atenelol vs propanalol

[ronna1978]

Does anyone know what the difference is between 10mg of propanalol and 25 mg of atenelol? Please help me. My doc recently took me off of 25mg of atenelol a day  and put me on 10mg a day of propanalol and I feel horrible, I take them for tachycardia and it seems worse ever since the switch.

[RCA7591]

Bad move, Ronna.

Atenolol is more potent when compared to Propranolol, and as such, your level of beta-blockade has been reduced. This will manifest as rebound hypertension and tachycardia. Anxiety may be prominent due to increased circulating Catecholamines (Adrenaline).

Atenolol is also cardio-selective, while Propranolol is not. Atenolol has several advantages over Propranolol for this reason. Atenolol is less likely to cause shortness of breath (or bronchospasm in the asthmatic).

However, for anxiety states which manifest with cardiac complaints (premature complexes and tachycardia), Propranolol is a better choice, as it targets all beta receptor sites, and as such, reduces the physical manifestations of anxiety by blocking endogenous Catecholamines (those produced by your "fight or flight" response). 20 mg, b.i.d. of Propranolol would be a near equivalent to your 25 mg of Atenolol. Propranolol should be dosed twice daily.

Augmenting the Propranolol with a long-acting Benzodiazepine, such as Clonazepam, is often of great benefit if a component of anxiety/panic is involved. The use of SSRI/SNRI drugs should be avoided where cardiac manifestations are prominent, as these agents increase autonomic hyperactivity and amplify the physical symptoms.

You can discuss these options with your doctor.

-Ryan