so disappointed: beta blockers

[LynnSB]

I've been taking metoprolol for a little over a month for very brief ( seconds) of PSVT, inappropriate sinus tach and lots of PACs and a few PVCs (documented on event monitor). I started out with 25mg. twice a day.. then half of that. I was and am so exhausted i can't believe it. I'm not talking tired -- I'm talking about it being a tremendous effort to do anything. I also feel slightly breathless and i'm still having palps. I talked to my doctor finally and he said just take 1/4 a 50 mg. pill once a day to see if i can tolerate that. I did that yesterday. i woke up still light headed, weak and miserable.
I just had the holter less than one month ago and had blood work done 2 weeks ago and don't seem to have any serious health problems. Questions:

1. Could this horrible fatigue REALLY be from the small amount of beta blockers?(I do have a history of hypersensitivity and actual allergies to a host of meds.. I don't drink because half a glass of wine and i'm sleepy).
2. If so, when can I expect to feel better if I quit taking the beta blockers all together? my doc says i have nothing life threatening. He won't refer me to an EP because there's so much data on my heart and nothing is sustained or dangerous. The beta blockers are for symptoms only and he says i don't need to take them if they don't make me feel better. I was finally exercising a bit and now i'm too pooped to even try.
3. If I quit cold turkey is there any danger?
4. how can these drugs make me feel so bad? BPisn't that low -- 98/55 sitting, heart rate from 64 to 78. Standing 110/75, heart 80-100. THANKS

[Cleveland Clinic]

LynnSB thanks for the post,

Beta-Blockers are a group of medications that block the effects of catecholamines(hormones that give you pep like adrenaline) in the bloodstream. In many cases it is the adverse effects of higher levels of these hormones that prescribing beta blockers help prevent. For example blocking these hormones can decrease the work on the heart after a heart attack.

Unfortunately, in some people beta-blockers can lead to fatige and mental slowing.  Sometimes, there are differences between agents, where a different beta-blocker will not have the same mental/fatiging effects.  What you are experiencing is not a true allergy, but an adverse effect of the medication. While your fatigue may be related, you should make sure your physican has looked for other causes of excessive fatigue like thyroid disease.

What you really need to determine is whether you need the medication at all. If you are truly asymptomatic or just have occasional palpitaions that are not debilitating then the answer is probably no.

There is no good electrophysiologic answer for pacs, pvcs that cause palpitations ther then trying medications like beta blockers. If you are having long runs of PSVT that are causing your symptoms then further evaluation would be in order. This would be determined by holter or event monitoring.

Quitting cold turkey is really only an issue for people at risk of severe complications from taking their beta blockers like after a heart attack or people with blockages in their arteries.  On the dose your on there is no risk.

Again the effects are not from BP or heart rate effects but more from the effects on the hormones in the body.

I hope this helps.

[Dr. Erik]

It's possible that with continued use of the Metoprolol the fatigue will subside or you may want to try a different beta blocker. Or you may try a calcium channel blocker. Good luck.

[LynnSB]

I kept HOPING this would get better but it's been over a month. For some reason on Monday, it just got so much worse I thought I was going to collapse... I can't believe it's not better after taking such a tiny dose the last couple of days. It's really scary to feel so tired.

[goodluckbear]

I've been taking metroprolol for over 3 years. For me, the fatigue has never gone away. My heart surgeon recently told me that "Toprol" (brand name) "will take the wind out of your sails".  A book that I have on the topic of Chronic Fatigue states that Toprol creates all the symptoms of chronic fatigue. I take 100 mg a day and have a great struggle with low energy. Some days I just can't get off the couch.

[LynnSB]

I have had the worst few hours ---- rapid runs of fast beats and irregular beats and feeling momentarily weak and horrible.. almost went to the ER but I figured they would pull up my records and see i just had an event monitor for a month less than 3 weeks ago and label me neurotic if the arrhythmias aren't going on in the er. I'm so scared.

I wonder if cutting back on the beta blocker dose could do this to someone very sensitive to the stuff.. i just don't know what to do anymore. I can hardly go on.. i tell myself the event monitor caught lots of stuff and none of it was life threatening so the odds that something malignant has developed is very small to nil.. but how does one decided when it IS appropriate to go to the ER with palpitations?

I'm so confused. And scared. and fed up.

[mis123]

I was taking 25 mg of toprol for a year for Fast Heart Rate -
Pat and Av nodal re entry tachy.  I had very vivid nightmares
and was extremely tired.  During this time my heart rate never
really was controlled with the drug.  My doctor changed me to
25 mg of Atenenol.  It's another beta blocker.  The fatigue
isn't as bad and it controls my heart rate better.  Not completely
but better.  Call your doctor and tell him you want to switch
to another beta blocker.  I tried the calium channel blocker but
had a constant headache and that didn't control my heart rate either.  I am sure since you already were prescibed a beta blocker
you probably just call the office and tell them you want to
change to another with out any problems.  All drugs work
differently for everyone.  I'm still tired by not nearly like I
was on Toprol.

[Cleveland Clinic]

Lynn, If you had an event monitor and experienced the symptoms then it would be documented what your heart what doing at the time.

You should ask specifically what the cause was and perhaps seek another opinion to confirm your doctors answers to allay your fears.

[LynnSB]

I'm not posting my doc's namee on this board  but you'd know it -- nationally known and editor of THE medical textbook on the heart ( hint) so I'm sure he knows his stuff.. and he said my holter showed non-sustained, brief runs of PSVT ( 4 to 11 beats), many, many PACs, rare PVCs, and tachycardia when I was just moving around a bit.. could be due to deconditioning. My internist agrees with the cardiologist .

Neither will refer to an EP because they are both so sure, now especially, that I have nothing life threatening, nothing dangerous.  all I know is, it can NOT be normal to go for hour after hour after hour with my heart beating irregularly. I am so frigging depressed.

Oh, well. Thanks so much for this great board and for your time.

[Anjakarena]

Hi Lynn,

I can totally understand what you are going through. My doctor put me on Metoprolol 25 mg for PVC's during a stressful recent move. After taking it for about 5 weeks, all over sudden I started to get shaky, felt really weak and nauseated. All I could do was just hold on to the chair I felt so bad. I also kept having this feeling like I couldn't breathe and was freezing all the time.
The doctor tapered me down to 12.5mg for 3 days and then I stopped taking the medication.
I am really glad I stopped, I feel so much better. Yeah my PVC's are back and now I am just going to take Magnesium and try to relax.
I am so sorry you are going through this, I am 34F and have had PVC's since I was 18 and they still drive me crazy.
God bless,
Anja

[jnj]

Hi All,

I will be 35 in Nov this year. When I was 27, I use to have Systolic Hypertention, 150/80+, at one time when I was very at work back then 170/90, only once, 170/90

The Company Doc's were so eger to put me on tablets, I ended up taking Coversil a French drug, quite expensive where I come from, that only brought my bp to 140/90 period.

I was not happy with that, so I changed my life style, diet,spliments light excercise and brought my bp down to 130/80 without any drug, and I felt much better also, like my intrest in girls came back. So when I left that company, I had no choice but to stop that Coversil, and since my b/p was 130/80, I just stopped. I think I took it for a year only


Now I am 34, married with one kid. What I had back then when I was 27 has somehow resurfaced after taking a four year break.
I don't know why, I know how to handel stress, my diet better now.

I guess being married with one kid and all the finance matters, had somehow got into my system, even my Mind and handel all this but my body cannot I guess.

Now I have pulpitation so bad, like a Concord plane ready to take off, or flying at the speed of sound, been to ER once

Just two days back, I was washing my car, just a light and quick wash, not a full wash. I bend down for less then a minute and as I lifted my head up, everything was spinning, that night I could not eat, did not eat dinner, could not sleep only until 1:30am
My b/p was 130/80, but the pulpitaion was bad. The pulpitation makes everything bad like head spining, going to colapse anytime

Done ECG twice now, all OK, blood test all fine, only colestrol is a border line case. Sugar 3.3mlol when fasting is that OK?, anf 5.5 mlol after food.

I am on Nifedpine 10mg once a day, should I take something else?

The funny thing the other day I eat Star Fruit before going to bed, I spelt well that night, meaning pulpitation came down, and my b/p came down together, felt so good. Now I am going to buy more of that and try.

The Doc has given me Valume or Zanax I think to bring down the Pulp, but I have not taken that yet.

All of the time I feel tired and like walking on air now!

Thank you All!

God Bless!
Joseph

[Linda123]

I see my own experiences in so many of your comments - I decided in the end to take the plunge and have an EP study which revealed I had scar tissue in the right atrium.  I see a cardiologist later this month to decide whether or not to have an ablation in that area.  It is thought an ablation may rid me of some of my distressing palpitations but not all of them.
Is it good that I know what is wrong with me?  Yes and No.  Yes that I know I'm not crazy (and so do doctors)and that I do know what is wrong, but no in that my hopes that perhaps my heart was just over sensitive, or that I ate too big a breakfast, or drank alcohol, or got up on the right hand side of the bed instead of the left and only twirled around 3 times instead of 4, was the cause were mistaken.  I now know that there is something definitely wrong with my heart and that makes me more anxious.  I think we all cling to the hope that there is some reason for our palpitations - but my own feeling is that many things are triggers but not the cause.
I wanted to find out what was wrong because drugs didn't help me and I wanted to know if an ablation would and it turns out that it might.
I don't know what to advise people to do but when life becomes intolerable with palpitations as mine has then I feel you've just got to try something.
Best wishes to all, Linda

[cyn123]

lynn,  You sound like i do on most days.  I have pvcs and pacs and   had svt but they were fixed with ablation   as far as my pvc and pac my intern my ep doc and my cardio all said they are not harmful and i could go on beta blockers.  I choose not to because i am one of those people that will get every side effect  even if it is only in my head.  I know the fear that you feel and i feel for you.  I think most of us are the same and you really cant expain it until you have it.  I try to not focus on them so much and that makes it better.  But as you see iam on here and reading about all of these people going through the same as us.   I wish you luck and i hope you learn to live with them, because it seems like fighting them just makes us worse.  Take care.  Cynthia

[John Morales]

My Name is John and IM 49, I can really relate to all of you.  I am a verteram of 6 EP Ablation procedures and can tell you I am worse off today that I have ever been, knowing what I know I would have stopped after 4 but like many I was searching for a cure and remedy I was told was possible.

For me this may not be possible. But  right now I need to find a way to get some way of normal life. Like you I have daily episodes of Afib with PAC/PVC and an elevated HR in the 100s right now my rate for the past 3 days has been 100-125...

I wonder sometimes if its Ok to have a HR that's 100-120 constantly and if anyone can answer this I'd appreciate it as I get anxious every time it starts to pound in my chest.

The Dr. say it won't kill me but they are not feeling what we are feeling I think if they did maybe they would feel differently. Im on 25mg of Lopressor which I tale 3 times a day 8/ 3/ 8/ it was helping I was supposed to take 200 Amiodarone once a day but started to feel better and decided not to. Guess that's me playing Dr. I took that before about 4 years ago but everyone tells me it so toxic I shouldn't but if it helps is it worth the risk..

Hay I risked 6 ablations anyway if anyone with similar experiences wants to communicate and talk PLMK my e-amil is ***@****

Thougth I have asked questions on here it is difficult getting on to do so.....

thanks
John

[EricaM.]

I am just so terribly depressed and scared that I had to post something now- while I am waiting to ask the doc a question.  (Does anyone know when you can post a question on the east coast?)  I am a 26 year old female in (fairly) good condition (used to be a dancer with a semi-professional ballet company) and I have had PVC's since I was about 16- I had a holter then and they said that I wasn't having very many and that it was nothing to worry about.  Then, about 4 months ago- I had an "episode" of a faster-than-normal heartrate (it was right around 80bpm at rest, where normally my resting rate is in the lower 50's) and I had a terrible time sleeping- partly because of worry- partly because of the fast rate.  I went to the cardiologist, who did a holter and an echo.  He said that the echo was fine and that the holter showed that I had "more skipped beats than normal" 4-5 an hour and it showed 2 PVC's.  This was also after about 4 days of little to no sleep.  When I went back to see him, the symptoms had all but gone away completely.  He said to come back-- if anything happened.  Well, two days ago- I woke up and my heart was beating really, really fast-- maybe 180-200bpm.  After about 10 minutes, it subsided.  I went to the doctor- who did an EKG- which was normal.  He told me he wanted to do an event monitor- but, I can't get it until Monday or Tuesday.  This morning it happened again for about 15 minutes, then subsided- but my resting rate today and yesterday has been slightly high.  I am just so frustrated that I have to keep going through this, not knowing if it is life threatening.  I have to mention here that my father has an arrhythmia and is on meds for both that and high blood pressure.  My blood pressure as far as I know has been normal (slightly high in the doc's office- because I am always nervous).  I just had to post this to make myself feel a little better.  Reading all of the other posts on here helps so much.  Just to know that I am not alone.  Sorry, this was a long one!

Erica

[Momto3]

Hi Erica!  Sorry to hear you are having a lousy time with your heart rate today.  Sometimes it does help to be among friends (your fellow arrythmia buddies) so feel free to post.  There's usually someone around to talk to...As to your question about when to ask a question on the forum.  I am in Ohio and have had luck around 8:45-9:00 a.m.  I think the event monitor sounds like a great idea...That way, when the episodes occur you can push the button and transmit the heart's activity right afterward.  Hope you are feeling better.

[LynnSB]

The event monitor will hopefully help the doctor pinpoint what's wrong. Of course, this is just a guess, but it sure sounds a lot like it might be  PSVT.. if so, don't worry, it's almost never dangerous!!

Here are some links to some info:
http://home.earthlink.net/~avdoc/infocntr/htrhythm/hrsvt.htm
and
http://www.geocities.com/Wellesley/Garden/8988/heartrhythmindex.html
and
http://www.midatlanticcardio.com/html/termshtml/paroxysmal.html

I used to have episodes that lasted from minutes to an hour.. now i just have episodes that last seconds.. but they still scae the you-know-what-out of me. I'm still having a horrible, horrible time with bursts of fast beats, skipped beats, " dropped" beats, you name it. It's miserable. I hope your heart  problem is better soon!

[EricaM.]

Thanks, you guys are great.  I feel a little less tense now, and who knows...maybe I will even get some sleep!  You have helped me so much- maybe soon I will be able to return the favor!  I will let you know what happens.  And you guys hang in there too.  The rhythm of our lives...

[charisma]

This is the first time I have read of anyone else taking Metoprolol.  I was put on it right after I had my first episodes of SVT back in March of this year.  i was on it for about 3 weeks and it was awful!!  I felt like I had bricks on my feet and my blood pressure was extremely low so I'd just about pass out after climbing the stairs.  I dreaded a life on these drugs!  My doc decided to change to Inderal-la (long acting). I take 80mg at night and I am like a new person!!  I still have one bout of fatigue everyday in the mid afternoon.  I feel really tired and can't keep my eyes open.  It only lasts for about 30 minutes, sort of a mandatory rest period now, then it just passes and I am fine for the rest of the day.  The fatigue may be fixed by taking the drug at a different time of the day, I will find out this week at my next appt.  So ask your doc about Inderal-la...it improved my life immensely...

[wingtip]

I was on Metatropal 2 years ago and felt tired, so my doctor switched me to a calcium channel blocker, and I felt better right away.  I started to run marathons and after the forth last October, the doctor decided my heart rate was too slow so he put me back on a beta blocker the didn't kick in until the heart rate got high.  I couldn't breath after ten steps, the fatigue was horrible, but the doctor figured cutting back my running wasn't a bad thing, so he left me on it.  I still can't run a 10k, much less a marathon, and I think I'm going to push it at my next appointment to get off the beta blockers, I hate 'em

[Shannan3]

I am a 40 year old female diagnosed with cardiomyopathy almost a year ago.  I went for a follow up yesterday and my EF has gone from 37% to 54% which is great.  However, I am on metropolol 12.5 mg 2times a day and 25 mg cozaar.  My quality of life is really cruddy because I have NO energy.  My cardiologist seems to think that because my EF is now normal that all is well.  She blames my fatigue on the fact that I have triplet 7 year old boys and that there is no way such a low dose of beta blockers could cause the fatigue.  I had more energy when my EF was 37 and I was on no drugs.  She really just blew off my concerns and I am wondering how I should handle this.  I am glad to know that I am not the only person out that that is having trouble adjusting to these drugs.  My cardiologist made me feel as is this was all in my head, not to mention just a minor inconvenience.  Thanks for letting me vent!

Shannan

[karie]

I am 35 and have been suffering with pvc's,pac's since 27. Do you have heart  murmurs , mvp, syncope as well ?
I exercise daily and follow all the Heart guidelines. What makes our electrical impulses more sensitive and able to feel the skips, pauses ?
Do you have family members who have passed from heart disease ?
Have considered a trial run of inderal , solatol at the doctors to see if in fact on a as is basis it could stop them when they are extreme.
thanks

[Momto3]

Shannan, I was also diagnosed with cardiomyopathy almost a year ago. Mine has been attributed to a substantial number of pvc's. In December/January, my EF was about 40...After 3 months on Tambacor it was up to about 45% (10% is considered a great jump). I understand that your EF is going up, but that does not explain your lack of energy.  I truly believe that even a small dose of beta blockers can cause fatigue in some patients. When I first started on Inderal, I was so exhausted...I was on/off for many years. The short story is....just had an ablation and so far, so good. I was at a point where the doctor said it was meds for life or try the ablation.  Of course, children can wear you out, but it does not seem fair to push your fatigue off so quickly.  Hey, the triplets have been in your life for 7 years already!! If you are not satisfied, I would suggest talking with another doctor. Do you have anyone that could personally recommend someone to you? For what it's worth, it makes a world of differene when you have a doctor who understands you, regardless of the test results, etc. Are you in the Cleveland area? Connie