Beta-blockers are one of the most widely prescribed classes of drugs in the world, especially for treating high blood pressure. They are suspected of having side effects on mental health, including depression.
Beta-blockers occupy a major place in the treatment of cardiovascular diseases. They are indicated as first-line treatment against arterial hypertension and in the presence of an acute coronary syndrome (stable angina, myocardial infarction). They are associated with decreased cardiac output and work, which decreases the heart’s need for oxygen (a beneficial action in coronary artery disease), as well as lower blood pressure. They are also prescribed for heart failure.
Among their possible undesirable effects, sleep disorders (insomnia, nightmares, etc.) are well identified. Other mental or psychological problems are reported, but the cause and effect are much less clear: this is the case with depression.
A German team (University of Berlin) looked into the issue. It cross-referenced data from dozens of studies carried out around the world, bringing together a total of just over 50,000 people treated or not with a beta-blocker. Most of this work has focused on the treatment of high blood pressure, and some have specifically focused on related mental disorders.
Many parameters were taken into account and it turns out, the researchers say, that no cause and effect relationship can be established between beta-blockers and depression. Indeed, the cases are not higher than with the administration of a placebo (a chemically inactive substance) or another antihypertensive drug.
On the other hand, the meta-analysis confirms that beta-blockers can be the direct cause of insomnia and nightmares, while the side effect most often reported is fatigue, one of the most common reasons for the discontinuation of treatment.
Beta-blockers are also prescribed after myocardial infarction. However, these patients are at greater risk of developing a depressive disorder. Even if this is unrelated to beta-blockers, it is essential to monitor the situation closely.
Finally, the researchers note that most of the large studies on beta-blockers were conducted many years ago, and it would be useful to update the knowledge.