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Beta-Blockers May Not Actually Cause Depression

Older woman taking cardiac medication.

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Key Takeaways

  • In a new study, beta-blockers did not predict depression in patients using them.
  • Researchers believe other causes may put patients who take beta-blockers at risk for depression, leading to a potentially false link between negative mental health consequences and the medication.
  • Scientists are hopeful the findings will reduce some of the negative stigma around prescribing beta-blockers.

Researchers have long since suspected that beta-blockers can potentially cause negative mental health effects. While these medicines are beneficial for treating multiple cardiovascular conditions, they have also been tied to side effects like depression.

But now, researchers in Germany, after reviewing 258 studies involving more than 50,000 people, found that beta-blocker use did not predict depression any more than other medications or placebo.

What Is A Beta-Blocker?

Beta-blockers are prescribed medicines, such as atenolol (Tenormin), bisoprolol (Ziac), and propranolol (Inderal or Innopran), that work by blocking adrenaline, reducing blood pressure, and slowing down the heart. They are mostly used to treat cardiac problems and high blood pressure. Less common uses include anxiety, hyperthyroidism, tremor, and glaucoma.

However, the data was less conclusive on other reported side effects, such as insomnia, sleep disorders, and unusual dreams. Researchers also found that patients who chose to stop taking the medication most commonly cited fatigue as the cause.

"Beta-blockers are very commonly prescribed drugs, and their possible psychiatric adverse events have been the subject of discussion in the scientific community for more than 50 years," study author Thomas G. Riemer, MD, PhD, a researcher from Charité – Universitätsmedizin Berlin and the Berlin Institute of Health, Institute of Clinical Pharmacology and Toxicology, tells Verywell. "Therefore, our results showing that beta-blockers are not causing most of their alleged side effects are quite consequential."

The study was published in mid-March in Hypertension, an American Heart Association journal.

What This Means For You

If you are taking beta-blockers, depression may not be a side effect of your medication. But it's important to keep an eye out for other side effects like fatigue, and sleep disturbances or insomnia. If you're experiencing any negative side effects from the medication, bring up your concerns with your doctor.

Why Have Beta-Blockers Been Linked To Depression?

According to the researchers, there are various factors that may predispose patients who are taking beta-blockers to depression, which could then be incorrectly attributed to their medication.

First off, Riemer says, patients with cardiovascular diseases may be at risk for developing depression. Because of this, the European Society of Cardiology recommends clinicians routinely screen patients with heart failure for depression.

Fatigue caused by beta-blockers can also "mimic" depression. "Patients suffering from fatigue may be misdiagnosed as being depressed," Riemer adds.

"Interestingly, one of the other common things that beta-blockers are associated with is a decrease in exercise tolerance," Vivek Bhalla, MD, associate professor of medicine at the Stanford University Medical Center and director of the Stanford Hypertension Center in California, tells Verywell. "There's this notion that, 'I can't get my heart rate up fast enough, so I can't exercise,' and many young people don't favor being on beta-blockers for the reason."

There's also a link between exercise and depression, he adds, which could be difficult to tease out among patients taking the medication.

Changing the Way We Look at Beta-Blockers

Ultimately, researchers say concerns about mental health shouldn't deter patients from using beta-blockers for health conditions. "Beta-blockers are mostly safe regarding psychological health,” study author Reinhold Kreutz, MD, PhD, a professor at the Berlin Institute of Health, Institute of Clinical Pharmacology and Toxicology, said in a press release.

At the same time, the researchers acknowledge that most of the beta-blocker trials analyzed in the study were conducted more than 20 years ago, before a uniform language to describe adverse mental health events was established. They also noted the risk of bias in some studies and limited the type of study analyzed to randomized, double-blind trials, which prevented them from including longer-term data on beta-blockers.

Given the size of this study, as well as its questioning of the status quo, its findings are noteworthy to the medical community and could potentially impact the ways beta-blockers are prescribed.

"Beta-blockers have had the stigma of being harmful for psychological health, which may have discouraged their use, [for example] in patients deemed vulnerable to psychiatric diseases," Riemer says. "We hope that our study will contribute to simplifying decision making in clinical practice."

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  1. Riemer TG, Villagomez Fuentes LE, Algharably EAE, et al. Do β-blockers cause depression?: systematic review and meta-analysis of psychiatric adverse events during β-blocker therapy. Hypertension. Published online March 15, 2021. doi:10.1161/hypertensionaha.120.16590