MEDICATIONS: BETA-BLOCKERS NOT ASSOCIATED WITH SUBSTANTIAL INCREASE IN SYMPTOMS OF DEPRESSION, FATIGUE OR SEXUAL DYSFUNCTION

July 16, 2002 — Patients taking beta-blockers are not at significant risk to develop depression, fatigue or sexual dysfunction, according to an article in the July 17 issue of The Journal of the American Medical Association (JAMA).

Dennis T. Ko, M.D., of the Yale University School of Medicine, and colleagues conducted a quantitative review of 15 previous clinical trials of beta-blockers used for the treatment of myocardial infarction, heart failure and hypertension. According to background information in the article, beta-blockers are considered effective for reducing mortality after myocardial infarction and for treating heart failure, but physicians may be reluctant to prescribe beta-blocker treatment, in part, because of concerns about side effects commonly thought to be associated with the drugs.

Using the MEDLINE database and reference lists of published studies, the authors searched for beta-blocker trials that met specific criteria of having placebo control, enrollment of at least 100 patients, and a follow-up period of at least six months. All studies that did not report information on depressive symptoms, fatigue and sexual dysfunction were excluded, resulting in 15 trials for analysis involving more than 35,000 participants.

The authors found that beta-blocker therapy was not associated with a significant increase in risk of depressive symptoms, although there were small, but statistically significant increases in the risk for fatigue (18 per 1000 patients treated for a year) and sexual dysfunction (five per 1000 patients treated for a year).

The authors also report that the rates of withdrawal of beta-blocker medication due to fatigue and sexual dysfunction were four per 1,000 patients treated for a year, and two per 1,000 patients treated for a year, respectively.

"...Given the survival benefits associated with beta-blocker therapy, concerns about the development of these adverse effects should not deter physicians from initiating long-term treatment when indicated, although surveillance for adverse effects remains prudent," the authors conclude.