To Take Beta Blockers Or Not To Take

[TheLivingDead]

ok i have a new(my first since pots)pcp and she is not that familiar with pots but she is willing to try and help. i got refered to a cardiologist and neurologist. the doc prescribed beta blockers because it "helps" pots. but the tachy and light headedness is one of my minor symptoms and is not there that often. i also have read that people that have been on them have go through **** after they stop taking them or miss taking them. ive had pots for a year and a half. my question is should i not take them because i can handle these issues or should take them if they help other issues with pots?

[emadden514]

I can't really say whether or not you should take them. I personally take Atenolol 25 mg once a day. I have problems with dizziness, tachycardia, and pre-syncope/syncope. It was a huge relief when I started taking them. They allowed me to be upright for more than a few minutes. After about 2 weeks, I needed another med adjustment though and I'm now taking Midodrine 3X a day as well. The Midodrine helped tremendously as well. Did you discuss your concerns with the doctor about taking them? It doesn't help all POTS people, but I'm wondering why the dr is prescribing based on your symptoms/concerns. Best of luck. Take care.

Elizabeth

[Sarah4444]

I am facing the same dilemma and don't have an answer. I had a terrible time in June and July with tachycardia and if I had been able to see the cardiologist promptly I'd probably be taking beta-blockers right now. However, but the time I saw him my heart had calmed down a bit and I was having the most problems with OI and some other strange things like muscle weakness/tingling, air hunger... I started with Florinef and can only manage a tiny bit and now take midodrine as well. This seems to be helping, and I am not clear whether to add the beta-blockers or not. I have also read that people have a hard time stopping them, and as my cardiologist seemed to know little or nothing about POTS, I don't know how to evaluate whether this is an appropriate medication for me or not. Apparently the loop monitor showed I had episodes of heart block?/sick sinus symdrome? but I haven't felt these very much since starting the other meds. Good luck, and I'll follow this thread with interest.

Sarah

[Noreen]

I was initially prescribed BB years ago. As a side benefit to helping manage syncope, they were to help with migraine. I could not tolerate them due to ungodly fatigue.

Check out this site Family Practice Notebook that Erik provided last week. It might help you understand your doc's thinking.

You won't know whether you might benefit unless you try it.

[TheLivingDead]

im not sure why my pcp prescribed them im sure because she didnt know much about pots and the "main" clinical issue with pots is the tachy and heart rate issues and that sort of thing. and bbs's are know to help these issues.

my symptoms in general are very minor with highlighted areas of really bad times. i.e. tachy, palps, naseau, tremors, light headness, fog, gi issues, fatigue, weakness, muscle pains, heat intollerance. the typical pots things. these times last for a few weeks at a time then gone for a month or two.

i can be on my feet for along time moving and working and doing things unlike most of the pots people so im not sure what is really going on. thats why im questioning the bb's.

i was once prescribed florinef in the begining of my pots diagnosis but it made my throat close up so ive been dealing with this cold turkey.

i have a cardio appt tomarrow so im going to run this same question by them and see what they think. hopefully they are somewhat familiar with pots.

[dianne.fraser]

I tried a couple of different beta blockers - I did well on them only for a few weeks, then they seemed to amplify the effects of my illness. If I was on my feet for too long, my fatigue would be unmanagable; if I flew inter-state, there was no guarantee I'd be able to get out of bed the next day. I'm one of those people who doesn't tolerate medications well in general - a cross-section of people with dysautonomia probably do well on them.

Dianne

[TheLivingDead]

came back from the cardio. today. he was alittle familiar with pots but not that it causes so many diff. issues.

the first question he asked was if i had anxiety. what a load of crap.

he said to not take the bb's but to take proamatine 5mg 2x a day. for six weeks to see if it helps my "episodes" from returning.

has anyone taken this, proamatine?

[dakota]

Proamatine is midodrine, and a lot of people take that. Unfortunately, it is not going to be on the market much longer unless something changes -- only until September 30. It would be a shame to find out that it worked for you, only to then not be able to get it any more. My daughter took midodrine for about 9 months, but it eventually stopped doing anything for her and she stopped taking it.

My daughter is on a beta blocker and it is the one med that has consistently helped her throughout her time with POTS. Unlike you, though, she does have quite a bit of tachycardia -- it's a lot less on the beta blocker but it still occurs.

I wish you luck in finding something that works for you!

[comfortzone]

While I do not officially have POTS - I do have much of the symptomatology and have been prescribed some of the same things - such as compression stockings, major hydration, and for my hypertension - I'm on Diovan, Dyazide and most recently a beta blocker.

My history with beta blockers (for a baseline heart rate of 100 a month or so ago & frequent palpitations & high b/p)was to be started on 25mg of metoprolol and then as it did nothing for my blood pressure which was sky high - it was upped to 50mg. This again did nothing for anything and had me feel mildly tired all the time. In my frustration I went to the doctor who ordered it and said - it's not helping - I need more or different medication so I won't stroke! He said no as I do get lows with my blood pressure & he didn't want me fainting. He also ordered a stress echo - and you have to be off the beta blocker for three days prior to the test so I stoped the metoprolol. That stopping it gave me the worst headache of my life and sent me to the ER with a b/p of 177/122! No one could understand why that would happen as I was only on a low dose for a very short amount of time - I think even so it was rebound hypertension from the med. I then went to my PCP who ordered Bystolic 5mg. <-- a newer beta blocker.

Bystolic at 5mg --- well one pill....just one single dose knocked my b/p low for an entire week! I went from 140's to 150's over 100 to 110 down to 80's over high 40's! Okay so I took NO Beta Blocker for that whole week. By weeks end I was back up to my high normal. So I then cut the Bystolic in half to 2.5 mg....and by one weeks time I was again in the 80/50's so I quit it a second time. Meanwhile I go to the Mayo Clinic and they in the end want me back on it (or just try anyway) - with the dyazide and 1/2 the Diovan I usually take.

So we'll see how I do - I do know that ever since that one pill of Bystolic 5mg my heart rate has been in the 80's not the hundreds - it's like it reset my clock so to speak. I have not had tachycardia since! Sounds weird but even with all the med changes - it has never returned to tachycardia since that initial 5 mg dose. It's all so mysterious.

I may not last long on it - my symptom set is a bit different so I'll be messing around with meds for awhile I guess till I get to a proper weight...

That's all - just my experience.... My best guess is that the tiredness I feel with them will dissipate or I'll get used to it -- and I never got a headache or anything at all adverse from stopping the Bystolic - just the metoprolol....

Good luck to you!

[Troy]

i also have read that people that have been on them have go through **** after they stop taking them or miss taking them.

I don't think the problem occurs because people become dependant on it and experience symptoms when they miss a dose, the problem occurs because in the absence of betablockers you get to really see how bad your POTS is. For me betablockers is absoloute magic, without it I cant stand up, walk, excercise, move or do anything for that matter, once I take my betablocker I feel slightly normal and I can do some physical activities without my heart and blood presure flipping out and without feeling flushed. If your POTS however isnt as bad that you cant function at all without betablockers then I think its better you dont start on it.