The use of beta-blockers to relieve exam-related anxiety is associated with later use of antidepressants and other psychotropic medications, a new study has found.

Researchers in Denmark used nationwide administrative registries and identified healthy students aged 14 to 30 (1996–2012) with first-time claimed prescriptions for beta-blockers during the exam period of May to June.  

A total of 12,147 healthy, exam-related beta-blocker users were identified and these were matched to 12,147 healthy students with no current or prior history of beta-blocker use (median age 19 years; 80.3% women). 

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Overall, 0.14%  of healthy students had a first-time beta-blocker prescription, with the highest portion (0.39%) aged 19 years. A significantly greater percentage of beta-blocker users were prescribed an antidepressant in the follow-up period than the non-beta-blocker users, 18.3% compared to 10.1%, respectively (P<0.0001). The follow-up ratio was similar for those prescribed a psychotropic drug; with 10.1% of the beta-blocker users and 5.4% of the non-beta-blocker users filling prescriptions (P<0.0001).

Sixteen (0.13%) of the beta-blocker users and 6 (0.05%) of non-beta-blocker users attempted suicide (P=0.03). 

Beta-blocker use related to exams was associated with an increased risk of antidepressant use (adjusted HRs, 1.68 [95% confidence intervals (CIs), 1.57–1.79], P< 0.0001), other psychotropic medication use (HR, 1.93 [95% CI, 1.76–2.12] P<0.0001), and suicide attempts (HR, 2.67 [95% CI, 1.04–6.82] P=0.04).

The researchers concluded that such beta-blocker usage may aid in identifying those patients who are psychologically vulnerable and may need special attention.

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