Differences Between Popular Beta Blockers Used For Pots

[CarmelRob]

Hi everyone,

I'm currently taking Pindolol which is a "nonselective" beta blocker for my hypertensive POTS and am interested in learning about the other popular beta blockers used for my condition and the pros and cons of each. There seems to be quite a lot of beta-blockers out there.

So far I've had mostly good experiences with Pindolol but have had to lower the dosage because it would increase the coldness in my extremities and add to my gastroparesis and intestinal dysmotility problem(which I think is directly related to a dysfunctional thermo-regularatory system with decreased blood flow). I've read that all beta-blockers cause cold extremities which kind of makes sense if the drug slows your heart down.

I'm mostly interested in which beta-blockers carry with them the least amount of side-effects and withdrawal symptoms since I'm super-sensitive with medications and their effects.

Thanks a lot for your help

-Robert

[CarmelRob]

I believe that Propranolol(non-selective agent meaning works on both B1 and B2 receptors) has been helping my low blood volume problem because of its inhibitory effect on Beta 2 receptors generating smooth muscle vasoconstriction.

"Stimulation of β2 receptors induces smooth muscle relaxation (resulting in vasodilation and bronchodilation amongst other actions), induces tremor in skeletal muscle, increases glycogenolysis in the liver and skeletal muscle.

Beta blockers inhibit these normal epinephrine-mediated sympathetic actions, but have minimal effect on resting subjects. That is, they reduce the effect of excitement/physical exertion on heart rate and force of contraction, dilation of blood vessels, opening of bronchi, reduce tremor, and breakdown of glycogen.

It is therefore somewhat unexpected that non-selective beta blockers have an antihypertensive effect, since they appear to cause vasoconstriction. The antihypertensive mechanism appears to involve: reduction in cardiac output (due to negative chronotropic and inotropic effects), reduction in renin release from the kidneys, and a central nervous system effect to reduce sympathetic activity." -Wikipedia (Beta Blockers)

So to rephrase the previous post, I'm interested in people's experiences with non-selective beta blockers like Propranol.

Here is a list of them:

Non-selective agents-

Alprenolol

Carteolol

Levobunolol

Mepindolol

Metipranolol

Nadolol

Oxprenolol

Penbutolol

Pindolol

Propranolol

Sotalol

Timolol