Does β‑Blocker Use Increase Depression Risk?

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While depression is often cited as an adverse effect of β-blocker use, there is limited evidence supporting this causal relationship.

The association between β-blocker use and depression was investigated in a population-based observational study recently published in the journal Drug Safety.

While depression is often cited as an adverse effect of β-blocker use, there is limited evidence supporting this causal relationship. To better understand the association between β-blockers and the risk of new-onset depression, the study authors analyzed data from the UK population-based Clinical Practice Research Datalink (CPRD) GOLD database.

“We identifed patients aged 18-80 years with an incident depression diagnosis between 2000 and 2016, and matched controls, and estimated the risk (odds ratio [OR]) of depression in association with use of β-blockers,” the study authors explained.

Findings of the analysis revealed an increased risk of developing depression among short-term users of β-blockers compared with no use at all (adjusted odds ratio [aOR], 1.91; 95% CI, 1.72-2.12).

Among short-term users, increased risk of depression was mainly restricted to patients with a neuropsychiatric disorder taking propranolol (aOR 6.33, 95% CI 5.16–7.76).  Patients on propranolol for a cardiovascular indication were found to be at slightly elevated risk of depression (aOR 1.44, 95% CI 1.14–1.82). Apart from propranolol, no other lipophilic β-blocker or hydrophilic β-blocker was found to increase the risk of depression.

Additionally, no association was observed between long-term use of β-blockers and the risk of depression (aOR, 0.85; 95% CI, 0.85-0.94).

“Our findings suggest that the reported association between use of β-blockers and depression may not be causal but rather a result of protopathic bias,” the study authors concluded.

Reference

Bornand D, Reinau D, Jick SS, Meier CR. β‑blockers and the risk of depression: A matched case–control study. Drug Safety. Published online January 19, 2022. https://doi.org/10.1007/s40264-021-01140-5.

This article originally appeared on MPR