Beta Blockers: How did they make you feel?

[LindaJoy]

Hi, everyone. Here I am with more questions. When I first began having tach episodes ten years ago, I was put on a beta blocker--tenormin. I would have terrible, heart attack like symptoms for an hour after taking the medication. I thought I was gonna die each time I took the stuff. I was later switched to a calcium channel blocker (cardizem) and I do much better on it. Did anyone else ever have heart attack symptoms with beta blockers? Why are they so bad for people with POTS?

Sorry if this issue has already been addressed.

Linda

[Ernie]

I took Metoprolol for 2 months and it increased my syncopes threefold. I stopped cold turkey because my specialist wanted me to continue taking it.

Then Dr Goldstein put me on Propranolol. I have no side effect on it.

Ernie

[Davidh53]

I have been taking atenolol for about ten months. It has changed my life ten times to the better. It cost about forty thousand dollars to find my problem and a sixteen dollar per hundred pill to help control it.

[geneva]

I was put on lopressor -- a tiny dose -- in the hospital 4 years ago and my bp bottomed out and the dr. was shocked. He switched me to Atenolol. It worked great for the tachycardia but even at a tiny dose, I had a terrible time with my bp dropping. I stuck with it for over 2 years and then stopped and manage without a bb now. I think my variety is hyperadrenergic, although I have not had tests specifically for that, and I have read beta blockers are not good in that case. So, I guess given the nature of one's dysautonomia, bb can be good or not. Also, there are so many different ones and it takes a lot of trial and error to find what works individually.

[calypso]

The beta blocker I take (Toprol XL, 50 mg) made me very, very tired at first. I also have a bit more shortness of breath for some reason. My cardiologist says if you have any underlying lung problems, which I don't know yet if I do, that a BB may worsen them because it raises pulmonary artery pressure a bit.

I have heart attack-like symptoms all the time due to sympathetic overactivity, but I don't know what role the BB has in these. I would think it should lessen them, but you always here of a few people who have the opposite effects ...

Amy

[Merrill]

Amy, it just hit me in a way this morning that it hadn't before ... have you and your doctor talked about the possibility of the 50 mg of Toprol XL causing your shortness of breath (or making what you've got from pots a bit worse)? We emailed about this one time ... 50 mg of Toprol gave me that symptom too, remember? I dropped down to 25 and am doing just fine on it (that is, many fewer episodes of shortness of breath and my tachycardia is under better control). Now my heartrate is definitely a little higher on 25 than it was on 50 (I only stayed on 50 for a week), but since I'm so used to extreme tach, being in the 90-120 range doesn't bother me a bit.

All this is to say ... I wonder if you'd feel any better on a slightly lower dose? (to help with the shortness of breath you've reported in the past and mentioned below).

Also--everyone--I'm concerned when people start talking about having "heart attack symptoms." Heart attacks manifest very differently in women than in men ... and I'm not sure exactly what people are saying. I've never had a heart attack, so I couldn't say that I ever have symptoms that feel like one! I have had sharp pains in my chest that have turned out to be gas, fatigue that's turned out to be pots & low blood pressure, numbness and pain radiating down my arm that's turned out to be bulging cervical spine disks... Know what I mean?

Take care all,

m

[MomtoGiuliana]

beta-blockers are actually very safe medications, and many POTS patients use them. They are actually prescribed for a variety of ailments, including reducing heart attack risk in patients who have had a heart attack. The problem they can cause for POTS patients is a drop in blood pressure that can cause fainting, fatigue, etc. That is why many can't tolerate them except in very low doses.

Merrill makes a good point and many POTS patients experience such a wide variety of symptoms--including chest pains and other sensations that feel like the heart is severely malfunctioning, when it is actually responding normally. I think I have seen on this board in the past, that some people experienced more intense POTS symptoms on a bb than off of one.

When I first started on a beta blocker my bp was all over the place--usually higher than normal, but I also had dips. I had episodes in the first weeks of being on the beta blocker where I nearly fainted, or had prolonged episodes of feeling slightly light-headed. Eventually, my bp evened out as I started to improve, and I tolerated the bb much better, and found it helpful for managing otherwise uncomfortable tachycardia.

There was a study recently that found that POTS patients with mast cell involvement tend to have trouble tolerating beta blockers. But, even POTS patients without this involvement can also have trouble tolerating them, according to the research.

Katherine

[calypso]

Merrill,

I wish it were as simple as the BB causing my shortness of breath, but it actually started before I started the beta blocker. I have played with the dosage and find it does get a little worse when I go from 25 mg to 50 mg, but my heart rate is much better controlled, so I deal with it.

As for the heart attack-like symptoms, I have strange referred pains in my left shoulder/arm, sharp chest pains, pressure in the chest, feelings of choking/breathlessness w/ runs of irregular beats, etc. These happen every now and then. These are similar to what people who have heart attacks report. I've also had waves of fatigue that coincide w/ these symptoms. But I know from testing that I have never had a heart attack.

Amy

[morgan617]

They give me such severe fatigue, a cough and some breathing problems I mentioned on a different thread. But I do know they help a lot of people, so I don't think of them as bad, just not for everyone. morgan