As I commented, maybe in the opening post, Atenolol was more effective, lower dose did more to slow my HR. As time passed and this thread developed I reported I have adjusted to Atenolol and now find the 25 mg twice a day just does the job, as did Metoprolol, taken at the same mg level.
To your question, if you symptoms begin more than 6 hours (typical half life of Anenolo, I believe) than a booster would make sense to me. Atenolol is not a true slow release (once per 24 hours being the base line for that definition) and taking it every 12 hours makes for a more "level" dose in the body. In this thread we/I have discussed how a 1/2 life of medications can build in the body - if that is of concern then one might skip the second dose once a week to "purge the system", if that was done I'd skip the evening dose once a week. As I've discussed I always forget to take one meds a couple of times a month and that is my "purge".
You are on what I consider a very low dose, 12.5 mg, so the side effects should be minimal, taking twice a day should not change you side effect experience, especially if you take one before going to sleep.
As always: Discuss With Your Doctor, neither I nor most of the others who post here are qualified to give medical advice to anyone, we can only share our experiences and personal conclusions.
This is the first time I have read this thread. Found it very interesting. I weaned myself off metroprolol 100 mg twice daily, over a 7 month period because I was so fatigued. I had been taking it for 30 years for high blood pressure. Sadly I was not able to manage with no beta blocker because I was having episodes of very high heart rate - over 140 per minute.
Now I am taking 12.5 mg of atenolol each morning but by evening I find myself short of breath with exertion with heart rate rising. Wondering if I should ask my doctor about increasing to 12.5 twice daily as much as I hate the way these drugs make me feel.
I have not further comment on the Atenolol verses Metoprolol beyond I now have about the same result. Seems my body has adjusted to the Antenolol to a degree that makes its effectiveness about the same as Metoprolol.
On the PVCs, I don't suffer but 10,000 is high to my recollection but not unusual for sufferers. The "normal" range rates must be available on a search for same.
I suffer from trouble mares, not nightmares. These dreams are every time I sleep, even a nap, and are indeed troubling, more depression than fear. This has been going on for years, I can't remember how long. I don't think the beta blocker is the driver, but the BB doesn't help stop them either, of that I am sure.
I was diagnosed with mild obstructive sleep (OSA) apnea and here's the way that diagnosis developed.
First I was troubled by waking up, sometimes from right at the onset of sleep, with the feeling I was suffocating. I talked with my wife (with whom I still sleep after over 55 years of marriage) and she has enough trouble sleeping to no put up with any unusual kicking or snoring on my part. She has complained some, but not often and so there was nothing there to suggest OSA. But, I was concerned enough I purchased a real time (not recording) Oximeter and put it on my night stand. I had a couple of reasons for the purchase, not expensive about $25, one being concerns about apnea the other about my heart rate. The device quickly (maybe 2 or 3 seconds) give a oxygen saturation level and hear rate. In fact one reason I purchased it was the Antenolol - I was concerned about it's affect on my HR being too high - maybe I could reduce the dose level. That didn't "pan out".
My Oxygen saturation level was normal to good: 95% to 98% most of the time, but I found when I woke up with the suffocation sensation clipping on the meter showed a O2 saturation as low as the mid 80s %. I had a scheduled physical exam so I mentioned my experiment with my Primary Care doctor. He prescribed an overnight recording Oximeter test. That was easy, and natural I did it at home, albeit I had to tape a detector on my finger which was wired to a recorder on my night stand. I woke up a couple of times that night (as usual - have to pee more at night it seems) and looked at the recorder, which had a display. I saw low readings there too when accompanied by the suffocation sensation. The results were reported back to my doctor recommending I purchase and use supplemental oxygen - in fact the company tried to get approval form me to send oxygen, my readings were bad enough they said I qualify under Medicare requirements for supplemental O2. I told them to hold on the O2, I'd talk with my doctor first. He prescribed a Sleep study. That got me an appointment with a sleep study center and the Pulmonary specialists - wow, Good news/bad news, the first test were x-ray and physical exams which resulted in a diagnosis that I did NOT have emphysema or other serious lung problems, the bad news (not all that bad) was because I am (now was) Obsess (come on, 250 pounds yes, but 6' 5" + to put it on) and that had reduced my air passage size in my throat. I asked would weight loss help that, the answer was YES, what else could they say. In any case this led to an overnight sleep study at the sleep center in my local hospital. I did a near normal sleep and the results confirmed "mild" OSA. It also showed I still got almost the normal required REM sleep (all the dreaming I think) to get rest, and that I can confirm as I did not suffer from day-time sleep problems. Hey, where am I going? Hope I haven't lost the question, or made too may typos to be understood. The doctor suggested I could benefit from a CPAP sleeping aid, and I said how about losing weight? He said it was worth a try. I lost 25 pounds and I no longer wake up feeling like I am suffocating. I need to confirm with another overnight recording oximeter test..here's my bottom line for you: do a recording overnight O2 test at home, and so it until you can do one with what you consider an overnight sleep.
As for the bad dreams, try reading up on Lucid Dreaming, I like the work by Dr. Stephen LaBerge at Stanford. I checked his book on the subject out of the library and listened to the audio CD many times. It didn't solve my problem, but I gave/give it only a cursory try as my dreams and not full of terror. The book also covers night terror I think. The point is to try to engage you conscious mind in your dreams, take control My solution to nightmares was similar, and I came up with it at the age of 12 or there about where I trained my mind to wake myself up when the terror scene was just starting to develop... it worked, I have a nightmare that I remember no more that a couple of times a year, it that often.
Good luck, I didn't proof read, already put too much time in. My typo rate is troubling, but most are easy to figure out.
Hi Jerry. I have had pvc's for many yrs. but as I get older they seem to be getting worse. Upon a prep for a colonoscopy they really got bad the day of the procedure, but the doctor decided to go ahead anyway and I guess because of pvcs he did not give me pain med. or anything else. Had a holter monitor (24 Hr.) which showed 10,000 pvcs in that 1 day period, which is according to my cardiologist is just short of max. He changed my med. from 25 mg. of atenonol twice a day to 25 mg. of Metoprolol twice a day. Have noticed an increase in heart rate when I wake up to about 80-85 and with Atenonol mid 60's.
I believe I also have sleep apnea but after going in for a sleep study I could not get to sleep so don't know what to do. I to get nightmares, headaches and shortness of breath. Do you have any thoughts on this.
Yep, I think we've had the discussion of the build up of medication that has an extended half live period (I'll say at least a large percentage of the period between taking doses) such as 6 hrs for Atenolol.
I am unable to write the series for this accumulation, perhaps it has a "closed form" so one can easily calculate the maximum of the sum. Unable to do that and to make things simple I offer the follow brief demonstration that the limit over extended periods of time is the doubling of the dose... never gets there, approaches asymptotically
I'll use a dose every 12 hours and a half life of 12 hours (6 hours half live would grow more slowly). I will normalize to 1 dose, not 25 mg, and calculate for 10 periods (5 days):
Dose 1 (1)
Dose 2 (1.5)
Dose 3 (1.75)
Dose 4 (1.87..)
Dose 5 (1.94..)
Dose 6 (1.97..)
Dose 7 (1.985..)
Dose 8 (1.992..)
Dose 9 (1.996..)
Dose 10 ( 1.998..)
So in 5 days the patient starts each period with approximately twice the level of one dose taken in isolation. Of course a 6 hour half-life grows more slowly, but I'll suggest (not doing the arithmetic) the 6 hour half-life will hit the double level in less than a month.
As we have also discussed, I manage to forget to take one of my 25 mg doses at least once a month. That said I have found my body has adjusted to Atenolol sufficiently that I no longer can directly associate taking a does with feeling dizzy or very low HR. Checking when just lying in bed, after waking from a sleep that usually is fraught with dreams I usually find a HR in the 60s, some upper 50s and some lower 70s. When I first started Antenolol I had some dizzy periods and low HR and BP... both of these are near normal now, but the low exercise tolerance remains, but then my atrium chambers are non functional.
Atenolol's plasma half life is approximately 6 hours. So in 6 hours, half the original dose remains in your blood, in 12 hours, in halves again, but you take another 25mg. If you work it out on paper, your see this roller coaster effect, hills and valleys if you will, but every day the amount of Alenolol remaining in your blood increases slightly. Compound this over days, and weeks, and slowly but surely you begin to feel like a zombie. It come on imperceptibly slow, but it happens. Personally, I take 75mg daily of Metoprolol. It too builds slowly. When I see my BP around 105/60, and I feel that it's taking too long for my heart to get up to speed when I work out, I stop a dose for a day, pehaps take half my normal dose the second day, then I go back on my maintenance dose. When you stop, the drug is slashed in half after 6 hours, then is slashed in half again in 12 hours, etc. At one time before my ablation I was on 200mg of Metoprolol for about a month and a half. The build-up was so great that I couldn't walk up the driveway to get the mail without that cinderblock on the chest feeling. I was a former athelete, so I knew somethng was wrong. I called the physician who had me stop for a couple of days, then start again on a 100mg dose. The results were remarkable. I guess if you knew the actual plasma level, you could correct it with more precision, but this rough method works for me and quickly puts me back to feeling like myself again.. I often wonder if physicians take this buildup into consideration when prescribing larger quantities of a partiucular drug.