beta blockers causing symptoms

[ianhunter2134]

Hi there wondering if you can help about 5 months ago i had couple of ecgs and an echo both reported as normal i did have an asd repaired by amplatzer device in 2003 at age 38.I then had some chest pain in februaury and was diagnosed with possible unstable angina and put on atenolol 25mg daily and given nitro spray however a stress test done few weeks later came back negative i lasted just under 10mins and achieved close to 85% target rate but the beta blocker made it hard to do this i was told i could be fitter but heart looked fine as for the atenolol i was informed since it had cut down palpitations which i used to get i could stay on it.However the chest discomfort and tightness has continued for months almost daily and my doc says she thinks it is combination of anxiety which i do have and possible costochondritis as chest does feel littele tender and movement even walking seems to aggrevate pain.My biggest concern is that in last 4 weeks i seem to have developed some leg oedema on both sides not major but still a new symptom for me.My gp after physical exam is not that worried and says the nature of my job a computer programmer where i am sitting for long periods is probably responsible.I am worried that beta blocker might be causing heart problems is it known to cause heart failure in someone who hads normal echo just recently and do you think it is urgent i get back in touch with g.p soon again or is my anxiety just getting better of me,thanks for help.

[CCF-M.D.-MJM]

Hi Ian,

Beta blockers can certainly affect exercise tolerance.  Many young people just don't tolerate them because it can make a significant difference interms of increased fatigue.  Beta blockers to not cause heart failure (lower extremity edema) in normal hearts.  It is possible that the ASD repair may have been preceded by decreased function of the right ventricle or increased blood pressure in your pulmonary circulation -- these are common long term affects from ASDs.  A good echocardiogram will evaluate pulmonary pressures and right heart function.  If you have any doubt, ask for a second opinion.  You may even want to see someone that specializes in adult congenital heart disease.  They probably have more experience with ASD repairs and the long term sequela.

Anxiety can cause chest pains that are not increased (sometimes even improved by) exertion and that sometimes gets worse with rest (ie to much time to think about what makes you anxious).

I hope this helps answer your questions.  Thanks for posting.

[rosetoes]

My experience with Beta Blockers were not good.  I started them due to an episode of rapid heart beat and I was admited overnight...test were ran, echo, ekg, stress test, all came back normal.  They chalked it up to sinus tach or SVT.  No medication was given.  I went into a severe anxiety attacks daily if not hourly.  I went to my GP and he gave me Xanax and Toprol for the palpitations.  

Toprol wasn't bad at first (so I thought), it was masked by the xanax I was taking.  AFter a few months on both I weaned off of the xanax and I had a 6 weeks of withdrawl (including the weaning) and after being off of xanax for a few months, I was feeling horrible, feet and finger ice colds, palpitations, lifelessness, pounding heart, tightness in my head, I started to stutter and was forgetful... mind you I was on Toprol Xl .50mg.  Not a high dosage.


After several weeks of weaning off Toprol and having serious back pain and aches, headaches, dizzyness, it finally subsided and I feel so much better without Toprol.  I think I was put on the beta blocker prematurely.  Only one episode, I don't think I needed that.  I occasionaly have palpitations, but not nearly as bad as when I was on Toprol.

[mrbh]

Hmmm...Toprol wasn't very good for me either. Started with 50mg per day, then moved to 100mg per day. I can honestly say it made my palps MUCH worse! The PVC's were more frequent and seemingly more intense. My episodes of sinus tach that usually run 115 regularly hit 134. Worse still were the weak spells, clouded thinking, and the intense (to put it mildly) gastric distress.

Back on Inderal now and down to 10mg 3x per day. Plan to wean off ASAP.

Before anyone jumps on my case, I fully recognize that beta blockers are important and necessary for some patients. I agree with the sentiment that they are sometimes handed out indiscriminately and possibly not necessary in certain instances.

I'll be interested in the answer from the CCF doc.

[PikaPika88]

I've that much of anxiety too.  Everyday!  Only when I sleep is the best time.  The anxiety that I've is either in palp or chest tightness.  No med was giving.  I was told to live with my life and not allow to complain.  I think I have the swelling in my hand and leg during the sleep.  It'll go away after I weak up.  Do anyone of you experience it?

Pika.

[tickertock]

For me personally the beta blocker atenolol does/works wonders for me, almost no tachycardic episodes while on it, PVCs are very rare these days, and B/P is very controlled along with cozaar and hydrochlorothiazide 12.5mg. I actually take a high dose of atenolol , I take 100mg daily , though I take it as 25mg x4 times daily, my cardio agrees with the way I take it, it works better for me in divided doses. Luckily I dont suffer any side effects from atenolol, only an occasional nightmare or vivid dreams.

I think the benefits of beta blockers have been well established though not everyone can take them for some they can literally give them back their lives.

[oneil420]

I hate to jump in on someone elses thread but pika if your truly living with that much anxiety you need to get help! I dont care who told you to deal with it or why you took their advice but there are some great doctors and programs out there to help you and im not trying to be a ***^&le but no one can do it for you! i have anxiety issues also but it does get better. this forum was a great start but dont stop here get that second and third opinion **** get a fourth if it helps. NEver stop asking for help if you need it. good luck and keep us informed

***@****

[PikaPika88]

I asked the GP to give me something for anxiety but he sent me to ER.  He said they'll start up from there.  The ER doc warned me "Don't complain anymore, don't go to your GP there and complain your heart!"  

I'm sorry.  I can't get a chance to post any question to the dr.  I'm trying and still keep trying.  If one day I can get that chance, I think I'll very anxious and end up with a heart attack on the spot!!!

Pika.

[jan]

Atenolol gave me back my life, too!  Unfortunately, I can't take much w/o the side of effect of depression, so my EP added verapamil ER.  I only take 6.25 mg of atenolol and found out thru another forum that I am not the only one on such a low dose due to tolerance/side effects.  My EP says it's a legitimate dose.  All I know is that I can't live w/o it!

[pbanders]

I take 75 mg of metoprolol daily to control my BP and reduce peak arterial pressure (I had an ascending aortic aneurysm repaired with a graft in '04). I'm 48 and male. It took me about 6 to 9 months to get used to taking the beta blocker. Initial symptoms were cold hands and feet, vivid dreams, general fatigue, and reduced exercise tolerance.

Today, the only symptom I still have is sleepiness throughout the day, which I counter by being aware of it, and taking a short walk to increase my mental acuity. My exercise tolerance is excellent - I just stuck to a solid aerobic program since '04 and the improvement in my VO2max has brought me back to the same level I was at before I took the beta blocker. I used to race bicycles and I can still ride quite well with other fit riders over distances of 50 miles or so - no racing, though.

Stick with your beta blocker for a while, you can adapt to it. If things don't improve in 6 months or so, work with your doc to modify dosage or the specific beta blocker you're taking.

[pbanders]

One more thing - I went from constant PVC's in early '04 to nearly zero today - and that took about 9 months to happen on the metoprolol, too.

[woodruff]

Pika, you seem to be aware that anxiety is a problem for you, and that's good.  Now, how to get it treated?

The ER is not the place.  A GP would be better, in that such doctors see anxiety a lot.  I think most of them, in fact, would be delighted to see a patient who understood that anxiety was the problem, and was seeking help.

However, the truth is that psychiatrists really know more about the various drugs and therapies that are used to treat anxiety.  They are MDs, and thus have some experience also in discriminating between physical and emotional problems.  Have you ever spoken with a psychiatrist?  If not, I would recommend that you make an appointment with one.  This would at least open up one more way of approaching your problem, and knowledge is a good thing.

[heartygirl]

Metoprolol also works wonders for me, so please don't give up on Beta Blockers just yet..... I take 100 mg. of Metoprolol daily for tachycardia and SVT and I actually love taking it.  My doctor mentioned that maybe down the road he might wean me off of it, I told him NO WAY! I love it and want to take it forever as long as it is working for me.  I keeps my tachycardia under control beautifully and as a result lessens my anxiety.  I wouldn't want to be without it.  Also, like a previous post mentioned, it either lessens my PVC's or makes them so light that they are unnoticable to me, either way as long as I don't know I am having them, it works for me! :)

Now, I will admit that when I first started them I was extremely tired but that only lasted about 1 week.  I do sometimes have vivid dreams - not always bad dreams, just very vivid, but it seems that the longer I take Metoprolol the less the dreams happen.  

My advice- don't give up on BB's just yet.... maybe you just need to switch kinds.  Good luck!

[Heartstrings]

Like Hearty Girl, I too LOVE my beta blockers. It almost seems that I can measure the quality of my life by the period of 'before' BB's and 'after' BB's. Since being on a regular regime of inderal not only have I eliminated my SVT and tachycardia problems, but have become a much more thoughtful, less panic-driven person. From a personal perspective, I believe that in my case, anxiety problems were driven by an overabundance of adrenaline. Maybe for others too.....it's great NOT to have those oh-so-previously common rushes of adrenaline! Best of luck to you.

[rosetoes]

While Beta Blockers work for some, they are definitely not for everyone.  I do have occasional palpitations, but they got worse with the beta blocker.  I took 50 mg XL toprol for almost 6 months and I dreaded everyday that I took them.  I could tell when the extended release was  released into my system.  

Also, I started to stutter and my memory hasn't been the same.  Words that normally comes to me, I had to really work to gather my thoughts.  Never in my life did I experience that and now that I stopped for almost two months, all has come back....no stuttering, memory fine, and no tightness across my head.

One thing that I noticed, recently when I had a rapid heart rate (around 105 bpm from a  75), I took a xanax and within minutes my rate went back to normal.  I don't take xanax daily, only when this happens or I've had a horrible stressful day....I've only have taken 2 within the last 2 months and they are .25mg....the lowest that they make.

My doctor did not want me to get off of the beta blocker and I don't know why.. I feel so much better now than when I was on them.  I have no heart issues other than sinus tach once and a few palpitations that I have been assured that it isnt serious.  All of my heart test came back normal.

If someone has a heart problem and beta blockers solve your problem, by all means you should take them, I would.  But it didn't work for me and they did more harm and caused more anxiety because of the constant palpitations, double beats, nightmares, no energy, etc.

Best wishes to all.

[woodruff]

Yeah, beta blockers can cause vivid or weird dreams.  Toprol did for me.  It wasn't the straw that broke the camel's back, but I wouldn't consider the dreams a plus.

Some months ago, I had a bout of high blood pressure, and my doc prescribed 25mg Toporl.  The drug brought those pressures down, and while that was going on, I felt great--much more relaxed than I had felt in weeks, but once my BPs were back to their old, low level, I had the same problem Rosetoes did:  I couldn't think my way out of a wet paper bag.  In addition, I just felt ill, as if I were three days into the flu or something.  It wasn't good.

[PacMan Fever]

Just thought I'd jump in.  

29 M, bad genes = high BP.  I've been on Toprol XL 50 for about 6 months now along with BenicarHCT (recently switched to LisinoprilHCTZ due to an insurance switch).  I don't know whether or not the Toprol XL makes me tired because I don't sleep all that well to begin with; never have.  I've always had cold feet and hands - Toprol never made it worse.  I also have PACs, and the Toprol has really improved the severity of them.  Before the BB, they'd freeze me and scare the hell out of me.  Now they're more of a, "huh -- that wasn't so bad."  And my BPs been better than 120/80 99% of my measures (was 160/105), even after the switch from the ARB to the ACEI.  

But like any drug, BBs are not for everyone, right?

[jan]

I have had vivid dreams/nightmares as a side effect of more than one medication.  I couldn't tolerate them when I was on amitriptyline aka Elavil.  There was another med, an anti-inflam (Mobic, I believe) that had the same effect.  My sleep is bad enough w/o that!

For those who can't tolerate the bb maybe a calcium channel blocker would help.  Just a thought as I have to take one, because I can only tolerate that lil dose of bb's.

[PikaPika88]

Can you buy ativan at the counter without Dr's script?  Would this drug causes dizzness?

Pika

[woodruff]

Ativan needs a prescription, and it might cause dizziness in some people, for a while.  It is a fairly mild anti-anxiety drug, of the short-acting type.

If you're dealing with chronic anxiety--something that you feel most of the time, every day, for a period of weeks to months--you probably want to discuss a longer-acting drug, like one of the SSRIs, with a psychiatrist.  Trust me:  The hardest thing about seeing a shrink is really just getting your courage up to make the appointment.

[madgrad92]

I agree, Pika. From reading your posts over the lasts few months, you sound really desperate for relief. I've been worried about you a few times after reading your posts, and I really think that an SSRI might be the answer. I got a prescription for Lexapro to help me with my anxiety, and though I haven't started taking it yet - not sure I will, we'll see - I'm glad I have it. You're dealing with TONS of anxiety, but just think about this...in the last 6 months that I've been reading your posts, you could have been LIVING LIFE, girl! Instead, you've been dealing with chronic worry, and that's no good for anyone, especially someone wiht heart issues. Please see someone - find a compassionate psychiatrist who can help you. You deserve it.

[PikaPika88]

Thanks for the reply.  I would ask my GP refer a psychiatrist for me.  See weather do I need a brain to be washed.

Pika.

[desertrat49]

I have been on 50mg of Metoprolol since last August.  No vivid dreams, no cold feet or hands.  Did notice a jump in my cholesterol level, however.  My biggest BEEF with Beta Blockers is how sleepy they make me.  If I sit down to watch TV I almost always doze off no matter what time of the day it is.  MADDENING TO ME.  I was always the one people wanted driving on long trips because I could stay awake for many hours at a time.  Sad to say that last month a friend of mine who was in Orlando on business (I live 2 hours away from Orlando) wanted me to drive down there to see her for the day.  I really wanted to, but, I truly believe I would fall asleep driving a short time. She was a former neighbor in another state and I had not seen her in 8 years.  I was so upset not to see her when she was so close, but, I believe I would be a HAZARD on the road driving for 2 hours.  I am getting use to not seeing the end of TV shows or movies.  I just TEVO them now.  Anyone else keeping a check on their  cholesterol level taking BETAS?  A jump in your count is one of the side effects as well.  I eat almost no cholesterol...I have a aortic root aneurysm so I guess I will have to be on these BETAS for the rest of my life.  Christine

[Flycaster305]

It might be time to discuss with your doc cutting the dosage.  Possibly a smaller dosage would still be a medicinal dosage that would be affective.  I had the same symptoms and cutting the dosage slightly brought back my energy and there was no increase in my angina hits.  Just a thought.  Meds are supposed to help, not hurt quality of life, and it takes thoughtful communication sometimes to achieve this balance.  Best wishes.

[sniggs]

I'm on Toprol 50 mg a day.  I actually have noticed that my dreams are vivid lately.  I usually don't remember them, but lately I've been waking up with a racing pulse and in fear.  Weird dreams I tell ya.  I also get minor ear ringing and lower back pain.  That's about it, though.  I only get like two or three PVCs a day now.  I used to get tons, so it does help with that tremendously.  The side effects are tolerable.  

I upped my dosage for a few weeks to 75mg a day and I started to see things.  I would think I saw shadows behind me, like somebody walking up on me and then I would turn it would be nothing there.  lol  Not scarey, just weird.  I lowered it back to 50mg and I'm fine now.  

A weird drug, but it works.