beta blocker and more

[LynnSB]

I have a (documented)history of hypersensitivity to many drugs.I was prescribed 25mg of atelenol(starting with 1/2 once a day)for my continued brief runs of fast beats and PVCs/PACs.An ablation in sept. for AVRN tachycardia eliminated the 210(rare)BPM but not what apparently causes most of my daily (sometimes hourly) symptoms -- bursts of fast beats ( 3 to 20) and skipped beats.the beta blocker made my BP go to 88/48,pulse from 80 to 60.I am now just taking 1/4 (for 2 days) and my BP is 90/60,pulse 65 or so.

If i decide to go off the atelenol, can i expect rebound problems at this tiny dose? I am still having what feel like PVCs/PACs but not so many fast runs. an option is to do another EP study/ablation but the EP doc says i am in no danger and seems to think if i could learn to live with, or ignore, the palps, might be the best solution. I'm trying!

another problem since starting the BB a couple of weeks ago - when I eat anything other than the tiniest amount of food, when i have a regular meal, i feel weak afterwards.Last night i had a salad and sandwich and felt VERY weak, heart went to 110.could atelenol cause post-pranial (may not be spelling this right)drop in BP?

also, I noticed my pulse pressure can be quite small sometimes - if you have a pulse pressure of 30 or even less is that indicative of any problem? dysautonomia? FYI:I had an echo last week -- normal with trace regurgitation of mitral valve (tech said so slight could be variation of normal) and EF of 60.Thanks as always for answering my questions. Lynn

[CCF-M.D.-RCJ]

LynnSB,

Thanks for the post.

Q1a:"If i decide to go off the atelenol, can i expect rebound problems at this tiny dose?"

Quite possibly, yes.

Q1b:"but the EP doc says i am in no danger and seems to think if i could learn to live with, or ignore, the palps, might be the best solution."

I recently read "Full Catastrophe Living", by Jon Kabat-Zinn.  You might find it interesting, and useful.

Q2:"could atelenol cause post-pranial (may not be spelling this right)drop in BP?"

Interesting question.  I suppose by blocking the reflex tachycardia after a meal, the beta-blocker might cause post-prandial hypotension.  I've never seen someone with this symptom, however.

Q3:"if you have a pulse pressure of 30 or even less is that indicative of any problem? dysautonomia?"

Not when the BP is low to begin with.  A BP of 200/170 would be unusual, for example, but a BP of 90/60 could be perfectly normal.

Good luck Lynn.

[LynnSB]

I've read various things about cross reactions between prozac ( only taking 10 mg) and atenolol.. but my doc said he doesn't think so. have you ever seen a problem with these two drugs taken together?

same thing with ibuprofen... is it ok to take atelenol with ibuprofen? aspirin?

sorry i forgot these originally.

L

[LynnSB]

>>I recently read "Full Catastrophe Living", by Jon Kabat-Zinn. You might find it interesting, and useful. <<

Thanks. Read it when it first came out some years ago. I do meditate, do yoga, yadda yadda... still have the frigging heart palps and they still bother me.. maybe some day this will all be better. I sure hope so.

[sheryl1945]

Hi Lynn...I took Prozac and Atenolol for years with NO problems (40 mg Prozac; 25 mg Atenolol).  Now I'm on Paxil CR and still on the Atenolol.  Don't be afraid of mixing these drugs.  Good luck :)

[LynnSB]

thanks!  has the atenolol helped your palps?  I am soooo disappointed.. first ,disappointed with the ablation which didn't "fix" me  and now with the beta blocker... sheesh...

Lynn

[Kimma]

this isnt for me...is blood pressure of 121/56 bad?? i was worried when my mom told me this was her bp because one is low and one is high? my mom smokes marijuana and ciggarettes everday and drinks on the weekends, she is 40yrs/ 5'1/110lbs. her dad died at about 40 from a massive heart attack. thanks so much. kim

[CCF-M.D.-RCJ]

Lynn,

I just saw your follow-up.  I've not encountered anyone who described a "cross-reaction" with prozac and atenolol.

Also, while I've certainly heard of yoga and meditation, I've also not encountered "yadda yadda" in my studies of coping techniques.  Is this an Eastern philospohy? ;) It sounds yiddish ...

[jan]

Lynn,

I only take 12.5 mg of atenolol and on two occasions stopped it.  On or about the 3rd day, ea. time, I was sob and in tachy.  I take verapamil for the tachy, too and even with that...

I take many different drugs while taking atenolol and many you will find saying it is a bad combo or even dangerous, like taking verapamil with it.  If you have concerns ask your dr. and let him put your mind at ease, ask a couple of times if you have to.  I did.  LOL

[LynnSB]

Yadda yadda does have Yiddish roots but is also cross-referenced as a decidedly  southern coping mechanism, technically known as the "Scarlett O'Hara 'tomorrow is ANOTHAH day'" prescription for what ails you.

[Dracee322]

So by suggesting the book on meditation are you implying that PAC/PVC's can be caused by stress/anxiety? I am fully aware of the rapid HR and anxiety but not familiar with the link to anxiety. How (etiologically) is it related? I know that a great deal of anxiety can occur as a result of arrhythmias. Have you tried and would a calcium channel blocker be a better option (especially for a younger person) for frequent PAC/PVC's? And Lynn, I appreciate your Dr's suggestion to "ignore" your arrhythmias but it is like trying to ignore a big fat "benign" tumor growing out of the side of your head! It is frustrating to see that you cannot find any relief for your very aggravating symptoms. Sometimes antidepressants can make things worse, especially at first! They are very tricky and what works for one person can be anothers nightmare. I have seen them work for a lot of people and be horrible for others! I admire your willingness to try all the options you have thus far! I understand that hormone shifts (I am not sure where you are menopausally) can wreak havoc on a womens heart. Especially related to tachycardia and PAC/PVC's.

[LynnSB]

Hi,

Of course, if someone is frightened or anxious, catecholamines are pumped out by the body and can cause heart rates to increase and the likelihood of heart "skips". Unfortunately, it seems that this fact has been extrapolated -- especially when it comes to women -- to mean to many docs ( not talking about the docs here) that women with palpitations = women with primary anxiety/panic problems.

I was recently talking to an electrophysiologist who said he's sending a paper that shows that it takes  women with arrhythmias -- including SERIOUS arrhythmias --  an average of THREE YEARS to be taken seriously and get a diagnosis.. they are usually blown off as "anxious".

Several years ago, an interesting study came out in JAMA,I believe, about PSVT being mistaken for "panic attacks". here is some info on that. hope this helps:

http://www.geocities.com/Wellesley/Garden/8988/heartrhythmindex.html

http://www.personalmd.com/news/a1997031002.shtml

[jkf]

Hi Lynn,
I too am very sensitive to drugs.  I take 1/4 of a 25mg of tenormin every night before bed.  Even that lowers my blood pressure but for the most part I feel pretty good on that low dose.  If I tend to have a breakthrough (those scary high rates of 220 which fortunately only happen once or twice a year) I just take another half and it calms things down without any other side effects.  I take Advil all the time with the tenormin.  My doctor said that it was actually one of the safer drugs to combine other drugs with (ie antibiotics, birth control, aspirin, Advil, etc.)  Good luck to you.

[sheryl1945]

Hi Lynn...I began taking atenolol for rapid heartbeat, and while it slows my heart down beautifully, I swear I have MORE skipped beats!  Drives me nuts!  I try to ignore them.  Good luck to you.

[I'mallheart]

hello i take 25 mg atenolol daily due to the fact this past fall went to the ER twice for fast heart rate..i also suffer from anxiety and the cardiologist says its Palps with Anxiety but to take the beta blocker..i also take buspar which is a waste i must add. I feel theses wierd like extra beats..pulse rates fine however and feel dizzy/lightheaded at times..pulse rate at time 50 and bp 90/60,,is this too low..i read its not that good for folks to stop atenolol but i know its not good for our bodies to take this stuff either..any suggestion to share with DOC? i see him tomorrow..i just wanna feel like i was a year ago. i know i am under stress also. im 27 newly married and a baby on the way..MARCH 21ST IS THE DUE DATE.. i just need to get this taken care of..i plan to also see a counselor for anxiety depression issues..any suggestions would be great
GOD BLESS
DAVE

[LynnSB]

>>but i know its not good for our bodies to take this stuff either..any suggestion to share with DOC? <<

Don't worry about taking the atelonol long term.. it's a very , very safe drug.Having said that, it can make some people feel tired, dizzy, etc.  See if your doc agrees if you can slowly either reduce, stop it or try another kind of beta blocker.

Also, insist that your doc let you wear an EVENT MONITOR so you can document exactly what your heart is doing when it feels "weird" and/or you feel dizzy.

One more possibility: you could possibly have dysautonomia or postural hypotension ( basically, both of these mean your blood pressure and nervous system could be a little out of whack -- nothing that's going to kill you but can make  you have the symptoms you mention).


god luck with the doc!

Lynn

[heart o mine]

Hi LynnSB
I'm not on prozack, but I have LGL and history of SVT.  I was recently diagnosed with Grave's Disease and Dr. put me on PTU and Atenolol.  I have similiar side effects with the Atenolol.  If I take it, my heart skips beats and speeds up and down.  I feel horrible and anxious with tightness in chest and neck and some dizziness.  I have taken it on rare occasion with no effects, but because of common effects, I'm very fearful and don't take it unless realy needed, which Cardiologist told me was fine.  Ironically, I just took it twenty minutes ago because I've been off my PTU three weeks pending radiation treatment and testing and I'm very jumpy with a fast pulse. Typically the reaction doesn't occure until about two hours after ingetion of the Atenolol. So far, so good.  Hope this helps in someway.

[Bigdobe]

Atenolol 12.5 mg has been great in controlling my BP and fancy arrhythmia (PVC, PAC, brief unsustained V-tach and brief unsustained supraventricular tacht).  On a routine EKG, my cardiologist was concerned when she noted a very slow rhythm  (48).  Actually, I have been feeling fine.  Because the dose was so small, she opted to stop the Rx abruptly so that she could quickly mount a Holter monitor (r/o sick sinus syndrome).  Within three days, I experienced a return of the arrhythmias and a very volatile BP.  So even tiny doses must be handled with care in some people like me.  Interestingly, I tried a quarter tablet (6.08 mg....)  Most of the irregularities were controlled but the BP remained a little too high.  My Holter was "normal" !!?? No sick sinus and I flew through the stress test with no problem.  For some of us, this Rx is wonderful but even tiny doses must be handled with care.