Sleep disorders, nightmares, depression and anxiety in an elderly patient treated with low-dose metoprolol

Gen Hosp Psychiatry. 2010 Nov-Dec;32(6):646.e5-7. doi: 10.1016/j.genhosppsych.2010.04.008. Epub 2010 Jun 3.

Abstract

In the Netherlands, the prescription of beta-blockers to patients older than 70 years has increased sharply in recent years. The neuropsychiatric adverse reactions associated with the use of beta-blockers are relatively uncommon and they are mostly seen with poisoning or overdose. We describe an 81-year-old man who developed sleep disorders, nightmares, depression and anxiety as probable adverse effect of low-dose metoprolol (25 mg/day). This case illustrates not only the neuropsychiatric adverse reactions of beta-blockers, but also that diagnosis of these reactions can be easily missed in elderly patients.

Publication types

  • Case Reports

MeSH terms

  • Adrenergic beta-Antagonists / administration & dosage
  • Adrenergic beta-Antagonists / adverse effects*
  • Age Factors
  • Aged, 80 and over
  • Amlodipine / therapeutic use
  • Angina Pectoris / drug therapy*
  • Antihypertensive Agents / therapeutic use
  • Anxiety Disorders / chemically induced*
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / psychology
  • Depressive Disorder / chemically induced*
  • Depressive Disorder / diagnosis
  • Depressive Disorder / psychology
  • Dose-Response Relationship, Drug
  • Dreams / drug effects*
  • Humans
  • Hypertension / drug therapy*
  • Male
  • Metoprolol / administration & dosage
  • Metoprolol / adverse effects*
  • Sleep Wake Disorders / chemically induced*
  • Sleep Wake Disorders / diagnosis
  • Sleep Wake Disorders / psychology

Substances

  • Adrenergic beta-Antagonists
  • Antihypertensive Agents
  • Amlodipine
  • Metoprolol