Beta Blocker Withdrawal?

[davecom]

So my headaches had been getting so constant that I decided to try a day without my 12.5 mg atenolol to see if it was the cause. The headaches were much better and I felt much more like myself mentally.

But... big but my heart rates went back to instantaneously going from 75 to high 130s when I stand (and going back down to 90s as long as I kept walking). While on atenolol I had hardly ever seen anything above 120 and often things would stay at 100 max.

So... 100s of kilometers of biking, walking 75 minutes a day for the past couple of months an I may no improvement without the beta blocker? Or could this first day off just be some sort of withdrawal? I also felt a bit jittery today.

It's a very low dose of atenolol so I'm surprised its impact could be this gigantic. I'll probably take half my normal dose tomorrow again. I thought dice it was already smaller than the smallest manufactured dose what I did today would be safe.

[corina]

Dave, it may depend on how long you've been on the bb. My cardio told me that being on a bb your body makes extra receptors to try bypass the bb and when you come off the bb they are the ones that bother you. The longer you are on bb's the longer it takes to get rid of the extra receptors. I'd like to add that although it may be a low dose, you need to check with your doctor before making changes to the dosage you're taking. Hope you will find out what works best for you to get rid of the headaches!

[Guest Alex]

Dave,

I know it must be frustrated but don't be too harsh on yourself and most importantly don't give up.

I decided to come off betas after I took them for 20 months, yet I suspected they were responsible for some of my problems, plus I didn't want to continue taking loads of pills (at one point I was taking 8 or so different meds a day). I weaned myself off the propranolol very slowly (that is the key to tapering off betas); it took me 2 months to go from 20 to 0 ( I cut 1/4 of a 10 mg pill every week) and I can tell you that my HR didn't react as bad as my dr expected, in fact things have been quite OK.

Based on what I've been reading, simply skipping a day in your treatment can cause rebound tachycardia and in some even rebound hypertension.

I'm not going to advise you to taper off your meds, but if you ever decide to come off your beta, do consult with your dr as s/he may be able to provide you with a reasonable schedule for that.

Just don't give up!

Alex

[Chaos]

As others have said, weaning slowly- perhaps even more slowly than "regular" doctors think you need to wean off them is key for us. That said, I weaned off mine very slowly and stayed off for several months and decided the symptoms were too miserable and I had lost too much function so went back on them again. My nadolol is one of my "desert island drugs".

Have you discussed trying another BB with your doc if your atenalol is causing you HAs? I know propanalol has been used to treat migraines albeit in much higher doses than what we use for POTS.

I think POTLUCK on here has documented pretty well how he weaned off propanalol 80 mg LA but still has to use 3.5 mg and hasn't been able to get off that last tiny little bit even with all his exercise he does.

[Hope]

Dave,

I don't know about withdrawals but as far as the headaches, maybe they could just switch the beta blocker? When I was first diagnosed with POTS I was given a beta blocker that gave me bad headaches. I wish I could remember which one, but I wasn't keeping track of everything yet at that point. Anyhow, they switched me to metoprolol on a low dose and it works pretty well. No headaches. I'm so sensitive to meds that I go low-dose on just about everything. If I get regular doses I usually have just as many symptoms from the meds as I do the illness. So I'm only on 2.5mg, and I do well with the heart rate. I was actually taken off if it recently to see if my low bp would jump up, but it only works on some days like that. Other days, I need the bb, so I take it as needed now.

I hope you find what works for you. So glad to hear you are out walking and biking.

[davecom]

It certainly has something to do with the atenolol. I had awful heart rates again yesterday morning but then in the afternoon they were a little bit better when I saw the doctor (they always are right?). He suggested I cut down to 6.25 mg for a week (1/4 of the lowest dose they make where as I was on 1/2 before) before stopping. I took that 1/4 of a pill and then the rest of the day yesterday had some of the best heart rates I've had period.

The doctor was surprised that atenolol was causing headaches since he had never heard that before, but it clearly is in my case. I even got mild ones after taking the 1/4 dose yesterday. Yet off of it again this morning and afternoon, I am much much better in that regard.

Okay first walk today was not awful (106 high, 90 average), then my second, I'm back to 140 and an average over 100 for the whole 15 minute walk (24 hours after taking the 1/4 of a pill). Tons of variability again too - even sitting down one second 90 bpm then 75, then 84 changing every 5 seconds. So now I again have to ask myself is this withdrawal or is atenolol fixing what's going on in the first place.

I am hesitant to again take 1/4 of a pill today because I don't like going through pseudowithdrawal every morning if that is what's happening. The plan is to try Clonidine when I have completely withdrawn from atenolol.