Beta Blockers

Neuropsychiatric symptoms occur frequently during treatment with beta blockers. The pharmacology of CNS side effects is unclear, although presynaptic and postsynaptic adrenergic inhibition has been implicated, as has serotonergic antagonism. '1 Nonselective beta blockers seem to

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cause CNS-related side effects to a greater extent than beta! -selective blockers.y It is unclear to what degree lipophilicity is responsible for this kind of side effect. Lassitude or insomnia and depression are the most common reactions, although vivid dreams, nightmares, hypnagogic hallucinations, and psychotic behavior have been reported with high doses (more than 500 mg/day of propranonol). Pre-existing major psychiatric illness and hyperthyroidism may predispose to the above-mentioned symptoms.

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