Afraid To Take Beta Blocker-Input?

[HopeSprings]

I saw a new Cardiologist (electrophysiologist) and he recommended Inderal. A beta blocker is the one medication I haven't tried. He said it's the one least likely to cause side effects and has a short half life so would be out my system quickly. He prescribed 10mg 3 times a day. He said if I do have a problem with it, we can try Propanolol. When I went to pick it up, the pharmacy person handed me a bottle of Propanolol. I was confused. The pharmacist said Propanolol is Inderal. ?? Does this Doctor know what he's talking about? Anyway, I have the medication, but I'm afraid to take it! I react badly to everything - that's my first fear. Secondly, I've read that people have trouble getting off them if need be and there can be rebound tachycardia and other problems. Why do people get off if it helps them? Does it stop working? Bottom line - Beta blockers... good or bad?

[southbel]

I tried Propanolol first and did not do well at all on it. Seemed to increase my adrenaline surges. My cardio put me on Metoprolol and that has worked pretty well with decreasing my tachycardia from standing, etc. Now, just to get something to decrease my nighttime adrenaline surges. I am also a person that reacts to just about every medicine. I get the same fear. Just make sure you have Benadryl on hand would be my only suggestion.

[roxie]

Inderal and propranolol ARE the same thing. It's like the medical & lay person name or something. For example, midodrine and proamtine are the same thing.

I've been on inderal/propranalol at night since this summer. I haven't had much problem with it once I adjusted to it. It's a short acting med.

I don't know why people go off of it but the rebound tachycardia may be from not tapering? Or like when we get side effects from starting you may have affects going off.

The hard/scary with new meds is you never know till you try. Sometimes it pays off sometimes it doesn't

[bizbiz]

The first medication that I was given after being diagnosed was Metoprolol. I don't think at the time that I would have been able to leave the hospital without it. It got me from bedridden to standing. My dose was 12.5mg twice a day. I didn't have any side effects from it at all.

After about 4 or 5 months I noticed that my symptoms were not as extreme as when I first got sick, so I stopped taking my afternoon dose and reduced my morning dose to 6mgs. Eventually, I cut out the morning dose too.

I went for almost 3 years without taking any meds at all. Unfortunantly, after a few years of good health I seem to have relapsed and have started taking Metoprolol again, 6mgs in the morning. My blood pressure is on the lower side and does drop when I flare, but I find that such a small dose does not make my BP go too low.

To answer your question of why people get off them if they help - I can only answer for myself, and I stopped taking the BB because I felt that the more time that passed the better I felt and the more my symptoms improved. I just felt that I didn't need it anymore. I really don't like taking meds, so if I don't need it, I wont take it.

I can totally understand your fear of meds though - even though I don't react badly to anything, I am always worried about side effects. I have unopened bottles of midodrine and a few others which I was always too scared to take!

[yogini]

Beta blokers may take a little while to adjust to, but are nothing like Florinef and SSRIs. Check with your dr, I am not sure about Inderal in particular, but many betas can be taken as needed. If you take them as needed there shouldn't be any withdrawal at all. If you take them every day, you would need to taper off. You could also try a fraction of a pill if your dr approves and then build up. I am not sure what other meds you have tried, but I'd say betas were a million times easier than something like florinef.

I know it is scary to try a new drug. If you ask about any drug on this forum, you will find that a lot of people have had a bad reaction. That makes it even scarier, but remember it is all so individual. betas are actually one of the more effective drugs for POTS. Remember that you will never know until you try. If it doesn't work for you, you will know pretty quickly and that is probably better than wondering.

[Guest Alex]

Inderal and propranolol are one and the same - strange that an electrophysiologist doesn't know that.

Regardless... I've tried 3 betablockers - metoprolol, bisoprolol and propranolol - in this particular order.

I couldn't tolerate the 1st two, even at very low doses - they made me very dizzy, lightheaded and lethargic. Propranolol ...is working somewhat I think, but I have to make sure I take florinef as well otherwise my BP tanks despite taking only 10 mg in the AM and 10 mg more at bedtime. .

Truth is - just like I hate bananas said - you won't know how you react until you try it...and it's the same with all the meds.

Best of luck, whatever you decide.

Alex

[Chaos]

I've been on propanalol for 5 years and feel like it's been a life saver. Definitely reduces my tachy as well as helping with hand tremors. Just last week my POTS neuro suggested trying to wean off it to see if it might help with my fatigue issues. Not crazy about the idea but am going to try it.

I'm guessing your cardiologist just misspoke. I can't imagine him not knowing that propanalol and inderol are the same thing. Probably meant to say a different BB.

You can always start with a smaller dose. Like others have said, it's short acting, so will be out of your system fairly quickly.

[HopeSprings]

Thanks for the responses. I think when I'm feeling brave I'll take a 1/4 of the dose and see if anything bad happens to me. If it doesn't, I'll up it and go from there.

[diamondcut]

I was going to say the same thing, i dont do well on new drugs, i take the smallest amount, and if you feel its too much in your system too soon, my Dr suggested to me to miss a day then continue. Sometimes you almost feel a sense of pressure that once you start a new drug you have to keep going. But just take it slow so that any reaction you could have will be minimal.

[Angelika_23]

Hi, I was in the same boat in the beginning... An ER doctor put me on Cardizem and it made me so much worse! When my doctor at Cleveland Clinic wanted to try me on Metoprolol I was very afraid to take it. I think I waited a few days before I got the courage to try it after the Cardizem fiasco. I'm glad I tried the Metoprolol, it is helpful to me. I am on a pediatric dose, but more is too much for me.

Southbel, I have nighttime adrenaline surges and Klonopin seems to help those. Maybe that's something to think about for you? I take a teeny dose, that's all I need.

[southbel]

Hi, I was in the same boat in the beginning... An ER doctor put me on Cardizem and it made me so much worse! When my doctor at Cleveland Clinic wanted to try me on Metoprolol I was very afraid to take it. I think I waited a few days before I got the courage to try it after the Cardizem fiasco. I'm glad I tried the Metoprolol, it is helpful to me. I am on a pediatric dose, but more is too much for me.

Southbel, I have nighttime adrenaline surges and Klonopin seems to help those. Maybe that's something to think about for you? I take a teeny dose, that's all I need.

Thanks - been suggested on my other thread about my lack of sleeping. Just need to convince my cardio is all. I'm also on a very, very small dose of Metoprolol. I wonder why POTS makes us all so sensitive to medication? I know, for a fact, that I wasn't this way before the onset of POTS.

[anna]

I wonder why POTS makes us all so sensitive to medication?

Do you think it might be more a question of the thing that makes us POTSie also makes us sensitive to loads of other things?! Oh it is all so confusing lol

[targs66]

I am in the "take a tiny bit and see what happens" camp - I hope that's not bad advice!! I have taken Propranolol and find it really useful in certain circumstances - when I am in that almost frantic, overstimulated, verge-of-tears mode. My BP runs too low to take it regularly - I just can't function at all when it's 85/55. However, if I've overdone it, and am exhausted and unable to turn off the racy, jittery feelings, I can take a tiny crumb - less than 1/4 of a pill - and it really feels very soothing. One problem, though, is that it can interfere with sleep (which seems counterintuitive because it seems to have a calming effect), so you might want to keep that in mind.

Good luck, and keep us posted.

[Guest wishing&hoping]

As a newcomer to this site, and also being extremely med sensitive after being diagnosed with CFIDS10 years ago, I"m wondering how important it is to get tested for NE, dopamine and other blood levels. My docs have been playing around with my meds; tried alpha blockers (yuk!) as well as 2 different beta blockers (Zybeta and Bystolic). Low dose of bystolic works well for me but is very expensive when my drug plan runs out (around May!) but calms down the adrenalin surges, although not the sweating interestingly. Tried Midodrine in the am's but my bp is too labile for it. However beta blockers do make me more dizzy, I think...I, too have been worse post hysterectomy for cancer. It's all very confusing!! A new cardiologist I saw thought I should be off beta blockers and consider an ablation, but she's in the minority. Help! Also wondering which facility is best: Mayo or Vanderbilt?

Diagnosed EDS, NMH 2011; also Hashimotos, COPD, fibro, GERD, migraines. Meds: Zofran, Zomig, Bystolic, Symbicort, Ativan, Klonopin; have midodrine but haven't taken it.

[peregrine]

I'm with Angelika - my doc prescribed diltiazem (calcium channel blocker) initially due to concerns about beta blockers and my mood. It was worse than being unmedicated for me - my tachycardia went away, but the POTS stuff got worse. I got switched to atenolol a few months later (triggered by edema from the diltiazem and supported by my desire to switch), and for me it's been very, very helpful - atenolol and clonidine are my two drugs of best effect. The ANS neurologist switched me to propranolol to see if it helped with the spaciness, and it didn't for me - I ended up switching back to atenolol six months later because the propranolol worsened my shortness of breath. If you have trouble with that, ask about trying a selective beta blocker (atenolol is one) instead, since they only block the beta receptors that deal with the heart instead of heart and lungs. The beta blocker didn't worsen my spaciness, if that's of help to you. And yes - taking a tiny dose should be fine. I started off with half of the smallest pill when I started the propranolol. The warnings about suddenly stopping are *mostly* there for folks taking much higher doses than most POTSies - most of us take doses that are tiny compared with those used for blood pressure or chest pain - but it's always a good idea to taper meds off if you can.

[HopeSprings]

Well, I took my quarter of a pill last night around 9pm, felt sleepy within 1/2 an hour and went up to bed. Was trying to figure out something with the remote control that I normally know how to do- was taking way too long for my brain to process and realized it might be the medication. Went to sleep, woke up wide awake at 4:30am and decided to take another 1/4 since I knew I'd be up again around 7am when my heartrate is the worst and wanted to test the medication out on this. Slept until almost 10am (this never happens), felt pretty loopy, lethargic etc. heart rate still went up into the 130's getting up. Felt weirder than normal in the head through the morning. Took another 1/4 in the afternoon, loopy head again, but not as bad as in the morning. I'd need a real dose to affect my heartrate, but I don't think my brain would tolerate it. I can't do this with kids. If I had several days to deal with side effects, time to adjust maybe, but not with people depending on me. I'll wait a few days and try again. If I get the same result, forget it. WHAT IS WRONG WITH ME?

[diamondcut]

I said in a post back a way dont feel pressured into getting the dose up high. It puts stress and strain on you mentally and physically if you do this. How about if you try taking a higher dose each time at night before bed, and not really taking in the day time for a while, could you do this just at night time regime until your body get adjust to the BB, then in maybe 2 weeks or so or however long it takes you as an individual, start to introduce in the day? My Dr suggested this to me with SSRI's.

[HopeSprings]

Diamond - that's good advice. Last night my husband was like oh come on, just take a whole pill and see what happens. I decided to try it since I'd be going to bed anyway - still had head weirdness, but it didn't put me to sleep this time. I was hoping there would be enough in my system to help the morning tachycardia, but nope - I was tachy as ever. Maybe I'll try your suggestion. Or I might wait until the fall when both kids will be in school all day and I can test things out without them being affected. I don't want to feel medicated - I want to feel better. There's also a lot of fear about addiction and withdrawal after past experiences with other medications. I'm not sure I can get past it. I'm a difficult patient, I guess.

[diamondcut]

I think you sound a very "normal" patient to me for on here

I dont know that much about BB's, but maybe some have more of a longer half life than others. So might be worth asking your Dr now you know your not allergic to them if you like, if there is one that stays in your system for longer, so it will see you through til the morning.

Anther drug that doesnt get mentioned much on here that my Dr asked if i wanted to try it as they tend to not cause so many bad reactions is this one i have put a link to. Just worth keeping on a list sometimes!!

http://en.wikipedia.org/wiki/Moxonidine

[imapumpkin]

10 mg of propranolol is a very low dosage to begin with. I was on it for 2 weeks and it really helped my energy level, but I had to go off it because it was giving me increased low blood sugar and parasthesias. I also could tell when I needed another dose because my hr would noticeably go up. My only advice would be not to mess around with the dosages and to take it as the dr suggests. If you are not comfortable taking it at all, then by all means you can refuse the medication, but beta blockers are serious business and you have to taper off them and the dosage should be consistent until you are ready to taper off. Why not discuss your concerns with your cardiologist? I'm sure he would be willing to discuss your concerns and poss side effects. Good luck!

[kalamazoo]

You sound just like me. I actually have medication phobia. I panic as soon as any medication hits my tongue. I think its because I've had so many bad reactions that I expect another. I did what tou suggested with taking tin amounts and then building up. But basically the tiny amount does nothing, i would take half the suggested dose at first. And wish this is what I did. I'm not a doctor but I know mediation are scary and sometimes its best to let our bodies just get used to it. I only took it a few times, mostly because it wasn't strong enough to help me. Now I'm seeing a different doctor and will be prescribed a new beta blocked on Monday. I'll probably take a nibble of the pill because I always do that, and then half and then full within a couple of days. Also, you could ask your doctor to take your first dose at the office just in case. That's what I do

[bellgirl]

Medication can be a good thing. I had to try several Beta Blockers before we found the right one for me; I went through the sluggishness, breathing problems etc., but I needed one with a longer half life, because my tachy was yo yoing. Bystolic has a 12 hour half life, so taking half in the morning and half at bedtime worked for me, but everyone is different. I only wanted to take it at bedtime, too, but then realized I was too tachy during the day, and had to take 1/2 two times a day, and now I'm rarely tachycardic anymore. Sometimes my heart rate goes a little crazy when I exercise, but I have dysautonomia after all. I can live with that... I thought it was pretty funny that all the generic names for BB end in lol...God does have a sense of humor. "Be strong and courageous. Do not be afraid or dismayed."

[Canadiangirl73]

I agree that slow and low is the way to go. Can be one of two things: this BB doesn't agree with you or the dose is too high. I had to try 1 CCB and 3 different BBs before I found one medication that worked for me. I tried diltiazem at first and wasn't able to build tolerance above 7.5 mg. Docs didn't believe me, but I felt drugged on that minute dosage. Then I tried bisoprolol, 1.25 mg, which dropped my BP dangerously low, and Atenolol, 6.25 mg. Again, it dropped my BP too low. I finally started Metoprolol, 6.25 mg, once a day. I stayed on that dosage for 10 days. I felt stoned for the first few days. Bottom line, I increased it slowly over the course of 8 months to my current dose of 12.5 mg tid. Don't rush and don't feel pressured by doctors to keep on taking a medication that doesn't suit you. I'd give it a chance on a small dose for a few days. If you still feel horrible after that time has lapsed, maybe you should get back in touch with your doctor.

[Altruism]

Offtopic: Do beta blockers work for all of you? They seem to do nothing for my HR... I still get 140+ upon standing. I've tried metoprolol 50 mg daily, 25 mg daily and 12.5 mg daily. No response whatsoever. Every single doctor keeps telling me that BB should be able to lower (if not control) my HR, but this is not the case with me. Am I the only one?

[peregrine]

One thing I would mention is that sometimes side effects go away after a few days to weeks as you get used to the medication (but obviously most of them stick around!). In the beginning with clonidine I was very lightheaded all of the time - I would stand up and my blood pressure would go from 110/70 to 85/45 and I would almost pass out and my BP wouldn't recover for several hours. Now that I've been on it for two months, I only get a slight bit of lightheadedness if I stand up very quickly, and it only lasts for a max of 30 seconds. Not to say that you should stick with something if it really isn't working out for you, but worth a thought. Two other things along those lines - the first time I tried atenolol I found it very sedating; now that I'm back on it it doesn't have the same effect. No clue why. And Seroquel - the medication I take for sleep - sometimes is sedating at low doses (what I take) but less so at high doses (which I don't need) - so sedation can be dose-dependent in weird ways.

(none of this is meant to be "go take it and don't be afraid!" thoughts, more just "drugs do weird things sometimes, sometimes side effects change over time" thoughts)