Although long suspected of causing depression and other psychiatric symptoms in patients undergoing treatment for cardiovascular disease, beta-blockers are not associated with increased risk of depression, according to a systematic review and meta-analysis published online in the American Heart Association’s journal Hypertension.
“Our results indicate that concerns about adverse mental health events, especially depression, should not affect the decision about beta-blockers,” said study corresponding author Reinhold Kreutz, MD, PhD, a professor at the Berlin Institute of Health, Institute of Clinical Pharmacology and Toxicology, Berlin, Germany. “Beta-blockers are mostly safe regarding psychological health.”
The review and meta-analysis included 285 double-blind, randomized controlled trials investigating beta-blockers in 53,533 patients. The analysis found that depression was the most frequent psychiatric adverse event reported with beta-blocker use.
Nevertheless, large-scale data failed to support a link between beta-blocker therapy and depression. Compared with placebo use, the odds ratio of depression with beta-blocker use was 1.02, according to the study. Furthermore, medication discontinuation due to depression did not differ between patients taking beta-blockers and patients on other treatments.
However, the study did find a possible link between beta-blockers and unusual dreams, insomnia, and sleep disorders. Because the original studies did not include individual patient data, researchers were unable to determine whether sleep-related symptoms were persistent. They recommended additional research into the issue.
And while the meta-analysis seemingly cleared beta-blockers of causing depression and similar psychiatric symptoms in users, researchers advised continued watching of patients for mental health concerns.
“Patients with a history of cardiovascular events such as a heart attack or stroke were prone to develop psychological complications,” said Dr. Kreutz. “Though we found beta-blockers were not causally linked, these patients should be monitored.”
Riemer TG, Villagomez Fuentes LE, Algharably EAE, et al. Do β-blockers cause depression? Systematic review and meta-analysis of psychiatric adverse events during β-blocker therapy. Hypertension. 2021 March 15;[Epub ahead of print].