Beta-Blockers and Depression After Myocardial Infarction

OBJECTIVES The purpose of this research was to explore the prospective relationship between the use of beta-blockers and depression in myocardial infarction (MI) patients. BACKGROUND Beta-blocker use has been reported to be associated with the development of depression, but the methodological quality of studies in this field is weak. METHODS In a multicenter study, MI patients (n 127 non–beta-blocker users and n 254 beta-blocker users) were assessed for depressive symptoms (using the Beck Depression Inventory [BDI] at baseline and t 3, 6, and 12 months post-MI) and International Classification of Diseases-10 depressive disorder (Composite International Diagnostic Interview). Patients were matched using the frequency matching procedure according to age, gender, hospital of admission, presence of baseline depressive symptoms, and left ventricular function. RESULTS No significant differences were found between non–beta-blocker users and beta-blocker users on the presence of depressive symptoms (p 0.10 at any of the time points) or depressive disorder (p 0.86). Controlling for confounders did not alter these findings. A trend toward increasing BDI scores was seen in patients with long-term use of beta-blockers and patients with higher beta-blocker dose. CONCLUSIONS In post-MI patients, prescription of beta-blockers is not associated with an increase in depressive symptoms or depressive disorders in the first year after MI. However, long-term and high-dosage effects cannot be ruled out. (J Am Coll Cardiol 2006;48:2209–14) © 2006 ublished by Elsevier Inc. doi:10.1016/j.jacc.2006.07.056