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The conventional
wisdom that beta-blocker therapy substantially increases the
risk of depression, fatigue and sexual dysfunction is largely
wrong, according to a study reported in the July 17 issue
of the Journal of the American Medical Association.
"There
is no significant increased risk of depressive symptoms and
only small increased risks of fatigue and sexual dysfunction,"
concluded the researchers, who hailed from Yale University
and the University of Alabama at Birmingham. "The risks
of these adverse effects should be put in the context of the
documented benefits of these medications."
To determine
whether such concerns were valid, the researchers conducted
a quantitative review of randomized trials that tested beta-blockers
in myocardial infarction, heart failure and hypertension.
They reviewed 15 trials involving 35,000 subjects that reported
on depressive symptoms, fatigue or sexual dysfunction.
The researchers
found that beta-blocker therapy was not associated with a
significant annual increase in risk of reported depressive
symptoms as they showed up in only six patients per thousand.
The annual increase in the risk of reported fatigue and sexual
dysfunction associated with the therapy was also small, appearing
in only 18 patients per thousand and five patients per thousand,
respectively.
"Concerns
about these symptoms may have contributed to the relatively
slow adoption of therapy," the researchers said. "Our
findings should alleviate concerns that long-term treatment
with beta-blockers causes substantial increases in these symptoms
that may compromise quality of life, and should encourage
the implementation of this life-saving therapy."
Source:
Heart
Disease Week of July 21, 2002
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