Beta Blockers and Depression

Faughnan's Notes mentions an article in the economist on beta blockers and memory. 

The mood and memory effects of beta-blockers are subtle, and despite some reviews in the medical literature, I do believe that this is clinically significant.  INdeed, the fatigue associated with carvedilol seems to be greater than that associated with older agents. 

Today I saw a patient who has been on carvedilol for about 10 months – and her ejection fraction has improved from 30% to 55%.  But she's terribly depressed and feeld so fatigued that she can't do anything.   

The SSRI has done rather little  – and today I called her cardiologist and we agreed to stop the cavedilol for a month or so and wee what happens.  

A 45 year old with hypertension felt that the metoprolol was doing fine.  But after a bit of careful discussion and a zung scale – I learned that he had depression.  This is the trouble with much of behavioral medicine.  Since the medication isn't discontinued – the problems are very likely more common than the studies suggest.