Confused About Beta Blockers, Can They Do More Harm Then Good ?

[DadJake]

In my last post, someone replied the following "As my electrophysiologist told me yesterday, in POTS if you block the hearts ability to compensate for whatever it's compensating for (ie low blood volume, loose blood vessels) then some will have problems like I did. "

So initially, I was place on Acebutolol 200mg 2 x day. This is a centrally acting Beta Blocker. It did good in controlling my Heart Rate and I guess Blood Pressure, but Blood Pressure was never an issue with me since I have Hyperadrenergic Pots. It would go up from time to time, but never past 140 off the beta blocker. So on the Beta blocker, I'm like low 100's with my top BP number and my resting HR is 70's to 80's with about 105 or so on standing. This was way better then the 160 or so I would have on standing.

I was switched to an equivalent dose of Coreg on the advice of the ANSAR Dr. who says Coreg targets Alpha 1, Beta 1 and Beta 2 receptors which you don't get all of this with the Acebutolol. Well, I don't feel any difference or better at all on this drug.

I've been reading how Beta Blockers can cause depression in people and I've been having big time depression that doesn't seem to have a source that I can identify with. I cry like a 2 year old very often several times per day. Some of it is dealing with a chronic illness, but it's too extreme, which tells me it has a physiological component perhaps.

The other thing is that I feel like I'm not getting proper blood flow to my brain. When I wake up, I'm shaking all over the place. Today, I noticed my vision was blury after I got up and then came back to normal about an hour after awakening. I feel tender spots all over my scalp and part of this feels like brain damage in the head with the weird sensations I'm getting. It's like electrical, but constant in different areas.

So 2 questions: If the Beta Blocker is causing problems, I want off of it. I took half my dose last night and nothing has changed. Today, I took half the dose and then added another 1/4 as the anxiety is getting bad and hard to tell, but I think I'm already getting rebound headaches.

2nd. Is it possible this is infection in the brain causing all of this. I was posting some of this in an anxiety forum and I got a private message that I should be tested for Lyme disease as many of my symptoms are found in the this disease. Sure enough, I'm looking around online and finding this to be true.

Justin

[Guest tearose]

It is not all cut and dry and an easy formula to figure out...or we would be all better by now!

I to have hyperadrenergic POTS and a few other body funkynesses which make it not possible to treat with a BB...

I cannot tolerate BB because:

It gave me chest pain and it moved a borderline bundle branch block into a more serious type of heart block.

As soon as the BB was discontinued I improved.

The "gold standard" question you raise is valid and will help you find a treatment plan that will work with your body challenges and funkynesses...

Here is what Mayo Clinic told me, They help figure out if our body is having

A"normal" response to an abnormal condition.

OR

An "abnormal" response to a normal condition.

[juliegee]

In my last post, someone replied the following "As my electrophysiologist told me yesterday, in POTS if you block the hearts ability to compensate for whatever it's compensating for (ie low blood volume, loose blood vessels) then some will have problems like I did. "

So initially, I was place on Acebutolol 200mg 2 x day. This is a centrally acting Beta Blocker. It did good in controlling my Heart Rate and I guess Blood Pressure, but Blood Pressure was never an issue with me since I have Hyperadrenergic Pots. It would go up from time to time, but never past 140 off the beta blocker. So on the Beta blocker, I'm like low 100's with my top BP number and my resting HR is 70's to 80's with about 105 or so on standing. This was way better then the 160 or so I would have on standing.

I was switched to an equivalent dose of Coreg on the advice of the ANSAR Dr. who says Coreg targets Alpha 1, Beta 1 and Beta 2 receptors which you don't get all of this with the Acebutolol. Well, I don't feel any difference or better at all on this drug.

I've been reading how Beta Blockers can cause depression in people and I've been having big time depression that doesn't seem to have a source that I can identify with. I cry like a 2 year old very often several times per day. Some of it is dealing with a chronic illness, but it's too extreme, which tells me it has a physiological component perhaps.

The other thing is that I feel like I'm not getting proper blood flow to my brain. When I wake up, I'm shaking all over the place. Today, I noticed my vision was blury after I got up and then came back to normal about an hour after awakening. I feel tender spots all over my scalp and part of this feels like brain damage in the head with the weird sensations I'm getting. It's like electrical, but constant in different areas.

So 2 questions: If the Beta Blocker is causing problems, I want off of it. I took half my dose last night and nothing has changed. Today, I took half the dose and then added another 1/4 as the anxiety is getting bad and hard to tell, but I think I'm already getting rebound headaches.

2nd. Is it possible this is infection in the brain causing all of this. I was posting some of this in an anxiety forum and I got a private message that I should be tested for Lyme disease as many of my symptoms are found in the this disease. Sure enough, I'm looking around online and finding this to be true.

Justin

Justin-

Beta blockers made me a lot worse too. They were among the first meds I was prescribed. I later learned that I had MCAD- which explained a lot. Beta blockers can exacerbate any allergy or asthma-type symptoms you may be having, such as trouble breathing, etc. If you are prescribed an epi-pen (like I am), they can also interfere with the effectiveness of that- should you need to use it.

You are in crisis mode now and searching for a med regimen to calm things down. It is a trial and error process. Always add ONE new thing at a time in the lowest possible dose and slowly titrate up until you find a therapeutic dose. Hang in there & stay strong. I suspect you will find a blend of meds to help. As far as a chronic Lyme infection- yes that is a possible cause of dysautonomia, as is a connective tissue disorder, post-viral onset, post-trauma onset, MCAD.....OR any combination of these and more. I would recommend getting through the crisis & then searching for the underling cause. I know your car accident began the symptoms, BUT what pre-disposed you in the first place?

I went back & read your 1st post. I strongly suspect that you are dealing with a mast cell disorder. The fact that benadryl is the only thing that calms you down (and NOT ant-anxiety meds) is VERY telling. It's very hard to find a doctor knowledgeable about MCAD. The World health Organization just met in Vienna to standardize diagnostic criteria, etc. I am hopeful that as a result of that meeting more doctors will become aware of mast cell disorders. Many dysautonomia docs recommend that patients try a combo of daily H-1's (like zyrtec or claritin), H-2's (like ranitidine or zantac), and an anti-leuketreine (like singulair) daily to keep mast cells calm. I also take nightly atarax. Doxepin was very helpful to me for really rough times. Maybe consider speaking to the doc who DXed you about trying this regimen. Many of the meds are very benign and OTC.

For a description of MCAD & symptoms, check out this link from The Mastocytosis Society: http://www.tmsforacure.org/mastocytosis.shtml

Better Times Ahead-

Julie

[Tachy Phlegming]

This does not appear to me to be one of those "take it, it's good for you" diseases.

Unless you have one or more physicians insisting that it's all in your mind (that happened to me), I think you'll find yourself needing to continue to seek treatment until you find one or more medications which make you feel significantly better. While most people on here seem to either feel significantly better or worse on beta blockers, having nothing happen is just that -- nothing.

Look through the medications listed as treatments on this site and read through a ton of posts until you get some idea of how each med treats symptoms. The reason to do this is that a lot of these meds are prescribed off-label for us and not every doctor is familiar with what a particular med can do for this disease. Then find the associated research and see if you can get someone to trial you on what you think will make you feel better.

Don't neglect trying to figure out if standing (probably not), walking, sitting or lying down for more than you would do normally -- makes you feel better. Given that you also said you have difficulty with heat, keep very cool. Make these experiments a little extreme (days at a stretch if it's lying down, a lot of walking if that helps) -- if whatever you're trying doesn't seem too unpleasant at first.

If they really had to do tests to figure out what you actually need before giving you anything which works, it would be a lifetime of tests and your suffering so do what you can to try to feel better in as short a time as possible.

[TXPOTS]

Justin,

If you are not feeling better and want to stop the beta blocker, please make sure to discuss a taper protocol with your physician. I know you are cutting them in halves and fourths, but you really need guidance on how much to taper and how soon. Beta blockers can cause rebound high blood pressure and other nasty symptoms, such as tremors, from stopping suddenly or tapering too quickly.

Yes, beta blockers can cause depression. Chronic illness can as well, so if possible, try to pinpoint when the depression started.

How high was your blood pressure when upright before the beta blockers? There is no point continuing a drug that is making you feel bad, but perhaps your physician was concerned about your blood pressure prior to starting the beta blockers. I would have an honest conversation with your physician about your concerns.

I'm sorry. I know POTS is rough, and it is tricky finding the right combination of non-pharmacological treatment and/ or medications. I'm supposed to be a drug expert and even I have had a rough go finding a suitable regimen. Hang in there. Statistically POTS patients become more functional over time with healing or various treatments. It takes persistence and trying different things. I agree with the poster that said you have to "experiment".

[MomtoGiuliana]

First I wouldn't worry too much about beta blocker being dangerous--however if you have concerns about any dangers, you should bring this up with your doctor (which can be difficult b/c drs often do not like to be questioned). In general, beta blockers are quite safe drugs. But there are exceptions--from what I have read they are not to be used by patients with MCAD or asthma, for example.

Yes, beta blocker side effect can be depression. This could improve over time, or not.

Beta blockers do not work for all POTS patients. As others have said, treatment of POTS can be a hit or miss process before you find the best treatment for you.

Good luck--as others have said the statistics are on your side for improving over time--either with time or with the right treatments.

[janiedelite]

I'm on coreg but only 6.25mg twice a day. I tried more than that and was terribly fatigued and had a bit more chest pain even. Perhaps your dose is too high?

[sj75]

Just to add that the side effects can decrease over time with continued use. I take bisoprolol but was on Atenalol before that, i had no side effects with Atenalol, but my cardiologist wanted me to move across to Bisoprolol which in the early days i got a lot of problems with but none (fingers crossed)now.

I was wrongly advised to stop the atenalol without tapering the dose- i would NEVER recommend it, i ended up in the back of an ambulance 4 days later as a result of rebound, very unpleasant!!