Beta-blockers use linked to sleep disturbances not depression: Study

"The possible mental health side effects of beta-blockers have been the subject of discussion in the scientific community for many decades," says Reinhold Kreutz, M.D., Ph.D., a professor at the Berlin Institute of Health, Institute of Clinical Pharmacology and Toxicology and the study's supervising and corresponding author. "So, our results showing beta-blockers are not the cause of so many of these negative side effects are quite consequential."

Results from the comprehensive analysis revealed:

• Despite being the most frequently reported mental health side effect, depression did not occur more frequently during beta-blocker treatment compared to placebo treatment.
• The rate of discontinuing medication use due to depression was not any different for those taking beta-blockers compared to those on other treatments.
• Unusual dreams, insomnia and sleep disorders may be linked to beta-blockers.
• Among the mental health events analyzed, the most common reason for discontinuing beta-blockers was fatigue/tiredness.

"Our results indicate that concerns about adverse mental health events, especially depression, should not affect the decision about beta blockers. Beta-blockers are mostly safe regarding psychological health," said Kreutz. "We found no indication of an association between beta-blocker use and depression. The same was true for most of the other mental health symptoms, as reported in the studies that were included in our analyses. However, sleep-related symptoms such as unusual dreams or insomnia did emerge during beta‑blocker therapy for some patients."

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

The original studies did not include individual patient data, so for this analysis, researchers were unable to investigate whether sleep-related symptoms were persistent for those taking beta-blockers. Additional research is needed to address this question.

The researchers report there an important limitation to consider when interpreting the results of their analysis: most beta-blocker trials were conducted more than 20 years ago, before a uniform language to describe adverse events was established. Additionally, the authors only considered randomized, double-blind trials for their analysis, which left out some studies that might provide more data on long-term beta-blocker treatment.