British journal of clinical pharmacology · 2024
β-Blockers and risk of neuropsychiatric disorders: A systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Eddin Lujain Ez, Preyra Rebecca, Ahmadi Fatemeh, Jafari Atefeh, Omrani Mohammad Ali, Muanda Flory T
Аннотация
AIMS: This systematic review and meta-analysis aimed to evaluate the association between β-blocker use and neuropsychiatric adverse events, specifically focusing on short-term outcomes.
METHODS: A comprehensive literature search identified studies reporting neuropsychiatric outcomes in patients using β-blockers, including randomized controlled trials and observational studies. Relative risks (RR) and 95% confidence intervals (CIs) were calculated for outcomes such as dizziness, insomnia, nightmares, drowsiness and delirium.
RESULTS: Our analysis revealed that β-blocker use was significantly associated with an increased risk of dizziness (RR 1.72, 95% CI [1.39-2.14]; I2 = 1%, 14 studies) compared to placebo. Lipophilic β-blockers, especially propranolol, showed an even greater risk of dizziness (RR 3.13, 95% CI [1.44-6.84]; I2 = 0%, three studies). Propranolol was also associated with increased insomnia risk compared to placebo (RR 1.13, 95% CI [1.00-1.28]; I2 = 0%, five studies). Our data did not show statistically significant increases in the reports of nightmares and somnolence. Other adverse effects, including drowsiness, sleep disturbances, hallucinations and delirium, were noted.
CONCLUSIONS: Our findings suggest a significant association between β-blocker use and an increased risk of neuropsychiatric adverse events, particularly insomnia and dizziness with higher risks associated with lipophilic β-blocker use. Given the ambiguity surrounding dizziness and its classification as a neuropsychiatric effect, our findings are exploratory, and we cannot exclude a potential cardiovascular origin for dizziness. Most studies (75%) were published before the CONSORT statement in 1996, indicating potential reporting limitations and a lack of recent research. Additionally, 60% of studies had a high risk of bias, underscoring the need for more rigorous and contemporary investigations into the neuropsychiatric implications of β-blocker use.
METHODS: A comprehensive literature search identified studies reporting neuropsychiatric outcomes in patients using β-blockers, including randomized controlled trials and observational studies. Relative risks (RR) and 95% confidence intervals (CIs) were calculated for outcomes such as dizziness, insomnia, nightmares, drowsiness and delirium.
RESULTS: Our analysis revealed that β-blocker use was significantly associated with an increased risk of dizziness (RR 1.72, 95% CI [1.39-2.14]; I2 = 1%, 14 studies) compared to placebo. Lipophilic β-blockers, especially propranolol, showed an even greater risk of dizziness (RR 3.13, 95% CI [1.44-6.84]; I2 = 0%, three studies). Propranolol was also associated with increased insomnia risk compared to placebo (RR 1.13, 95% CI [1.00-1.28]; I2 = 0%, five studies). Our data did not show statistically significant increases in the reports of nightmares and somnolence. Other adverse effects, including drowsiness, sleep disturbances, hallucinations and delirium, were noted.
CONCLUSIONS: Our findings suggest a significant association between β-blocker use and an increased risk of neuropsychiatric adverse events, particularly insomnia and dizziness with higher risks associated with lipophilic β-blocker use. Given the ambiguity surrounding dizziness and its classification as a neuropsychiatric effect, our findings are exploratory, and we cannot exclude a potential cardiovascular origin for dizziness. Most studies (75%) were published before the CONSORT statement in 1996, indicating potential reporting limitations and a lack of recent research. Additionally, 60% of studies had a high risk of bias, underscoring the need for more rigorous and contemporary investigations into the neuropsychiatric implications of β-blocker use.