I have read that there can be an adjustment period, but not sure how long is normal. My lightheadedness and tremors have been worse, and I have been woken up by my heart racing the past couple of nights. Wednesday morning was my last dose after tapering off of it. Has anyone else experienced something similar when coming off of Pindolol? I am increasing my fluid from 3 to 4 liters a day hoping it will flush out the medication and offset the increased symptoms.
Beta blockers dampen the effects of sympathetic nervous system overactivity by blocking beta-adrenergic receptors specifically. Once you have been on beta blockers for even a modest period of time, you can be susceptible to withdrawal effects. Due to the mechanism of these withdrawal effects, it stands to reason that they would be more pronounced in people with dysautonomia:
with propranolol in man has also now been shown
to increase beta receptor numbers on lymphocytes
by about 50 per cent over five days, the number
declining to normal over five days after stopping
The clinical manifestation of beta-adrenergic
hypersensitivity will clearly depend on the degree
of increased beta adrenergic responsiveness (as
receptor numbers decline towards normal) and on
the degree of receptor activation, which will in
turn depend on the sympathetic drive and declining
plasma levels of the beta-blocking drug."
"Adrenergic Hypersensitivity after Beta-Blocker Withdrawal"
That article is really excellent if you want to get into the nitty-gritty of why you're not feeling well, but I can tell you briefly that the *short* of it is that while you're probably feeling the effects more acutely than a person without dysautonomia might, I don't believe the symptoms will persist longer for you. So you shouldn't expect this to last longer than a week, and if it does, it would warrant a call to your doctor. In the meantime, if it's unbearable or any of your vitals are doing something abnormal enough to be scary, by all means call a squad and go to the emergency department/call the doc on call/call your doctor/etc., whichever is appropriate. It may be possible that you need a slower taper if things aren't going well. Even if it seems like the pills won't break/cut that way, a slower taper is ALWAYS possible. (A place like a compounding pharmacy can work MAGIC getting precise doses.) So if in doubt, talk to your doc. Otherwise, rest assured, this too shall pass.
And in the meantime, feel free to talk to us about how yucky the symptoms are. :-D
It took me about a week to feel back to my old self after stopping my beta blocker. I had horrible headaches, really high blood pressure (which is abnormal for me, typically I run low) and the tachycardia returned with a vengence.
I survived coming off of Pindolol. I had three nights of waking up from dreams incorporating my pounding heart. The first one included my daughter running, and the pitter patter of her feet was the sound of my heart beating. The tremors are a little bit better. Haven’t thrown a potato chip lately, and am a little less clumsy.
I started wearing waist high footless compression stockings. I was worried my feet would swell too much, but they have been okay. I can wear sandals, which is great in Atlanta. I even found black ones that I can wear like leggings. They haven’t helped with my ongoing lightheadedness, but they have helped with the burning and pain in my legs. I have ankles and have definition in my legs again. So, I guess they are helping to keep the blood and fluid above my waist. I am working as an usher for graduation at work Monday, so hopefully they will help keep me on my feet.
I went from taking 5mg of Midodrine to 10 mg three times a day today, and hope this will finally do the trick. I am tired of everything rocking side to side when I walk, and the altered vision. It has been four months, which I know isn’t long compared to most people, but I am hoping I can finally have one good day soon!
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