June 20, 1986

Antidepressant Use in Patients Prescribed β-Blockers

Author Affiliations

New York Hospital—Cornell Medical College

JAMA. 1986;255(23):3248-3249. doi:10.1001/jama.1986.03370230054022

To the Editor.—  In the recent article, "Increased Antidepressant Use in Patients Prescribed β-blockers,"1 the authors point out an association between β-blockers use and the use of tricyclic antidepressants (TCAs). The authors based their study on numbers crunched out from computerized Medicaid prescription data. After reading this study, I wish to condemn its findings.The authors stated that 10% of study subjects were receiving TCAs at some point during the two-year period studied. Tricyclic antidepressants were taken by 11% of all hypertensive persons, by 10% of hypertensive persons taking methyldopa, by 10% of hypertensive persons taking reserpine, by 15% of patients taking hydralazine or hypoglycemic agents, and by 17% of patients taking hydrochlorothiazide. In contrast, tricyclic antidepressants were taken by 23% of patients taking β-blockers. The author suggests that this shows that β-blockers may frequently cause depression.I offer the following criticisms: (1) The temporal relationship between TCA use