Which side effect is particularly associated with lipid-soluble beta-blockers?

Lipid-soluble beta-blockers are known to cross the blood-brain barrier more easily than their water-soluble counterparts. This property is significant because it enables lipid-soluble beta-blockers to exert effects on the central nervous system. One of the notable side effects attributed to this action is the occurrence of vivid dreams or nightmares.

This side effect arises from the modulation of neurotransmitter activity in the brain brought about by the blockade of beta-adrenergic receptors. Patients may experience disruptions in their sleep patterns or alterations in the quality of their dreams, contributing to nightmare experiences. The risk of such effects is particularly heightened with the use of certain beta-blockers that have higher lipid solubility.

Other potential side effects, like bronchoconstriction or hypotension, are more commonly associated with beta-blockers in general and do not specifically relate to their lipid solubility. Weight gain can be a subtle effect linked to beta-blocker therapy, but it typically develops over a longer duration and does not have the same immediate connection to lipid solubility. Thus, the association of vivid dreams or nightmares with lipid-soluble beta-blockers is the most accurate answer in this context.