Beta Blockers and Their Effects

B-blockers are used to treat hypertension, angina, acute cardiovascular events, heart failure, and arrhythmias, as well as migraine, symptoms of hyperthyroidism, and glaucoma. They are often used for anxiety and have been suggested for clinical depression and aggression, but evidence is conflicting.

Researchers have found in a new study that beta blocker use was associated with lower rates of violence. It was observed that there was a reduction in violence in individuals using Beta adrenergic-blocking agents (β-blockers) compared with periods when they were not taking the medication. If the findings are confirmed by other studies, β-blockers could be considered as a way to manage aggression and hostility in individuals with psychiatric conditions.

The study has been published on January 31st in the open access journal PLOS Medicine.

Seena Fazel of the University of Oxford, UK, and colleagues at the Karolinska Institute in Sweden investigated psychiatric and behavioral outcomes:

• Hospitalizations for psychiatric disorders
• Suicidal behavior and deaths from suicide
• Charges of violent crime

They compared 1.4 million β-blocker users in Sweden to themselves during medicated and non-medicated periods over an eight-year period from 2006-2013.

Periods on β-blocker treatment were associated with a 13% lower risk of being charged with a violent crime by the police, which remained consistent across the analyses. Additionally, an 8% lower risk of hospitalization due to a psychiatric disorder was reported, as well as an 8% increased association of being treated for suicidal behavior. However, these associations varied depending on psychiatric diagnosis, past psychiatric problems, as well as the severity and type of the cardiac condition the β-blockers were being used to treat.

Previous research has linked severe cardiac events to an increased risk of depression and suicide, and these results might suggest that the psychological distress and other disabilities associated with serious cardiac problems, rather than the β-blocker treatment, increase the risk of serious psychiatric events. In secondary analyses, associations with hospitalization were lower for major depressive but not for anxiety disorders.

In order to understand the role of β-blockers in the management of aggression and violence, further studies including randomized controlled trials are needed. If these confirm the results of this study, β-blockers could be considered to manage aggression and violence in some individuals.

Fazel adds, “In a real-world study of 1.4 million persons, β-blockers were associated with reduced violent criminal charges in individuals with psychiatric disorders. Repurposing their use to manage aggression and violence could improve patient outcomes.”

Reference:

Yasmina Molero, Sam Kaddoura, Ralf Kuja-Halkola, Henrik Larsson, Paul Lichtenstein, Brian M. D’Onofrio, Seena Fazel. Published: January 31, 2023. https://doi.org/10.1371/journal.pmed.1004164