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W. C. Appel, PhD
Bureau of Human Prescription Drugs Health Protection Branch Health and Welfare Canada Vanier, Ontario

JAMA. 1986;255(23):3248.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

The recent article by Avorn et al¹ 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 . . . [Full Text PDF of this Article]

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