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Beta-blockers are associated with increased risk of depression in heart attack patients
Last reviewed: 02.07.2025
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All heart attack patients are usually treated with beta blockers. However, according to a Swedish study earlier this year, for those heart patients who have normal blood pumping function, this group of drugs may not be necessary. Now a substudy from Uppsala University shows that there is also a risk of depression in these patients as a result of the treatment.
"We found that beta blockers caused slightly higher levels of depressive symptoms in patients who had a heart attack but did not have heart failure. At the same time, beta blockers do not have a vital function for this group of patients," said Philipp Leissner, a graduate student in cardiac psychology and the study's first author.
Beta blockers are drugs that block the effects of adrenaline on the heart, and they have been used for decades as a basic treatment for all heart attack patients. In recent years, their importance has been questioned as new, more successful treatments are developed. This is especially true for heart attack patients who still have normal blood pumping function after the attack, i.e., those who do not have heart failure.
The researchers decided to study the side effects of beta blockers, namely their impact on anxiety and depression levels. This is because previous studies and clinical experience have linked beta blockers to negative side effects such as depression, sleep problems and nightmares.
Earlier this year, a large national study in Sweden ( nejm.org ) found that patients taking beta blockers were no less likely to have a recurrence or die than those not taking the drugs. Leissner and colleagues built on that data to conduct a substudy that ran from 2018 to 2023, involving 806 patients who had had a heart attack but did not have heart failure. Half were taking beta blockers, and the other half were not. About 100 of the patients taking beta blockers had started doing so before the study, and they had higher depressive symptoms.
"In the past, most doctors would prescribe beta blockers even to patients without heart failure, but now that the evidence for that approach is less compelling, that's worth reconsidering. We've noticed that some of these patients have an increased risk of developing depression. If the drug doesn't have a significant effect on their heart, they're taking it unnecessarily and are at risk for depression," Leissner adds.