Weening off Inderal-dosage?

[alish2006]

Hello,



I was recently diagnosed with Graves/Hyperthyroid. I have not been put on any medication for it yet. My heart has been racing..around 110. BP is normally 100/70.



First I was given 25mgs of Toprol, and it did nothing to lessen my heart rate, but brought my BP down to 80/60. It also made my head feel strange. My GP has now given me Inderal 10mgs. I have not taken it yet.    



My questions are:  

1.How do you ween off Inderal 10mgs?



2.The insert from the pharmacy states Inderal is not to be used with any Thyroid Medication.  Many sites say it is used all the time with ATDs?



3. Is there any medication that just works on lowering the heart rate?



4. Do all beta blockers make your head feel strange? And does it subside?



Thank you very much. Great Board!

Alish

[Cleveland Clinic]

alish,



1.How do you ween off Inderal 10mgs?



Most of the time I just stop it. Once your throid comes under treatment, you can decrease the dose or stop it. Your physician will follow you.



2.The insert from the pharmacy states Inderal is not to be used with any Thyroid Medication. Many sites say it is used all the time with ATDs?



Beta blockers are often used with hyperthyroidism. A package insert can be a confusing thing because of all of the specifics written which must entail all of the adverse and interactions of the medications. It is important to administer and change dosage of any medication with a physicians guidance.  



3. Is there any medication that just works on lowering the heart rate?



The elevated heart rate in hyperthyroidism is best treated with beta blockers.



4. Do all beta blockers make your head feel strange? And does it subside?



A lot of people do feel side effects from beta blockers. There are some hypothetical differences between the different beta blockers that one may not have the same effect profile as another. All you can reall do is try one and see. I would give the medicine a good try before switching agents though.



good luck

[cristabelle]

Hello,

I've weened off Inderal a couple of times, under a physicians care.  It wasn't too difficult.  I broke the 10's in half for a week and then went every other day for a couple of weeks. But please check with your Dr., because I know my physician said I could not quit the Inderal Cold turkey.  When I was getting off the Inderal I was also titrating up on a new med, so it could be different with you.  I am not an MD, just sharing my experience.  I thought Inderal was a good med. and served me well, and helped me with migraines also.



cristabelle.

[Mgmark]

This was exactly the question I was wanting to ask.  Quick history:  



I've actually been through hell the last 8 weeks.  Went to the ER with a real bad run of PVC'S and was told I had "acute anxiety"  In the ER they actually avoided telling me if there was any serious heart related problem associated with the PVCS but really puhsed the whole "acute anxiety" issue.  Of course I'd have anxiety with my heart acting that way it's only natural.



I was handed 1mg of Ativan and my nightmares began.  When I saw my GP a few days later ready to find out about the PVCS he endorsed no need for tests in realtion to the heart and felt it was just a case of "stress" and pushed to take more of the Ativan.  I even told him after taking the Ativan only 3 times I felt like I was crawling out of my skin and it made my heart race.  He just said TAKE MORE!!



For 8 weeks that Ativan destroyed my body. Gave me constant interdosal withdrawals.  I had the most intense mind numbing anxiety of my life and not one health care provider ever told me I was in constant withdrawal because of the way I was taking the pill.  They wouldn't believe me when I said it was making my heart race. Prior to taking this pill my heart never raced liked that.



FINALLY after my 3rd trip to the ER with a racing heart rate of 138 resting for over 5 hours they said it's "possible" I was having interdosal withdrawals and said they would help to get me off Ativan.  It took a week of pure hell to endure getting off that poison.  After 8 weeks of that poison I had lost over 30lbs.  I have experienced the most intense forms of panic and anxiety that I can't even describe it only to say ... HORRIFIC!



In the process they gave me Inderal and I was told to take 20mg every 4 hours for this new tachycardia caused by the Ativan. Well being completely med phobic after the hell I'd been through with Ativan I decided to break the Inderal in half and take only 10mg with an added small little chunk which would amount to "maybe" 12mg of Inderal once a day.  



This little pill actually gave me some relief while withdrawaling from that poison Ativan.  I am thankful for that little bit of relief but from day one taking it I have been in fear I will have another bad reaction to another med. So far no side effects other than feeling tired. Can you imagine that?  Tired on that small a dose?  Thank God I didn't take the 20mg.



It has now been 2 weeks taking the small dossage of 12mg of Inderal once a day.  I'm ready to get off this pill but looking to see how to avoid any serious withdrawal symptoms.  I'm going to freak out if my heart starts racing thinking that another pill has poisoned my system and this time it's a pill that regulates my heart.  so I'm looking for a way to avoid that withdrawal symptom.  I figure my dossage was soooo small and the fact I haven't been on it so long that perhaps I will get lucky this time around with a med and I won't have too many unpleasant events with withdrawal.



I finally see a cardiologist this Tuesday to address the PVCS and any general concerns I have with my heart.  8 weeks later and after going through all this hell and I'm just now getting to address what started all this nonsense. Ironically since I've been so sick with all the withdrawals from the Ativan the PVCS have really let up.  They actually disappeared for a brief bit around easter before even starting on the Inderal.  They've come back after withdrawal of Ativan but the are just slight and for some reason I'm not as scared of them.  I guess I've faced so much with this ativan reaction I'm too exhausted to get too worked up.  



God I hope my heart doesn't start racing after I taper from the Inderal.  If so my question would be..... when do you contact a DR or head to the ER if this happens?  That last bit of tachycardia caused by the Ativan was scary as hell.  Lasted for hours and I tried everything to bring it down and it just wouldn't come down.

[mrbh]

Inderal is an excellent medication. It can be a little tough on the digestion at times, but honestly, 10mg a DAY is a TINY dose. I take 80 mg a day for PVC's and sinus tachycardia, and have been on Inderal since the late 90's.



In general, beta blockers do not have the withdrawal profile of benzodiazepenes like Ativan or Xanax. To my limited knowledge and understanding, the only people who need to taper off BB's slowly are 1) those with pre-existing CAD, 2) those who have had an actual heart attack, and, 3) those who have been taking fairly high doses for an extended period of time. These groups have to be quite careful.



I'm truly sorry you suffered so badly on the Ativan. That group of meds can be very beneficial to folks with acute panic/anxiety conditions.



Bottom line is ALWAYS consult your doctor before changing, reducing or eliminating any medication. I am certainly NOT a doctor, so your mileage and instructions may vary. I doubt you will have a problem with your Inderal, and wish you the best of luck.

[alish2006]

Thank you for the replying.  I am going to make a new post with what happened in the ER.