“Repurposing their use to manage aggression and violence could improve patient outcomes,” according to the authors.
New research published today in the open-access journal PLOS Medicine found that those who use Beta adrenergic-blocking agents (β-blockers) had less violence than those who do not.
If more research supports the results, β-blockers could be used to treat aggressive and hostile behavior in people with psychiatric disorders.
Treatment with β-blockers includes the management of hypertension, angina, acute cardiovascular events, heart failure, arrhythmias, migraine, hyperthyroidism symptoms, and glaucoma. Despite contradictory data, they are often used for anxiety and have also been linked to severe depression and violence. Though inconclusive, they may raise suicide risk.
Seena Fazel of the University of Oxford in the UK and her colleagues at the Karolinska Institute in Sweden looked at hospitalizations for psychiatric disorders, suicidal behavior and suicide deaths, and charges of violent crime. Over an eight-year span from 2006 to 2013, they compared themselves to 1.4 million -blocker users in Sweden during their medicated and non-medicated years.
Periods of β-blocker therapy were associated with a 13% decreased likelihood of being charged with a violent offense by the police, a finding that held true across all studies. The chance of being hospitalized for a mental disease was also found to be 8% lower, and the likelihood of receiving treatment for suicidal behavior was 8% more likely. However, these relationships differed based on mental diagnosis, prior psychiatric disorders, and the severity and kind of cardiac illness being treated with β-blockers.
Previous research has found a link between serious heart problems and an increased risk of depression and suicide. These results may suggest that the psychological distress and other disabilities caused by serious heart problems, rather than the β-blocker treatment, increase the risk of serious psychiatric events. In secondary analyses, the links between major depression and hospitalization were lower, but they were not lower for anxiety disorders.
More research, including randomized controlled trials, is needed to figure out what role β-blockers play in controlling aggression and violence. If future studies match these findings, β-blockers may be a viable option for the treatment of aggressive behavior.
“In a real-world study of 1.4 million persons,” Fazel adds, “β-blockers were associated with reduced violent criminal charges in individuals with psychiatric disorders. Repurposing their use to manage aggression and violence could improve patient outcomes.”
Source: 10.1371/journal.pmed.1004164
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