What To Do Next
If you believe that you may be experiencing symptoms of depression, whether they are related to a drug that you are taking or not, you should consult with your personal physician.
Do not stop taking your medication without your doctor’s permission. If you are experiencing severe depression or having thoughts of suicide, do not hesitate to seek immediate medical attention.
Every situation is different, so your doctor will look at your health history and symptoms in order to determine what steps to take next. In some cases, it may involve switching to a different medication or adjusting your dosage.
Your doctor will also try to determine if your depressive symptoms are linked to the new medication or some other cause. If there is an underlying depressive disorder, your doctor may recommend treatments such as antidepressants and psychotherapy.
If you or a loved one are struggling with depression, contact the Substance Abuse and Mental Health Services Administration National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.
For more mental health resources, see our National Helpline Database.
Antihypertensive Drug Use And The Risk Of Depression: A Systematic Review And Network Meta
- 1State Key Laboratory of Natural Medicines, School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, China
- 2Department of Cardiology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China.
Background: Although numerous cohort studies have reported an association between antihypertensives use and depression, the exact effect of antihypertensives on depression remains unclear.
Objective: To clarify the association between antihypertensives use and risk of depression.
Methods: We retrieved relevant literature using PubMed database until August 30, 2021. Four main classes of antihypertensives, thus, angiotensin antagonists, beta blockers, calcium channel blockers and diuretics were studied. The incidence of depression was pooled based on a single drug category. Network meta-analyses were conducted to comprehensively assess the effects of the four classes of antihypertensives on the risk of depression.
In conclusion, our results indicate that the use of angiotensin antagonists, beta blockers and calcium channel blockers are potential risk factors of depression.
Why Do I Keep Getting Tension Headaches Everyday
Many chronic tension headaches develop for no apparent reason. Working long hours bent over a computer may trigger them. Some people get tension headaches if they drink too much caffeine or alcohol, if they don’t drink enough water or if they go for a long time between meals and become tired and hungry.
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Study Selection And Characteristics
The workflow of study selection is illustrated in Figure 1. In brief, a total of 9,557 publications were retrieved from the PubMed database, and 9 studies consisting 6 cross-sectional studies and 3 cohort studies were finally involved in this study .
FIGURE 1. Flow chart of published studies included and excluded in this study.
Characteristics of selected publications are presented in Table 1. Overall 414,873 individuals were included in the final analysis. The sample sizes ranged from 573 to 181,709 individuals. Subjects were recruited from a total of 10 countries, including Australia, China, Germany, Netherlands, Norway, Singapore, the United Kingdom and the United States. Of note, the methods used to assess depression or symptoms of depression varied across the nine studies. The two main diagnostic classification systems were Diagnostic and Statistical Manual of Mental Disorders and International Classification of Diseases . In all nine studies, three studies identified depression based on these two criteria .
TABLE 1. Characteristics of included studies.
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Statins And Other Cholesterol
While statins are the most commonly prescribed drugs for lowering cholesterol, other drugs, such as fibrates, colesevelam, ezetimibe, and nicotinic acid can also be used for this purpose.
There have been some reports linking these drugs with depression. It is thought that these drugs may cause depression by lowering the levels of cholesterol in the brain, where it serves many important functions.
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Contrary To Conventional Wisdom Some Blood Pressure Drugs Are Linked To A Lower Risk Of Depression
Like all medications, blood pressure drugs sometimes cause unwanted side effects. While many are mild and short-lived, some are more worrisome, including mood changes such as depression. But contrary to what doctors have long assumed, blood pressure drugs may not raise the risk of depression. In fact, some appear to be linked to a lower risk, according to a recent study .
“The traditional view has been that blood pressure drugs that cross the blood-brain barrier are more likely to cause depression,” says Dr. Randall -Zusman, a cardiologist at Harvard-affiliated Massachusetts General Hospital. Depression has also been associated with drugs known as beta blockers. But beta blockers can also make you feel tired and listless, which may dampen your mood, Dr. Zusman explains.
Who Needs A Beta Blocker
Beta blockers are used for many reasons, including:
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cardiac healing after a heart attack
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heart rhythm problems such as atrial fibrillation or palpitations
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high blood pressure
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hypertrophic cardiomyopathy
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noncardiovascular conditions such as anxiety, essential tremor, glaucoma, migraine, and others.
Once a mainstay for treating high blood pressure, beta blockers have been elbowed aside by newer drugs, such as ACE inhibitors, and older ones, such as thiazide diuretics.
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Heterogeneity And Publication Bias
Given the obvious heterogeneity shown in the forest plots, the sensitivity analysis was conducted by omitting one study at a time . In line with the results earlier mentioned, associations between angiotensin antagonists and diuretics use and depression were little, and the result was not excessively influenced by any single study . After removing the study by Simonson et al., a significant association between use of beta blockers and depression was observed with the heterogeneity decreasing from 85 to 40% . When the study by Cao et al. was excluded, no association was found between calcium channel blockers usage and depression .
To evaluate publication bias, funnel plots were constructed. No publication bias was found in the beta blockers group , while apparent biases were found in the other three groups .
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Which Beta Blocker Would Cause The Least Depressionbystolic
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Study: Beta Blockers Unlikely To Cause Depression Could Contribute To Sleep Disturbances
Adverse effects, such as strange dreams, insomnia, and sleep disorders may be more likely for patients with a history of cardiovascular health issues.
Although depression may occur during treatment with beta blockers, new research suggests that the drugs are not the likely cause.
Beta-blockers are used to reduce heart rate, the hearts workload, and the hearts output of blood, all 3 of which can contribute to lowering blood pressure. They are a common treatment for conditions such as heart failure, arrhythmias, chest pains, and high blood pressure.
In a press release, the study authors said they have long suspected beta-blockers of having negative psychological adverse effects , including depression, anxiety, drowsiness, insomnia, hallucinations, and nightmares.
The possible mental health side effects of beta-blockers have been the subject of discussion in the scientific community for many decades, said Reinhold Kreutz, MD, PhD, a professor at the Berlin Institute of Health, Institute of Clinical Pharmacology and Toxicology, in a press release. So, our results showing beta-blockers are not the cause of so many of these negative side effects are quite consequential.
In addition, the researchers found that unusual dreams, insomnia, and sleep disorders may be linked to beta-blockers. Among the mental health AEs analyzed by the team, the most common reason for discontinuing beta-blockers was fatigue or tiredness.
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Other Drugs That Can Cause Depression
Some other medications that may be linked to depressive side effects include:
- Acne medications
- Problems with appetite or weight
- Problems with thinking, memory, and concentration
- Loss of interest in things once enjoyed
- Thoughts of death or suicide
It can be helpful to write down details like when your symptoms first started and when they are the most severe. With many medications, you may begin to start noticing such symptoms within the first few weeks after you begin a new drug.
Because many medications that can cause depression are not prescribed to treat mental health conditions, people may not be adequately warned of this possible risk.
It is also difficult to know what your individual reaction to a drug may be, or how it may interact with other medications that you are currently taking. For this reason, it is important to always fully inform your doctor about anything else you are taking, including any over-the-counter medications and herbal supplements. Always talk to your doctor if you experience any unusual side effects after taking a medication.
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Interpretation Of The Results
On the surface, this very large meta-analysis21 of placebo arm and active arm parallel group RCTs provides strong evidence for the absence of risk of new-onset depression following initiation of BB treatment. So, what is the reason for the longstanding clinical concern that BB treatment is associated with an increased risk of developing depression?
There are 2 explanations. One is that it is well known that IHD and depression are each associated with an increased risk of the other,22,23 and IHD is an important indication for the initiation of BB treatment. So, confounding by indication may explain clinical observations of new-onset depression after initiation of BBs in patients with IHD. The second explanation is that tiredness/fatigue and unusual dreams, which Riemer et al21 found to be significantly more common with BBs, are common symptoms of depression and may be misinterpreted and misreported as depression.
Riemer et al21 wrote in their abstract that insomnia and sleep disorder were other psychiatric adverse events that were possibly related to BB therapy. Whereas neither adverse event emerged as a significant finding in the main quantitative analyses for either placebo- or active-controlled comparisons, there were some significant or near-significant associations with BB treatment in sensitivity and subgroup analyses. So, insomnia and sleep disorder may additionally contribute to the possibility of nonspecific adverse events being misinterpreted as depression.
Other Serious Side Effects
Besides the abovementioned serious adverse reactions, beta-blockers can also cause swollen ankles or legs, chest pain, wheezing, tightening feeling in the chest, and jaundice.
Make sure to seek emergency medicine department attention if you experience the signs of heart, liver, or lung problems caused by beta-blockers. Heart problems include chest pain, lung problems manifest themselves through breathing difficulties, whereas jaundice is a sign of a liver issue.
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Is It Safe To Stop Using Beta
Its dangerous to stop taking beta-blockers suddenly, even if youre experiencing side effects.
When you take beta-blockers, your body gets used to your hearts slower speed. If you stop taking them suddenly, you could increase your risk of a serious heart problem, such as a heart attack.
Contact your doctor if you experience unpleasant side effects with beta-blockers that last for more than a day or two. Your doctor might suggest another type of medication, but youll still need to slowly taper your beta-blocker dose.
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Research Does Not Support Worry That Beta Blockers Cause Depression Fatigue And Sexual Dysfunction
There is no data to support the worry that beta blockers, prescribed following a heart attack to guard against future episodes, commonly cause depression, fatigue and sexual dysfunction, according to a study by Yale researchers published this week in the Journal of the American Medical Association.
Harlan Krumholz, M.D., associate professor of internal medicine and cardiology at Yale School of Medicine and senior investigator of the study, has long been concerned about the underutilization of beta blockers by physicians as a tool in preventing future heart attacks. A study by his group in 1995 showed that 50 percent of heart attack patients who could benefit from beta blockers were not being prescribed the medication. Krumholz said that figure today reportedly is as high as 75 percent.
He said he conducted the study to hopefully dispel some of the misconceptions about the medication that may contribute to the underutilization.
Beta blockers are any of a group of drugs widely used in the treatment of patients with heart disease and hypertension. The drugs, among them propranolol, naldolol and atenolol metoprolol, decrease the rate and force of heart contraction by blocking the beta-adrenegic receptors of the autonomic nervous system.
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Can Medications Given For A Heart Attack Cause Depression
Dr. Richard Stein answers the question: Can Beta Blockers Cause Depression?
& #151 Question: Can medications given for a heart attack cause depression?
Answer: Beta blockers are, for a cardiologist, a sort of the rock and the hard place thing. They reduce your risk of having a second heart attack and of dying of it, so its really a compelling medication for us to use. But they clearly can increase your risk of becoming depressed and staying depressed on the medication. So what you need to do is to tell your cardiologist about this, and your cardiologist should actually ask you about this, and your doctor should talk to you about it and adjust the doses or add some drugs to take care of the depressive side of it at the same time.
What Beta Blockers Do
Tiny proteins called beta receptors sit on the outer surface of many cells. There are three main types. Beta-1 receptors are found almost exclusively in heart cells. Beta-2 receptors reside mostly in lung and blood vessel cells, though heart cells also have some. Beta-3 receptors are located on fat cells.
The job of beta receptors is to latch onto chemical messengers released by the nervous system. In response to these messengers, the heart beats faster, blood vessels constrict, the airways relax, and the kidneys increase production of a protein that boosts blood pressure.
Beta blockers subvert these processes by settling onto beta receptors and preventing the chemical messengers from binding to their receptors. That slows the heart, improves the conduction of electrical signals in the heart, relaxes blood vessels, and lowers blood pressure.
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Search Strategy And Selection Criteria
We searched the PubMed database using and expanding the MeSH terms antihypertensive agents and depression until August 30, 2021. The full search terms were illustrated in Supplementary Appendix S1. Literature retrieval was limited to human studies published in English. Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines for systematic reviews were followed and fulfilled . Publication that simultaneously fulfilled the following criteria were included in our study: 1) control groups were users of other classes of medication and/or nonmedicated participants 2) studies that used a validated method to assess depression or symptoms of depression, and the measure of depression was used as a categorical variable rather than a continuous variable and 3) studies with sample size of more than 100, so as to avoid selection bias. The selection of relevant literature was independently conducted by two researchers, and disagreements were resolved by consulting a third reviewer.
Side Effects Of Beta Blockers
Most people taking beta blockers have either no or very mild side effects that become less troublesome with time.
Contact your GP if youre having symptoms that bother you or last more than a few days.
Side effects commonly reported by people taking beta blockers include:
- feeling tired, dizzy or lightheaded
- cold fingers or toes
It happens rarely, but some people have serious side effects when taking beta blockers.
Tell a doctor straight away if you have:
- shortness of breath with a cough that gets worse when you exercise , swollen ankles or legs, chest pain, or an irregular heartbeat these are signs of heart problems
- shortness of breath, wheezing and tightening of your chest these can be signs of lung problems
- yellow skin or the whites of your eyes turn yellow these can be signs of liver problems
These are not all the side effects of beta blockers. For a full list, see the leaflet inside your medicine packet.
You can report suspected side effects using the Yellow Card Scheme.
For more information on the side effects of beta blockers, read about the specific medicine you take in our Medicines A to Z.
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Characteristics Of The Study Population
We identified 118,705 cases with a first-time diagnosis of pharmacologically treated depression between 2000 and 2016, and the same number of matched controls. The majority of cases had a depression episode without further classification, but severe enough to be treated with antidepressant therapy. Patients had a mean age of 40.3 years at the index date and the majority were female . The mean duration of active history in the database prior to the index date was 11.3 years .
Table 1 Characteristics of the study population
Is It Better To Take Beta Blockers At Night
Blood pressure medications/beta blockers: If you’re taking these medications, talk to your health care provider about the ideal time of day to take them, though as a general rule of thumb, evening is best. Providers may specify to take these in the evening because of side effects that can occur, Verduzco said.
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Take A Survey About Work And Depression
Tufts Medical Center is developing a new health program for working adults with depression, which is provided over the phone and does not involve medication. By taking a free, anonymous survey online, you may be selected to participate in a research study related to the program. To learn more, visit Tufts Work & Health Initiative.