atenolol

[mindy335]

i am currently taking 50mg twice a day for one week now for anxiety and panic attacks. but i have also been taking small doses of klonopin(weening off of klon.) too during past week.  is there anyone out there who takes atenolol and has sleeping problems associated with it.  i heard it may cause insomnia. it hasnt with me yet.    mindy335   ***@****

[amish1979]

I don't take it, I take another beta blocker.  Having said that, if you haven't been experiencing insomnia within the first week I'd say you are probably in the clear.  A beta blocker doesn't take a long time to reach efficacy like an SSRI does.

[greenlydia]

Hi mindy, and welcome to the forum!
I took atenolol for many years and never had a problem with insomnia, although it is listed as one of the POSSIBLE side effects. But then, so are drowsiness and fatigue. Side effects usually disappear after a few weeks, (+/-) on most meds, but you say this hasn't been a problem for you yet. It's my humble opinion that since it hasn't produced this particular side effect, it probably won't. Most untoward side effects show up fairly soon after beginning a new med. My advice..........stop worrying about it or you WILL find yourself sleepless!
What I can't figure out is why your doctor prescribed atenolol for your anxiety/panic. It is not an anti-anxiety medication, and even it's "unlabeled" uses state nothing about anxiety. I would definitely ask the doc why he gave you an antihypertensive, especially since he knew, (at least I'm hoping he knew) that you were also taking Klonopin.
I was given atenolol for my high blood pressure and Xanax for my panic attacks.......I really think a discussion with your doctor is in order.
Peace
Greenlydia  

[RCA759I]

Tenormin (Atenolol) is a β-1 (cardio-selective) β-blocker. Of the available β-blockers, it is the most cardio-selective (targets chiefly the myocardium). In addition, it is very poorly lipophilic, and hence, does not readily cross the blood-brain barrier. This greatly reduces the risk of neuropsychiatric side effects such as depression, hallucinations and insomnia when compared to non-selective, highly lipophilic β-blockers such as Inderal (Propranolol). This is the primary benefit of selecting Atenolol over the others for a psychiatric patient, or for a patient who is predisposed to developing depression. However, it should be borne in mind that selectivity is only relative and not absolute, hence, insomnia remains a rarely reported side effect. As with any drug, the result is highly individualized.

The logic behind using a β-blocker such as Atenolol for off-label use in panic states is to block the sympathetic effects of endogenous catecholamines (norepinephrine). Over-firing of the sympathetic nervous system is responsible for the bulk of panic symptoms. By antagonizing the effects of norepinephrine on specific β receptor sites, the physical manifestations of panic are reduced. This is particularly true for those who suffer predominantly from cardiac manifestations of panic, or for whom have developed a fixation with regard to their heart function.

The logic behind using a long-acting Benzodiazepine, such as Clonazepam, is to induce a dose-dependent reduction in neurological functioning centrally. By decreasing neurological functioning centrally, the response to panic-provoking stimuli is blunted, which in turn, leads to a reduction in the secretion of endogenous catecholamines - reducing the physical symptoms of panic. This has advantages and disadvantages. Clonazepam is indicated for the acute or long-term treatment of panic disorder, and is used chiefly as a prophylactic agent. The downside to using Clonazepam is the CNS depression that it exerts, which in turn (over the long-term) induces cognitive dysfunction, blunts emotion, induces depression (mental, physical or both) and inhibits the ability to process new information, thoughts, ideas, perceptions, etc. Hence, the drug masks the physical manifestations of panic while blunting sensory perception. And while it is effective for masking physical symptoms, it has a derogatory effect in that it blunts your ability to process the attacks, and inhibits your ability to overcome them on your own initiative, which leads to psychic dependency on the drug. For this reason, Clonazepam and comparable agents should only be used during the acute phase of anxiety/panic, agoraphobia, or during a severe depressive phase presenting with acute anxiety if possible. Additional treatment after adjunctive psychotherapy, if warranted, should first be initiated with a trial of an antidepressant for at least two months. For cases refractory to antidepressants, or in cases where antidepressants are intolerable, the long-term use of Clonazepam would then be justified. Clonazepam should be reserved as an option of last resort, given the probable long-term implications associated with its use - including severe psychic and physical dependency.

You are tapering off of Clonazepam (which is good), and for this, Atenolol will help to minimize some of the physical presentations often witnessed during its discontinuation. Transiently elevated blood pressure, hyperventilation, numbness/tingling sensations secondary to hyperventilation, tachycardia and similar symptoms are likely to be minimized.

-Ryan