Lujain Ez Eddin, Mohammad Ali Omrani, Niaz Chalabianloo, Flory T Muanda
{"title":"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。","authors":"Lujain Ez Eddin, Mohammad Ali Omrani, Niaz Chalabianloo, Flory T Muanda","doi":"10.1177/02698811251349190","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Aims: </strong>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.</p><p><strong>Method: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"2698811251349190"},"PeriodicalIF":5.5000,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"β-blockers and risk of neuropsychiatric adverse events: An active-comparator restricted disproportionality on the FAERS.\",\"authors\":\"Lujain Ez Eddin, Mohammad Ali Omrani, Niaz Chalabianloo, Flory T Muanda\",\"doi\":\"10.1177/02698811251349190\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Aims: </strong>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.</p><p><strong>Method: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":16892,\"journal\":{\"name\":\"Journal of Psychopharmacology\",\"volume\":\" \",\"pages\":\"2698811251349190\"},\"PeriodicalIF\":5.5000,\"publicationDate\":\"2025-07-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Psychopharmacology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/02698811251349190\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Psychopharmacology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/02698811251349190","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
β-blockers and risk of neuropsychiatric adverse events: An active-comparator restricted disproportionality on the FAERS.
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.
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.