « State-Trait Anxiety Inventory ( STAI ) » . Le « digit span » , test mnémonique numérique et le test de Trieger nous servaient à mesurer les fonctions cognitives avant et après l’opération . Les trois médications utilisés n’ont pas démontré de propriétés anxiolytiques différentes , les niveaux d’anxiété allant décroissant dans les trois groupes à partir de l’admission 
    Output:
    