β-blockers and risk of neuropsychiatric adverse events: An active-comparator restricted disproportionality on the FAERS.

IF 5.5 3区 医学 Q1 CLINICAL NEUROLOGY
Lujain Ez Eddin, Mohammad Ali Omrani, Niaz Chalabianloo, Flory T Muanda
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引用次数: 0

Abstract

Background: β-blockers (β-adrenoceptor antagonists), commonly used for cardiovascular conditions, may be linked to neuropsychiatric adverse events (AEs). However, many prevalent ones, including delirium and hallucinations, remain insufficiently studied.

Aims: To compare the neuropsychiatric risks of β-blockers with other antihypertensive drugs using data from the FDA Adverse Event Reporting System (FAERS) and differences between lipophilic and hydrophilic β-blockers.

Method: An active-comparator restricted disproportionality analysis was conducted using data from the FAERS (2004Q1-2023Q4). Neuropsychiatric AEs were analyzed using Preferred Terms and the System Organ Classes from the Medical Dictionary for Regulatory Activities for β-blockers compared to lisinopril and losartan. Adjusted Reporting Odds Ratios (aRORs) were calculated using logistic regression to account for potential confounders.

Results: β-blockers were linked to a significantly higher risk of nervous and psychiatric disorders, compared to lisinopril and losartan. Among the nine types of neuropsychiatric events studied, six-dizziness, nightmares, insomnia, hallucinations, somnolence, and disorientation-showed higher aRORs with β-blockers. Propranolol, a lipophilic β-blocker, exhibited the highest aRORs for psychiatric disorders and six types of neuropsychiatric events, including nightmares, delirium, hallucinations, disorientation, altered mental status, and somnolence, compared to lisinopril and losartan. Compared to atenolol, propranolol remained significantly associated with delirium, hallucinations, and disorientation.

Conclusion: β-blockers, especially propranolol, may be associated with a higher risk of neuropsychiatric AEs compared to lisinopril and losartan. These findings highlight the importance of considering the specific β-blocker prescribed, particularly in patients at risk for central nervous system side effects. Further population-based studies are warranted to confirm these results.

β受体阻滞剂和神经精神不良事件的风险:一个有效的比较限制了FAERS的歧化。
背景:通常用于心血管疾病的β-受体阻滞剂(β-肾上腺素能受体拮抗剂)可能与神经精神不良事件(ae)有关。然而,许多常见的疾病,包括谵妄和幻觉,仍然没有得到充分的研究。目的:利用FDA不良事件报告系统(FAERS)的数据,比较β受体阻滞剂与其他降压药的神经精神风险,以及亲脂性和亲水性β受体阻滞剂之间的差异。方法:使用FAERS (2004Q1-2023Q4)的数据进行主动比较器限制性歧化分析。使用优选术语和医学词典中的系统器官分类对β受体阻滞剂与赖诺普利和氯沙坦的调节活性进行分析。使用逻辑回归计算调整报告优势比(aRORs),以考虑潜在的混杂因素。结果:与赖诺普利和氯沙坦相比,β受体阻滞剂与神经和精神疾病的风险明显更高。在研究的九种神经精神事件中,有六种——头晕、噩梦、失眠、幻觉、嗜睡和定向障碍——β受体阻滞剂的aror更高。与赖诺普利和氯沙坦相比,亲脂性β受体阻滞剂普萘洛尔对精神疾病和六种神经精神事件的aror最高,包括噩梦、谵态、幻觉、定向障碍、精神状态改变和嗜睡。与阿替洛尔相比,心得安与谵妄、幻觉和定向障碍有显著相关性。结论:β受体阻滞剂,尤其是心得安,与赖诺普利和氯沙坦相比,可能与更高的神经精神ae风险相关。这些发现强调了考虑特定β受体阻滞剂处方的重要性,特别是在有中枢神经系统副作用风险的患者中。有必要进一步开展以人群为基础的研究来证实这些结果。
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来源期刊
Journal of Psychopharmacology
Journal of Psychopharmacology 医学-精神病学
CiteScore
8.60
自引率
4.90%
发文量
126
审稿时长
3-8 weeks
期刊介绍: The Journal of Psychopharmacology is a fully peer-reviewed, international journal that publishes original research and review articles on preclinical and clinical aspects of psychopharmacology. The journal provides an essential forum for researchers and practicing clinicians on the effects of drugs on animal and human behavior, and the mechanisms underlying these effects. The Journal of Psychopharmacology is truly international in scope and readership.
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