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March 1992

ß-Blocker Treatment and Depression

Author Affiliations

Melbourne, Australia

Arch Intern Med. 1992;152(3):649. doi:10.1001/archinte.1992.00400150147031

To the Editor. —  Psychologic depression is considered by many to be an occasional adverse effect of treatment with propranolol and other β-blocking drugs. This suspicion is apparently confirmed by Thiessen et al1 in their article concerning the increased prescription of antidepressant drugs to patients who recently started treatment with a β blocker, particularly propranolol.Were those patients actually suffering from depression or from something else? Patients treated with a β blocker rarely suffer from a depressive illness, as described in the manual of mental disorders.2 The major features of the syndrome include loss of energy, alertness, drive, and interest, together with fatigue, inertia, or ennui. There is no sense of sadness, guilt, or self-accusation. Pleasure is reduced in working, loving, and living because of inadequate stimulation. There is no single word to describe the syndrome. Patients claim that they need a "charge" or stimulus. They seem to