discontinuing atenolol

[Elen__0__0]

  Hello,
  I just read an earlier message about not discontinuing atenolol abruptly.
  I have breathing trouble and chest pain, the cause of which has yet to be
  diagnosed.  I was put on atenolol when I complained that my heart rate seemed
  to go up when I would stand up (I have "reduced cardiovagal function").  The atenolol helped that.  However, the
  breathing problem and chest pain continue.  Well, I have a new pulmonary
  doctor and he suggested stopping the atenolol.  He said that can sometimes
  cause make breathing worse. Also, he has retested me to see if I have reactive
  airways, which now it seems I do test positive for.  Now I'm taking meds for
  that for a few weeks to see if it helps at all.  I was taking atenolol 50 mg
  once a day.  The pulm. told me to take 1/2 pill for a few days and then stop.
  He told me if I start feeling bad to start taking it again.  I took 1/2 pill
  for 3 days, then stopped. Began to feel aware of the heartbeat again.
  It's faster, too. I guess I was excited about the thought that I'd get rid
  of the atenolol (I always wondered whether I really needed it all all -
  I can endure a fast, pounding heart as long as I know it's not dangerous.
  No one ever suggested it was dangerous.) I'm thinking that without the atenolol,
  maybe the airways meds will have a chance to work better.  But have I perhaps
  discontinued the atenolol too abruptly?  Should I talk to my internal medicine
  doctor about it?  Should I be monitored in any way, now that I'm not taking the
  atenolol?  I've just moved to a new city and have a new round of doctors, with
  whom I am very pleased so far.  I've been trying to get a diagnosis for my
  breathing problem for so long now, and finally I'm getting a truly fresh look,
  starting from scratch.  So, I don't want to ruffle feathers by asking one doctor
  about the other doctor's instructions about the atenolol, unless I truly need to.
  If I do ask, how should I approach it?  You can probably gather that I tend to
  walk on eggshells around my new doctors as my naturally assertive manner has not
  enamored too many of my former doctors to me!!  But if I shouldn't let these
  questions slide and this is important to be following up on, I won't be doing
  anyone a favor by being quiet.  
  In case it's important to know, I also take Norvasc for hypertension 10 mg/day.
  Thank you for any suggestions,
  Ellen
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Dear  Ellen,
Topic Area: Heart Disease
There is no exact science to stopping beta blockers (such as atenolol).  Stopping them abruptly can cause "rebound tachycardia" that is a increase in the heart rate.  For most people this rise in heart rate is not dangerous.  I think that the method your doctor gave you for stopping the medication is fine.  If you want to extend it you could take a quarter table for an additional 3 days.  Don’t worry about asking questions to your doctors - you are the patient and their responsibility is to answer your concerns in the best way they can.  Hope this helps.
Information provided here is for education only.  It is not intended to replace your doctors care.  Only your physician can make specific diagnosis and recommend treatment.  If you would like to be seen at the Cleveland Clinic please call 1-800-CCF-CARE and ask to make an appointment with a cardiologist.