Beta blockers that aren’t associated to despair; Connection to sleep disorder much less clear

March 24, 2021

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Beta Blockers That Aren't Associated To Despair;  Connection To Sleep Disorder Much Less Clear

Disclosure:
Kreutz reports that outside of the submitted work, he has received modest fees for advice, lectures and research funding from Bayer Pharma, Berlin-Chemie Menarini, Daiichi Sankyo, Ferrer, Sanofi and Servier. The other authors do not report any relevant financial information.

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Beta blockers have not been associated with depression and other psychiatric adverse events, although a meta-analysis suggests that they may be linked to sleep disorders.

“This analysis of large-scale data from double-blind, randomized controlled trials does not support an association between beta-blocker and depression. Likewise, no effect of beta blockers on other psychiatric side effects was found, with possible exceptions for sleep-related disorders, ”the researchers write.

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Beta-blocker has been linked to dreams and insomnia, the researchers wrote.

“The possible psychiatric consequences of beta blockers, especially depression, have been discussed in the scientific community for more than 50 years. The medical literature, including books on clinical pharmacology, cardiovascular medicine, and psychiatry, lists depression among the side effects of beta-blockers. ” Thomas G. Riemer, MD, PhD, from Charité – Universitätsmedizin Berlin and the Berlin Institute of Health, Institute for Clinical Pharmacology and Toxicology, said Healio. “Several case reports have been published of depression apparently caused by beta blockers. Depression has also been reported frequently in both American and European post-marketing surveillance systems. “

The researchers performed a systemic review and meta-analysis of 53,533 patients from 285 studies taking various beta blockers, most of whom had cardiovascular disease.

Compared to placebo, the risk of depression was no higher under beta-blocker (OR = 1.02; 95% CI 0.83-1.25; P = 0.88).

The researchers wrote that the rate of drug withdrawal for depression among taking beta blockers was the same compared to placebo (OR = 0.97; 95% CI, 0.51-1.84; P = 0 , 91).

According to the researchers, most of the studies were conducted in patients with cardiovascular disease, with the most common indication being arterial hypertension (32,042 patients on beta-blockers in 197 studies), followed by myocardial infarction, HF, and angina.

The most noticeable non-vascular indication was migraine (1,313 patients in 19 studies).

“Patients with a history of cardiovascular events such as heart attacks or strokes tended to develop psychological complications. Although we have found that beta blockers are not causally linked, these patients should be monitored. ” Reinhold Kreutz, MD, PhD, Professor at the Berlin Institute for Health, Institute for Clinical Pharmacology and Toxicology, in a press release.

“The selection process for a drug to treat a disease always involves weighing the risks and benefits. In the past, beta-blockers have had the stigma of being detrimental to mental health, which may have deterred their use in patients believed to be susceptible to psychiatric illness. Our results show that concerns about psychiatric adverse events, particularly depression, should not influence the decision whether or not to use beta blockers, ”Riemer told Healio.

For more informations:

Thomas G. Riemer, MD, PhD, reachable at thomas.riemer@charite.de.

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