Barbara Geller, MD reviewing Butt JH et al. J Child Adolesc Psychopharmacol 2016 Oct 26

Students who received prescriptions for beta-blockers during examination times had significantly increased risks for future suicidal attempts and other psychotropic prescriptions.

People often take beta-blockers to decrease autonomic symptoms during performances and academic exams. Whether young people who request beta-blockers for these situations are at higher risk for later psychopathology has not been previously examined. Because all prescriptions in Denmark are registered and almost all academic exams are scheduled from May to June, researchers were able to examine beta-blocker prescriptions during examination times.

The investigators used Danish registries of demographics, school enrollment, prescriptions, and medical conditions. The 12,147 healthy students identified with a beta-blocker prescription in May or June (median age, 19; range, 14–30; 80% female) were matched to nonuser controls. Fifty-nine percent of students received prescriptions of 100-pill packs.

During 16-year follow-up, beta-blockers were associated with significantly increased risks for antidepressant use (adjusted hazard ratio, 1.68), other psychotropic medication use (HR, 1.93), and suicide attempts (HR, 2.67). Antidepressant prescriptions were significantly higher in males than females (HRs, 2.14 vs. 1.62). After a beta-blocker prescription, the mean time to a first prescription for antidepressants or other psychotropic was about 5 years; it was about 3 years to a suicide attempt.

CITATION(S):

Butt JH et al. Beta-blockers for exams identify students at high risk of psychiatric morbidity. J Child Adolesc Psychopharmacol 2016 Oct 26; [e-pub]. 

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