In order to compare the beta blockers
bisoprolol and
diazepam in the treatment of
cardiac neurosis, 40 patients (16 males and 24 females, mean age: 39 +/- 11 years) were examined in a double-blind, crossover study. Following a 4-week placebo period, patients were randomized to receive either
bisoprolol 10 mg daily or
diazepam 5 mg twice daily for 4 weeks. After a second 4-week washout period on placebo, patients were switched to the alternative regimen for a further 4 weeks. At the end of the placebo periods and during each phase of treatment, the following parameters were evaluated:
somatic symptoms by self-assessment questionnaire, anxiety state by Hamilton rating scale, reaction time to both acoustic and visual stimuli, blood pressure, and heart rate. Both treatments were effective in reducing
somatic symptoms of
cardiac neurosis, but
bisoprolol was significantly more effective than
diazepam (p less than 0.01). On the contrary,
diazepam was superior to
bisoprolol in improving the Hamilton scale related to psychic symptoms. Only
diazepam prolonged reaction times. Both treatments were well tolerated; however, 12 patients complained of drowsiness and nine of sedation under
diazepam. In conclusion,
bisoprolol appeared to be as effective as
diazepam in the treatment of
cardiac neurosis, but with better effects on
somatic symptoms and without affecting patients' psychomotor performance.