Antidepressant Use in Patients Prescribed β-Blockers

Abstract

To the Editor.— The recent article by Avorn et al 1 on increased antidepressant use in patients taking β-blockers appears to be a chicken-and-egg problem when viewed from a perspective that is different from that of the authors. Their conclusion—we consistently found a higher frequency of antidepressant use among patients prescribed β-blockers—should be examined as to the validity of the reverse case: the frequency of β-blockers use among patients prescribed tricyclic antidepressants (TCAs). Since the overall frequency of use is greater for TCAs than for β-blockers in two age groups (20 to 44 and older than 65 years), can their use be attributed to β-blockers use? The finding that β-blocker use is greater than that of other antihypertensive drugs may simply confirm the results of the survey quoted by the authors, ie, that β-blockers are more frequently prescribed than other drugs. This may equally apply to hypertensives among a population