Side Effects of Beta Blockers on the Elderly

Beta blockers treat migraines, anxiety, high blood pressure and glaucoma. These drugs work by blocking the effects of adrenalin on the heart. This reduces heart rate and allows the heart to relax. Because beta blockers affect the heart, they can cause side effects.

Elderly people experience these side effects differently than younger patients, making caution important when using beta blockers to treat elderly patients.

Cold Sensitivity

Beta blockers make elderly patients more likely to experience cold sensitivity, according to the Migraine Awareness Group. Cold intolerance develops as a response to the effects of the beta-blocker. Because beta blockers slow heart rate and reduce the workload of the heart, blood flow to the skin may decrease. This makes elderly patients more susceptible to Raynaud's phenomenon, which is when cold temperatures cause exposed skin to pale and blood vessels to stiffen.


Beta blockers reduce heart rate and blood pressure, which is important for people with hypertension and other cardiac conditions. It's possible for blood pressure to drop too much while taking a beta-blocker, resulting in dizziness and other hypotension (low blood pressure) symptoms. Dizziness caused by beta blockers also increases the risk of falls in the elderly, increasing the risk of sprains, broken bones and other injuries.

Respiratory Effects

Elderly patients are more susceptible to the respiratory side effects of beta blockers than people in other age groups. In a study published in the June 24, 1995 issue of "The Lancet" (volume 345), researchers revealed that some elderly patients receiving beta blockers for glaucoma treatment developed obstructive pulmonary conditions during the course of therapy. Once study investigators discontinued the beta-blocker and prescribed a different drug, these conditions improved. This study was cited in a 1995 article published in vol. 79 of the "British Journal of Opthalmology." Respiratory complications caused by beta blockers cause shortness of breath, wheezing and difficulty breathing.

Psychiatric Effects

Elderly patients are also more susceptible to the psychiatric effects of beta blockers than people in other age groups. When used for anxiety treatment, beta blockers can actually cause increased anxiety and agitation. Other psychiatric effects include hostility, mania, aggressiveness, impulsive behaviour, rage and hallucinations. These side effects are rare, according to the Texas Heart Institute.

Urge Incontinence

The American Society of Consultant Pharmacists reports that beta blockers have cholinergic effects on the body. This means that beta blockers enhance the effects of acetylcholine in the central or peripheral nervous systems. This effect is associated with urge incontinence caused by dysfunction of the detrusor muscle. This muscle contracts to squeeze out urine; hyperactivity of this muscle results in involuntary urine leakage at inappropriate times. The cholinergic effects of beta blockers are more prominent in elderly patients.