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CLINICAL RESEARCH: MYOCARDIAL INFARCTION AND DEPRESSION

Beta-Blockers and Depression After Myocardial Infarction

A Multicenter Prospective Study

Joost P. van Melle, MD, PhD^_*,_*, Daniëlle E.P. Verbeek, MD^_*, Maarten P. van den Berg, MD, PhD^_*, Johan Ormel, PhD, Marcel R. van der Linde, MD and Peter de Jonge, PhD

^_* Department of Cardiology, Thoraxcenter, University Medical Center Groningen, Groningen, the Netherlands
Department of Psychiatry, University Medical Center Groningen, Groningen, the Netherlands
Department of Cardiology, Nij Smellinghe Hospital, Drachten, the Netherlands.

Manuscript received February 21, 2006; revised manuscript received July 12, 2006, accepted July 24, 2006.

^_* Reprint requests and correspondence: Dr. Joost P. van Melle, Department of Cardiology, Thoraxcenter, University Medical Center Groningen, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands. (Email: j.p.van.melle{at}med.umcg.nl).

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.

Abbreviations and Acronyms   BDI = Beck Depression Inventory   CIDI = Composite International Diagnostic Interview   DepreMI = Depression and Myocardial Infarction Study   LVEF = left ventricular ejection fraction   MI = myocardial infarction   MIND-IT = Myocardial INfarction and Depression-Intervention Trial

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