Topical β-Blockers Are Not Associated with an Increased Risk of Treatment for Depression

Purpose: To investigate the effect of topical β-blockers on the prevalence of depression among glaucoma patients. Design: Retrospective observational population-based cohort study. Participants: We reviewed the electronic medical records of all the members in a district of the largest health maintenance organization in Israel (Central District of Clalit Health Services) who were older than 20 years (317 469 members). Methods: We documented all antiglaucoma prescriptions (n = 274 023) and all antidepressant prescriptions (n = 16 948) filled by glaucoma patients in the district between January 1, 2001 and December 31, 2003. We included only those patients who filled at least 6 consecutive antiglaucoma prescriptions at least once every 2 months (n = 6597; 5846 [88.6%] were treated with topical β-blockers). Depressed patients were defined as patients that filled at least four prescriptions for antidepressants during the study period (n= 810, 12.3% of all glaucoma patients). Main Outcome Measure: Relationship of topical β-blocker use and prevalence of depression among glaucoma patients. Results: No significant demographic differences were noted between glaucoma patients treated and not treated with topical β-blockers. Of those treated and not treated with β-blockers, 12.2% (12.7% after age-adjustment) and 12.7%, respectively, were also receiving drug therapy for depression (P = 0.7, chi-square test). With stratification by age, treatment with topical β-blockers did not influence the prevalence of depression in any age group. Logistic regression analysis revealed a significant effect of age, place of birth, and gender on the prevalence of depression, but the prevalence of use of topical β-blockers had no significant effect. Conclusions: Use of topical β-blockers by glaucoma patients does not appear to increase the risk of depression in this population.