Psychiatric-Mental Health Nurse Practitioner (PMHNP) Purple Book Practice Test

Nonselective beta-adrenergic blockers can contribute to depressive symptoms. Propranolol, a member of this class, crosses the blood-brain barrier and can cause fatigue, sleep disturbances, and mood changes in some patients. In someone with depression, these effects can worsen mood or mimic/augment depressive symptoms, so it’s important to review whether a beta-blocker might be contributing to the clinical picture and consider alternatives if needed. Other drugs listed are not classically linked to worsening depression in the same way: omeprazole, levothyroxine, and clarithromycin have different primary adverse effect profiles and mood effects, so they’re less likely to be the cause of mood deterioration.