Reductions in violence are seen in individuals using Beta adrenergic-blocking agents (Beta-blockers) compared with periods that they are not taking the medication, in a study published in the open access journal PLOS Medicine. If the findings are confirmed by other studies, Beta-blockers could be considered as a way to manage aggression and hostility in individuals with psychiatric conditions.
Beta-blockers are used to treat hypertension, angina and 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. They have been linked to an increased risk of suicidal behaviour though evidence is inconclusive.
Seena Fazel, from the University of Oxford, and colleagues at the Karolinska Institute in Sweden, investigated psychiatric and behavioural outcomes including: hospitalisations for psychiatric disorders; suicidal behaviour and deaths from suicide, and; charges of violent crime. They compared 1.4 million Beta-blocker users in Sweden to themselves during medicated and non-medicated periods over an eight-year period from 2006-2013.
Periods on Beta-blocker treatment were associated with a 13 per cent lower risk of being charged with a violent crime by the police, which remained consistent across the analyses. Additionally, an eight per cent lower risk of hospitalization due to a psychiatric disorder was reported as well as an eight per cent increased association of being treated for suicidal behaviour. However, these associations varied depending on psychiatric diagnosis, past psychiatric problems, as well as the severity and type of the cardiac condition the Beta-blockers were being used to treat.
Professor Fazel said:
“In a real-world study of 1.4 million persons, Beta-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.”
Previous research has linked severe cardiac events to an increased risk of depression and suicide and it is thought these results might suggest that the psychological distress and other disabilities associated with serious cardiac problems, rather than the Beta-blocker treatment, increases the risk of serious psychiatric events. In secondary analyses, associations with hospitalisation were lower for major depressive but not for anxiety disorders.
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