Meta-analysis finds no association between beta-blocker therapy, depression

Beta-blockers were not associated with psychiatric adverse events, including depression, a meta-analysis found.

The analysis included 285 eligible studies (69% hypertension trials) with 53,533 patients who had been exposed to 24 different beta-blockers. Seventy-three studies were placebo-controlled, 12 compared a beta-blocker with both placebo and an active substance, and 200 tested a beta-blocker against an active substance. Results were published by Hypertension on March 15.

Depression was the most frequently reported psychiatric adverse event, with 1,600 cases out of 26,832 exposed patients. Similarly, depression was also the most common psychiatric adverse event that led patients to stop treatment, with 47 cases out of 13,225 exposed patients. However, depression did not occur significantly more with beta-blockers than placebo (odds ratio [OR], 1.02; 95% CI, 0.83 to 1.25). Patients taking beta-blockers were not any more likely to stop therapy due to depression than those taking placebo (odds ratio, 0.97; 95% CI, 0.51 to 1.84). Similar results occurred for comparisons with active agents. Among other psychiatric adverse events, only unusual dreams, insomnia, and sleep disorder were possibly related to beta-blocker therapy.

Psychiatric events are relatively common in patients requiring beta-blockers, and physicians should monitoring for these symptoms, the authors said. “However, our data do not support an adverse association between [beta]-blocker use and most PAEs [psychiatric adverse events] or withdrawal of therapy due to PAEs,” the authors wrote. “Consequently, concerns about a potentially increased risk for PAEs are mostly unwarranted. They should not affect the use of β-blockers in clinical practice.” The authors noted that beta-blockers may have a potential adverse effect on sleep and said that this relationship should be explored in future studies.