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.
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.
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.
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.”
