Which side effect is most often caused by atenolol
Pro Research Analysisby 
Searched over 200M research papers
Consensus Meter
Common Side Effects of Atenolol
Atenolol, a beta-blocker commonly prescribed for hypertension, has been associated with various side effects. This article synthesizes findings from multiple studies to identify the most frequently reported adverse effects of atenolol.
Central Nervous System (CNS) Side Effects
Sleep Disturbances and Dreams
Several studies have investigated the CNS-related side effects of atenolol, particularly focusing on sleep disturbances and vivid dreams. One study compared atenolol with metoprolol and found that while metoprolol significantly increased the incidence of sleep disturbances and restless nights, atenolol did not show a significant increase in these CNS side effects. Another study comparing atenolol with pindolol also reported a decrease in sleep disturbances under atenolol treatment, suggesting that atenolol is less likely to cause sleep-related issues compared to other beta-blockers.
Acute Psychotic Behavior
Although rare, there have been reports of acute psychotic behavior associated with atenolol. One case study described a patient who developed vivid dreams, nightmares, and short-term memory lapses shortly after starting atenolol. This escalated to a period of violent behavior and confusion, which subsided after discontinuation of the drug. Despite its hydrophilic nature, which generally results in fewer CNS side effects, atenolol can still cause severe CNS disturbances in some individuals.
Dermatological Reactions
Drug-Induced Lupus Erythematosus
Atenolol has also been linked to dermatological side effects, including drug-induced lupus erythematosus. One case study reported a patient who developed connective tissue disease and antihistone antibodies after three years of atenolol treatment. The symptoms resolved after discontinuation of the drug, and reappeared upon rechallenge, confirming atenolol as the cause. This indicates that while rare, atenolol can induce significant dermatological reactions.
Lack of Sedation and Drowsiness
Comparative Studies with Methyldopa
In studies comparing atenolol with other antihypertensive agents like methyldopa, atenolol did not produce significant sedation or drowsiness. Methyldopa, on the other hand, was associated with prolonged reaction times and increased subjective drowsiness. This suggests that atenolol is less likely to impair cognitive function or cause drowsiness compared to some other antihypertensive medications.
Conclusion
In summary, while atenolol is generally associated with fewer CNS side effects compared to more lipophilic beta-blockers, it can still cause significant adverse effects such as vivid dreams, sleep disturbances, and in rare cases, acute psychotic behavior and drug-induced lupus erythematosus. However, it is less likely to cause sedation or drowsiness, making it a preferable option for patients concerned about these particular side effects.
Sources and full results
Most relevant research papers on this topic