Beta-blockers may reduce aggression in people with psychiatric disorders

By Stephen Beech via SWNS

Controversial heart tablets may reduce aggression in people with serious psychiatric disorders, new research suggested.

Beta-blockers are prescription-only pills that slow down the heart by blocking the action of hormones such as adrenaline.

Now an eight-year study involving 1.4 million people has shown reductions in violence in patients using beta-blockers compared with periods when they are not taking the medication.

The tablets, which have previously been linked with an increased risk of suicidal behavior, were associated with reduced violent criminal charges in people with psychiatric disorders.

Scientists say that if their findings are confirmed by other studies, beta-blockers could be considered as a way to manage aggression and hostility in patients with psychiatric conditions.

Beta-blockers are used to treat high blood pressure, angina and acute medical events such as heart failure as well as conditions including migraine and glaucoma.

They are often used for anxiety and have been suggested for clinical depression and aggression, but previous evidence is conflicting.

They have been linked to an increased risk of suicidal behavior, although evidence is inconclusive.

Professor Seena Fazel, of Oxford University, and colleagues at the Karolinska Institute in Sweden investigated psychiatric and behavioral outcomes, including hospitalizations for psychiatric disorders; suicidal behavior 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 to 2013.

Prof Fazel said: "Periods on beta-blocker treatment were associated with a 13 percent lower risk of being charged with a violent crime by the police, which remained consistent across the analyses.

"Additionally, an eight percent lower risk of hospitalization due to a psychiatric disorder was reported, as well as an eight percent 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 beta-blockers were being used to treat."

He continued: "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 beta-blocker treatment, increases the risk of serious psychiatric events.

"In secondary analyses, associations with hospitalization were lower for major depressive but not for anxiety disorders."

Prof Fazel added: "In order to understand the role of beta-blockers in the management of aggression and violence, further studies, including randomized controlled trials, are needed.

"If these confirm the results of this study, beta-blockers could be considered to manage aggression and violence in some individuals."

The findings were published in the journal PLoS Medicine.