Study: Beta Blockers Unlikely to Cause Depression, Could Contribute to Sleep Disturbances

Although depression may occur during treatment with beta blockers, new research suggests that the drugs are not the likely cause.

Beta-blockers are used to reduce heart rate, the heart’s workload, and the heart’s output of blood, all 3 of which can contribute to lowering blood pressure. They are a common treatment for conditions such as heart failure, arrhythmias, chest pains, and high blood pressure.

In a press release, the study authors said they have long suspected beta-blockers of having negative psychological adverse effects (AEs), including depression, anxiety, drowsiness, insomnia, hallucinations, and nightmares.

“The possible mental health side effects of beta-blockers have been the subject of discussion in the scientific community for many decades,” said Reinhold Kreutz, MD, PhD, a professor at the Berlin Institute of Health, Institute of Clinical Pharmacology and Toxicology, in a press release. “So, our results showing beta-blockers are not the cause of so many of these negative side effects are quite consequential.”

The study is the first of its kind to examine the entire spectrum of mental health AEs in relation to the class of drugs. The investigators analyzed data from more than 50,000 individuals in 258 studies including beta-blockers in double-blind, randomized controlled trials. Nearly 70% of the studies were clinical trials focused on high blood pressure treatment and 31 of them assessed depression in placebo-controlled trials.

According to the study, the authors found that despite being the most frequently reported mental health AE, depression did not occur more frequently during beta-blocker treatment compared to placebo treatment. Furthermore, the rate of discontinuing medication use due to depression was not any different for those taking beta-blockers compared to those on other treatments.

In addition, the researchers found that unusual dreams, insomnia, and sleep disorders may be linked to beta-blockers. Among the mental health AEs analyzed by the team, the most common reason for discontinuing beta-blockers was fatigue or tiredness.

“Our results indicate that concerns about adverse mental health events, especially depression, should not affect the decision about beta blockers,” Kreutz said in the press release. “Beta-blockers are mostly safe regarding psychological health.”

Kreutz said they found no indication of an association between beta-blocker use and depression, and the same was true for most of the other mental health symptoms. Some AEs may be more likely for patients with a history of cardiovascular health issues.

“Patients with a history of cardiovascular events such as a heart attack or stroke were prone to develop psychological complications,” Kreutz said in the press release. “Though we found beta-blockers were not causally linked, these patients should be monitored.”

The researchers noted that the original studies did not include individual patient data, so for this analysis, they were unable to analyze whether sleep-related symptoms were persistent for those taking beta-blockers. They said additional research is needed to address this question.

REFERENCE

Beta-blockers not likely to cause depression yet may contribute to sleep disturbances [news release]. American Heart Association; March 15, 2021. https://newsroom.heart.org/news/beta-blockers-not-likely-to-cause-depression-yet-may-contribute-to-sleep-disturbances?preview=7e28. Accessed March 15, 2021.