Beta Blocker Side Effects

I am a 19 year old female who was diagnosed with neurocardiogenic syncope four months ago. After undergoing extensive testing (EKG, echo, Holter monitoring, looping event recorder, and EP Study), my cardiologist could not conclusively determine a cardiac trigger to attribute to my light-headedness and syncope, so he diagnosed me with NCS and prescribed a low dose of a beta blocker.   The medication seems to be helping as I have only passed out twice in 4 months, but I have been experiencing some unusual sensations since I began the medication (other than the common ones like constant lethargy, dizziness, and trouble sleeping).

This may sound strange, but sometimes when I am sitting down, my body begins to rock in synchrony with my heart beat and this can last up to a couple of minutes.   Literally, it is almost as if I am in a rocking chair swaying not forward and backward but side to side.  I normally have palpitations when I lay down at night, but this is a much more forceful, overwhelming event that leaves me shaky and very lightheaded.  Are these simply palpitations?

Additionally, since I have been on the beta blocker, I find that my chest will sometimes feels very constricted, especially noticeable upon taking a deep breath or after exercising (jog 4-7 miles/day).  It is not excruciating pain, but a dull feeling of pressure that also occasionally(but not always) extends from my mid chest to my left shoulder, upper arm, and lower jaw. I know that chest pain often stems from non-heart related conditions but it has continued to become much more prevalent and burdensome.

Finally, I have been experiencing Raynauds much more frequently than before. (There is a long history of SLE in my family, and though I have not tested positive for lupus yet, I have experienced some of the initial symptoms, like Raynauds, that follow the pattern of SLE onset in my family). I first experienced Raynauds a couple of years ago; however, since I began the beta blocker, the intensity and frequency has dramatically increased.  

I am a history major and therefore know very little about medicine and the human body in general.  I don't smoke or drink alcohol, and I am not too overweight but did gain the dreaded freshman 15 during my first year of college.  I do not know whether I should really be concerned about any of this.  Can these symptoms be attributed to the beta blocker?  Is there a possibility that my syncope is not NCS? Could it actually have a cardiac origin?  

Originally, my cardiologist thought my problems were a result of SVT leading to sick sinus syndrome (tachycardia-brachycardia syndrome), but he could not conclusively prove this through my test results.  Something like those conditions would have been detected through those tests.  Right?  (My cardiologist is one of the best in in town but is extremely difficult to talk to about any of my concerns.)

Any comments or information will be useful. Thanks.  

[Cleveland Clinic, MD]

Dear Beth,
Well, those are definately not typical beta-blocker side-effects. Different people may have different responses to medications and the only way to know for sure is to stop the medication and see if the symptoms stop.  If they do then the medication must be suspected, although it is not proof that the medication was causing them.  

Did your doctor discuss some of the other non-pharmacologic methods of dealing with NCS?  Some of the methods that may help patients with NCS include: salt liberalization, raising the head of your bed, compression stockings, and contraction of your calf and leg muscles when you feel lightheaded.

If you continue to have difficulties you may wish to see someone who specializes in syncope (fainting).  We have two doctors here that do and you can make an appointment with one of them by calling the number below and asking for an appointment in the syncope clinic. I wish you all the best.

[Betty Powell]

Hi,

   I am on Inderal 10mg 3 times a day for chest pain and dizziness and palpatations that are yet to be diagnoised.
I have been on Inderal(beta blocker) for about 3 weeks now and the side effects are very bad at this point..They keep telling me my body will adjust and they will lessen but so far they have not done so...and i am on a very small dose of this as it is...

I get really shaky and almost pass out, I get that swaying feeling and I stay very very tired....Before I started the Inderal I had insomnia at night, now I cannot stay awake for anything it seems...I wake up tired...and I feel so sluggish and my chest feels tight and restricted as well...so i know how you feel..


Now I have a curious question, How did they Diagnoise NCS for certian and what exactly were your symptoms..Did you ever get weird sensations in your chest? What about pain? Dizzy and faint or almost faint?

Take care and I wish you luck.....
And i do hope your side effects go away..but please give it a fair shot I am sure trying....
Betty

[stevebu]

Hi Beth.  First, I will say that having an unapproachable doctor, no matter how good they are, isn't worth much.  If your doctor does not want to listen to your concerns, he may miss some vital information that you have to give him.  I would find another good doctor and have your tests results sent to them.

I had SVT and took calcium channel blockers, not beta blockers, but I had some of the same symptoms you describe.  I also run, but never experienced the pain you are discribing.  Sometimes at rest I feel pain in my arms, but since my echo/stress test/ekg are normal I try not to worry about it.  I think it is important that your doctor knows about the pain in you in your chest and jaw and that he address it.

Good luck to you

Steve

[Beth (to Betty)]

Betty, it is a relief to know that I am not crazy and at least someone can relate to these "side effects".  For you sake,I hope that your body adjusts quicker to Inderal than mine has to toprol(my beta blocker).  Likewise, my doctor reassured me that the side effects would go away. I have to admit that the first month was pretty rough, but now after 4 months of these symptoms, I am getting a little fed up with the situation.  
  In response to you inquires, my problems began when I passed out one evening about 30 minutes after exercising. I then passed out again the next morning upon getting out of bed. At that point, I sought medical attention and eventually ended up at an electrocardiologist. After going through a bunch of tests, the results were inconclusive as to the cause of my syncope (one indicated possible SVT, another sinus tachy., another inappropiate sinus tachy., and another severe tachy-brachy. syndrome)  So, because of such inconsistencies, my cardiologist diagnosed it as NCS based on the frequency of fainting (up to 5 times/wk) and the probable cause of initiation.  He told me that he had seen this before in several patients my age.

Prior to my whole syncope ordeal, I had fainted 2 or 3 times in my life, but I am quite certain those isolated events were due to dehydration. Occassionally, I would experience identical chest pain or a weird constrictive sensation (I do not know exactly how to describe this feeling) a few minutes after intensively exercising, but this happened only 2 or 3 times a year. I have had (undiagnosed) palpitations almost every night for the last 3-4 years but because it occurs on a regular basis, I never considered them significant. I used to constantly be dizzy in high school, but I attributed this to being very atheletic and having a my blood pressure typically 80/60 and resting pulse around 50 bpm. (Once I came to college and put on some weight, the dizziness somewhat lessened with an increased BP of 120/90.)  
A few random question for you. Since you began treatment for chest pain and dizziness with a beta blocker, have these sensations diminished any?  How intense and how frequent were your bouts with chest pain/dizziness before you sought medical help?  When you get that swaying sensation, can you feel your blood vessels pulsating?  

I wish you the best of health. Good luck.  - Beth

[Terri]

Hi,

I take inderal 60 mg. once a day for palpitations and tach. I started out taking 10mg. 3x/day 3 years ago and increased to the 60mg.  I still get break through palpitations and mild tach. at times, but I am afraid to increase any more.  I have noticed since I have been on the inderal I have gained around 10lbs. and I have a difficult time concentrating.  The drs. say that those concerns are not a side effect, but I never had the trouble before.  I also experience fatigue and weird dreams.  Just recently I have had trouble with the top of my head tingling and sometimes my hands.  The drs. also say this is not related to the inderal, but I can't help but wonder. I know that in general I just feel different then when I started the beta blocker, but I am afraid to get off of it.  I wish you all the best of luck with health.  I don't know why my problems started but I sure wish they would go away.  The drs. say I have a healthy heart, but it sure doesn't feel that way when it is jumping around.

Good luck to all.

[Shannon to Peter]

Hi -- I've taken about five different beta blockers (I have high rate following open heart surgery), and each one had different side effects for me.  On Toprol, I also experienced that weird feeling in my chest, like I couldn't take a breath without feeling chest pressure and also like my breathing rhythm had disappeared.  Really strange.  Didn't experience any of the rocking feeling.  I do have the cold/tingly hands and feet, but that's true for me with all beta blockers.  (In fact, it's so noticeable that one of my office colleagues framed a "Cold Hands, Warm Heart" drawing for me!).

The one that caused the least problem for me has been atenolol at a low dosage (25 mgs/day).  Everything else also made my blood pressure so low that I passed out periodically -- just what you don't need!

Hope all of the patient input helps. I agree that a doctor who doesn't communicate well with you isn't worth a great deal in sorting out what will work best for you.  My surgeon didn't have great bedside manners, but at least he was tops in his field and I didn't have to talk much with him.  My cardiologist is the exact opposite and it has made so much difference to me -- knowing that he's listening and considering my comments, and then working with me to find solutions.

Take care,

Shannon

[Mary Lou to Beth Re: Raynaud's]

I am on a beta blocker also (Zebeta 2.5 mg) and it has had hardly any side effects on me, but it is a very low dose, just for my pac's and pvc's. However, when researching beta blockers over the net, I saw numerous times that they can increase the severity of Raynaud's Disease. It was on several of the sites regarding beta blockers...I am very surprised the cardiologist who responded to your question didn't remark on this. I have found that Pharmacists are pretty good at knowing side effects of drugs, and they are much more open to phone calls and speaking with you about it on the phone than dr.'s. I don't know much more about your other symptoms, but maybe another beta blocker would help. Good luck  Mary Lou

[jan]

I have raynaud's and told my cardio. he just shrugged it off and put me on beta blockers anyway. I had the worst time with it this winter (my 1st winter taking it)!

[Betty Powell To Beth and Terri]

Beth,
  I have had the chest pains and heaviness for a while but it has been really bad over the past few months. The swaying feeling is still here and yes I get the pulsating feelings as well...I am still getting dizzy even on the Inderal now..I am going to give it another week and see after that I am going to talk to the doctor about weaning off of the Inderal.

Terri,
   I have the same weight gain and loss of concentration and hair loss...my concentration level has dropped significantly. And I cannot remember anything at all..
I researched Inderal in my PDR and on other sites and it seems that these are typical side effects. The PDR lists possible side effects as,
Abdominal cramps,colitis,congestive heart failure,constipation,decreased sexual ability,depression,diarrhea,difficult breathing,disorientation,dry eyes,fever with sore throat,hair loss, hallucinations,headaches, light headedness, low blood pressure, lupus like reactions,nasuea,rash, rddish or purplish spots on skin, short trem memory loss,slow heartbeat, tingling,prickling in the hands,tiredness, trouble sleeping,upset stomach,visual changes,vivid dreams,vomiting,weakness,worsening of certian heartbeat irregularities.

Take care all,
Betty

[lorretta]

Ive just started taking inderal 10mg 2x daily. Ive been on it a week and so far im seeing not much benefit but quite a few side effects. Im thinking of stopping before It gets to late. Apart from the tiredness and jitters..ive developed this wierd fluttering feeling in my throat..like a palpiataion but lighter and in my neck area..kind of makes me feel like i need to cough all the time. anyone else experience this??
thanks
lorretta

[me to]

loretta,
could be atrial fib or flutter.....

[ZEET]

I began using toprol in september of 1999. The first couple of weeks I felt really tired at night. That passed, what I notice now But I don't know if it is related to toprol or not is vivid dreams, like my dreams are very clear, also my vision once in a blue moon gets funny. When this happens it will lasts about ten minutes or so. It is like when your eyes catch headlights while driving at night. If you put your two hands out in front of you you may only see one. Some one I know used to be on inderal and this used to happen to them. Even on the toprol I still feel my arrythmias, sometimes every day. But they are less in frequency and severity now , than before the toprol. I had never had a diagnosis for what I have but  what I feel is fast heart rate(not so much now with toprol) Then like a hard heart beat I guess. You feel it once then its over with. Also I feel like a flutter, then my heart rate is slow, I cough or walk or do something fast, then I feel like a hot flash and my heart goes to the normal rate. My cardiologist has not given me a name for this. I have been trying to see if anyone else on this website comments on similiar symtoms (symptoms).

[jan]

Valerie, It sounds like you have PAC's or PVC's. Also, I know beta blockers can give you vivid dreams or nightmares. You will find that listed under the side effects. As for the visual thing, it sounds like a visual migraine. I used to get them often when I was younger without the headache, itself. I remember only seeing part of the glass and thinking if I held it I could pour into it even though I couldn't see the whole glass, it didn't work. It was really scarey when I would get it while I was driving. The barrier in the middle of the hwy. would disappear! I know others in my family get this with their migraines.  I hope this info helps.

[ZEET]

Thanks Jan,
I just logged on to the website and saw your comment. You have made me feel very relieved. Because so far no one else had commented about the dreams or the visual thing. I don't want to stop toprol because of either one. The dreams I only notice the last week or so being very clear or vivid, and the vision thing happens once in a great while. Someone had told me that when they were on inderal they used to get the vision thing. But if I remember correctly I used to get this when I was a kid in school. Sometimes like a sinus headache would follow, sometimes not. I don't think in my case it is related to toprol, being I used to get it when I was in high school, also I have only been on toprol about a year now. I guess when your on a beta blocker you have to weigh out what you can or can't stand more, the side effects to the medication or the stinking arrythmia. That is the only side effect I have to the med. is the dreams and vision I'm not sure if that connected. I still  feel everyday or every other day  different things in my heart, but the med. has helped alot.
Thanks Again.