Drugs such as beta-adrenergic antagonists (beta blockers) have been linked to a range of side effects, including depression. But how reliable are these data, and what are the possible psychological side effects caused by these drugs? These questions were addressed by a team of researchers from Charité – Universitätsmedizin Berlin, whose complete meta-analysis was published Hypertension. Although treatment with beta blockers was not found to be associated with an increase in depression, some studies recorded higher levels of sleep disturbance.
Beta-adrenergic antagonists such as metoprolol or propranolol are among the most commonly prescribed drugs for the treatment of cardiovascular disease. Their effect is to lower heart rate and lower blood pressure, which is why they are used in patients with heart failure, arrhythmias, and high blood pressure. Beta blockers have been linked to increased risk of depression, but also other side effects such as anxiety, sleep disturbances and sleep deprivation; these connections have not previously been systematically studied.
We found no evidence to suggest a link between beta blocker use and depression. The same goes for most of the other psychiatric symptoms described in the studies included in our analysis. “
Prof. Dr. Reinhold Kreutz, Director of the Institute of Clinical Pharitology and Toxicology Charité
Continuing his description of the meta-analysis carried out by his team – the first to study the full range of psychiatric effects – he says: “However, some patients have developed symptoms related to sleep during treatment with beta blockers. “The researchers analyzed data from more than 53,000 people. These were taken from 285 individual studies and included 24 different beta blockers. Only data from randomized, double-blind controlled trials were included in the analysis. Most of these were associated with high blood pressure and were caused more than 20 years ago.
Despite the fact that this is the most commonly reported psychiatric side effect, depression did not occur more frequently during treatment with beta blockers than during treatment with placebo. Dr. Kreutz, who is currently President of the European Tolerance Association, explains: “Patients with a history of cardiovascular problems such as heart attack or stroke per se tend to develop mental health problems. This means that, although we have not found a causal link to this problem with beta blockers, these patients should at least be examined in this regard in clinical practice. “
Patients treated with beta blockers were less likely to discontinue their medications due to depression than patients receiving different treatments. However, sleep and fatigue were the most commonly reported reasons for stopping treatment. Among the other side effects studied – such as anxiety and loss of desire, memory, or libido – only sleep disturbances and abnormal dreams associated with beta blockers were found.
Summarizing the findings of the research, Prof. Kreutz says: “Our results show that concerns about undesirable psychological effects, particularly depression, should not affect the decision-making process regarding the use of beta blockers. For the most part, beta blockers have a good mental safety profile. “Therefore, concerns about psychological health should not affect the clinical use of beta blockers.
Source:
Charité – Universitätsmedizin Berlin
Magazine Reference:
Riemer, TG, et al. (2021) Do β-blockers cause depression? Systematic review and meta-analysis of psychiatric adverse events during β-blocker therapy. Hypertension. doi.org/10.1161/HYPERTENSIONAHA.120.16590.