Sleep disorders, nightmares, depression and anxiety in an elderly patient treated with low-dose metoprolol.
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.
Department of Geriatric Medicine, Rijnstate Hospital, Arnhem, the Netherlands. amirahmed1@hotmail.com
Amir I A
AI
Ahmed
Patricia
P
van Mierlo
Paul
P
Jansen
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D000367:Age Factors; D000369:Aged, 80 and over; D017311:Amlodipine / Q000627:therapeutic use; D000787:Angina Pectoris / Q000188:drug therapy*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000139:chemically induced* / Q000175:diagnosis / Q000523:psychology; D003866:Depressive Disorder / Q000139:chemically induced* / Q000175:diagnosis / Q000523:psychology; D004305:Dose-Response Relationship, Drug; D004325:Dreams / Q000187:drug effects*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008790:Metoprolol / Q000008:administration & dosage / Q000009:adverse effects*; D012893:Sleep Wake Disorders / Q000139:chemically induced* / Q000175:diagnosis / Q000523:psychology
D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D017311:Amlodipine; D008790:Metoprolol