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Avatar universal

Weaning off of beta blockers

Long time no post!  I needed someone to help me out with this issue I am having.  If you read the anxiety post I am sorry because I posted the same thing there.

I have been weaning off of my beta blockers for a LONG time now.  My cardio's office has a new PA and she told me the amount I was taking was really nothing at all (12.5 mg every other day) and I could just stop if I wanted to.  I was too nervous to do that so I am now on 6.25 every other day.  I have been feeling panicky lately.  The first week I started it I wasn't bothered, but lately I am having like small panic attacks.  Today it seems really bad!  I feel like I could just fall over any second.  I keep telling myself that it is ALL IN MY HEAD, but I am just getting a little nervous.  My heart palps haven't been that bad, but I can feel myself on the verge of a full blown attack and I haven't had one of those in over a year.  Am I crazy?
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612551 tn?1450022175
COMMUNITY LEADER
I agree with the "new PA", 12.5 mg to 0.0 mg should not have any noticeable side effects.
But, people are different, my experience may not apply to many... I have gone from 200 mg a day down to 100 mg and then down to 50 mg in only a few days.  I have also gone from 50 mg to 0 mg without any problems.  I'm on 50 mg right now.

Try to put it out of your mind, that's what my experience suggests.
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Avatar universal
Sorry, I am beginning my beta blocker medication on Monday.  Why are people eager to reduce or stop their beta blocker medication?  Do they cause bothersome side effects?
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Avatar universal
I have been on the beta blocker for almost 2 years now because of heart palps.  And all the doctors tell me the cause of the palps are anxiety so......I  just don't want to continue taking meds for the rest of my life if at all possible.

But now It seems that my blood pressure wants to rise on me.  I have NEVER had pressure problems until all this anxiety started-go figure.  But that is another post :-)

Well thanks Jerry.  I really do think it is in my mind, but I have to come here from time to time to get reasurrence.  I am to afriad (I depend on them in a way) to cut them out completely.  But I know the amount I am taking AND it being every other day probabl isn't doing much at all.  It's almost like a babysitter.
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177337 tn?1310059899
My doctor also told me I was on a dose similiar to a homopathic dose it is so low.  I don't know what beta blocker you are on, but I take 6.5mg of atenelol every evening.  He told me that wouldn't hurt me at all if I wanted to take it the rest of my life.  He also told me if I wanted to stop I could just stop.  I'm sure all beta blockers are different but if you are taking atenelol you are not feeling withdrawl from it.  That dose is just too small.
Maybe as you already know from your comment above that you are feeling anxiety because that pill was kind of like a "security blanket" in keeping your ectopics at bay.  
It is amazing how fast our anxiety hormones can resensitize our body isn't it!  I think we are just some of the lucky people that have excessive amounts of adrenaline in our bodies and need something to help keep it quiet.
Be well
Frenchie
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212059 tn?1292938529
Frenchie,

Does the 6.5mg of atenelol help with your PVC's?

Lori
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177337 tn?1310059899
Hi Lori~
Yes it worked really well for me for 20 years.  I just bumped it up to 1/2 of the pill due to peri menapause and hormones.
Jodie  
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612551 tn?1450022175
COMMUNITY LEADER
As with most (all?) medications "less is better", none is best.  That's the way I look at it.

As far as beta blockers are concerned, yes they do have side effects ranging from decreased sexual capacity in males to dizziness/light-headed ... of course how much depends on the individual and the dose.  I have few if any problems with 50 mg of Toprol SR (or Metoprolol ER), but 100 mg or more starts to give me problems.
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Avatar universal
I am on 6.25 of metoprolol-I know I didn't spell that right- every OTHER day.  Yep, it is a security blanket.  I especially feel like I need it when my hormones are acting up.  Ugh, what's a girl to do.  I hope to be off of them perhaps by the spring.

I am beginning an exercise routine also.  So that has me a bit edgy.  My thoughts are constantly "what if's."  I am trying though.  One foot in front of the other, day by day.  

Thanks for all of your responses!
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267401 tn?1251852496
Give yourself permission to start nice and slow.  Stretch, do a slow ramp up to your activity, and a nice, long cool-down period.  Several years ago my wife bought me a Polar heart monitor - the kind that straps around your chest and transmits to a watch.  I found that to be really useful and comforting when exercising - you can manage exactly how much effort you put out by watching your heart rate.

For me on the treadmill, once I'm at about 30 minutes of going the same speed and same HR, my heart rate will ever so slowly start to climb - I let it go up to a certain point, then start decreasing the speed just a tad to bring the HR back into the range I want.  It really affords you lots of control over your heart rate which lends a lot to your peace of mind.

You can find them online and at probably any sporting goods store in your area.

Just an idea to help get you started.  

You can do it.
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Avatar universal
Thanks so much for the encouragement.  I am currently walking/using the eliptical and I really do enjoy it.  My heart rate usually gets up to 133 or so and I am fine.  What I am really shooting towards is starting to run again.  I know that is going to take a while, but at least I am thinking about it.  There was a time when I wouldn't even walk around my house fast because I was so fearful.  Boy what these palps can do to a persons mind!
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1102682 tn?1260838475
Or in my case Metopolol.
I am weaning myself off this beta blocker very carefully. I believe it has caused me to have fuzzy thoughts, some dizziness, and in general a less than optimal life.
I had the flu about 3 weeks ago and didn't take it for 2 days. During the second day I felt better than I had in years. I had mentioned to my counselor that I seemed to have a low grade depression all the time now when I used to only have seasonal affective disorder which I successfully treated with Vitamin D3 (from Wellness Pharmacy in Alabama).

I was on 25 mg a day but have cut the pill one time so that I'm now taking 3/4 of the 25 mg pill so 18.75 mg a day.The first week or so I tried to go from 25 to 12.5 too fast. I had headaches, racing heart and increased anxiety.I couldn't be around stree as it made my heart beat uncomfortably. When I went down slower, my heart adjusted. I've been doing this dose for 3 weeks, I'll give it one more week then will cut to 12.5, I plan to give that l month then go down to 6.25 for 1 month then off.

I believe the doctors put me on it because one doctor made a mistake in my hospital record saying I had a history of light blood pressure. I have a history of low blood pressure. My heart does have irregular beats when I'm stressed and I do have angina so according to my Nurse Practioner the doctors had good reasons for putting me on this meds. However in general I don't have a lot of anxiety and keep my stress pretty low. My angina is in control with fish oil and my blood pressure remains low. I believe in natural solutions to healh problems whenever possible and as few pharmacological meds as possible. I'd rather have fewer days but better days than more days in the fog I lived in.
My question is - what side effects of Toprol have you experienced and is anyone else going off that beta blocker
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Avatar universal
Hi! I had a post not to long ago on trying to wean off Atenolol, a beta blocker. I was on 3/4 of pill for PSVT. I am perimenopausal , am hypothyroid and think this all came on due to hormones changing... have always been extremely healthy all my life.
   I really liked how you stayed on your reduced dose for a month, sounds like great advice to me. I asked my cardiologist last checkup if I could try and reduce dose or go off. I HATE the side effects which are dizziness, ( I have always had low BP prior to taking this and now its even lower), also fatigue, and heaviness in chest. Dr said to reduce doseage 1/4 pill a week... well no way- did not work for me. I had shakiness, anxiety, heart racing, ect... felt terrible. I am now down to last 1/4 pill and I think I will stay with that dose for some time. I feel SO much better on the lower dose, more human again!!  This is a very hard med to get off ....so you are not alone.( my naturopath dr said it is like getting off cocaine- no experience in that area and never will )
Maybe to some this a small dose, but your body has become used to it so it needs time to adjust.
By the way I tried topral before taking atenolol. I absolutely hated it, headaches and depression... which I never have/had. Dr. switched me to atenolol saying it has lots less side effects which was true for me. Maybe if you feel you need a beta blocker try a newer one which he says has less side effects than the older generation.
I wish you best of luck. Let me know how you progress.
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Avatar universal
Recent studies suggest that for some people tapering off BBs can be much more difficult than doctors may be aware of. I am hoping an ablation I had earlier this year was successful and if it indeed was, I am planning to begin tapering off a daily dose of 25mg Toprol XL (extended release Metoprolol) in about January and have been looking into this at some depth since when I was instructed to stop my BBs cold turkey for my recent ablation, the first few days seemed fine, but within about 3 days I was having significant symptoms. I had an opportunity to speak at length to a pharmacist who specializes in cardio meds and she told me that there is pretty strong evidence that as the body "adjusts" to some BBs, it actually produces MORE beta receptor sites so that when you begin the taper, your body may be far more sensitive to the naturally produced beta chemicals your body makes.

The research I looked at and the information I have seen suggests the following may make tapering more difficult -- but certainly NOT impossible: 1.) The BB crosses the blood brain barrier (as in Propanolol) which means it's affecting not only the heart and other organs, but also the chemicals in the brain. These BBs are often helpful not only for heart and BP issues, but may occasionally be prescribed for anxiety, migraines and repetitive thoughts and may cause an increase in these even if you were taking them only for cardiac or BP symptoms. 2.) The patient has been on very high doses or on BBs for a long time as the body has learned to "operate" with this drug and must re-learn to work well and efficiently without it. 3.) Patients who take certain drugs that may act "synergistically" with BBs in some way -- these are suggested to be such meds as benzodiazepines and some other tranquilizers, some anti-depressants and some sleeping pills. It's not that these drugs act in exactly the same way, but that they enhance the action of each other. The medical community is somewhat split on the issue of what combining BBs with these other classes of drugs may mean to efficacy, dose and to withdrawal from either benzos, antidepressants or BBs as it seems in some cases taking one in place of the other may actually help the patient get off one or other of the drugs -- this is especially true of patients going through w/d of benzos who find BBs may lessen their symptoms. 4.) Quitting cold turkey or trying to go off too fast. Many docs recommend the half divided by half divided by half at weekly points method which seems to work for many, but for those having a harder time a reduction of 10% every week or two with holding points at "stabilizing doses" may be a more workable plan.

The point is, all these types of drugs can result difficult w/d. On the other hand, some people get right off the drugs and never have a problem with w/d at all, so as always, individual anatomy and physiology is the crucial factor here. My first thought is that you may not be "too sensitive" or "imagining" this, but to listen to your body and look for alternatives, like good diet, exercise, meditation and support groups to help you finally beat those BB blues. BBs can be lifesaving drugs for many, many people, but they can also have unpleasant side effects, develop tolerance levels and be difficult to taper off of. Good luck and let us know how it's going -- I fear/hope I may be in the same place as you in a few weeks!
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Avatar universal
Thanks for the great post and all the info.  I read the same thing concerning the heart and beta blocker receptor sites which makes sense to me.
  I have to say before I was on a beta blocker  my FORMER dr put me on an antidepressant thinking it was all anxiety. I was on for 6 months til I found new PCP and did testing and found SVT. I slowly decreased my antidepressant dose til I was totally off and it was by far much easier than weaning off a beta blocker.
Good  luck to all who try and get off... slow and sure wins the race!!
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1102682 tn?1260838475
I've only read your response so far so I want to comment to you first. Thanks for the feedback. I'm brand new here and really feel the support and am glad what I'm sharing may help others.  
Going off is such an individual choice. My doctors are watching me but didn't want me to go off but like you I am beginning to feel like myself again after all those years in a fog. If I hadn't missed my dose for 2 days when I had the flu I wouldn't have known what I was missing...I was missing me.!
I think you must take more than a week to go down 1/4 pill by 1/4 pill. My first week was not fun as I mentioned above. My Advice is never cut the time released pill twice. Only one cut and the integrity of the time release is in tact. I cut twice because I wasn't thinking straight. I cut the 25 mg in 1/2 then the 1/2 in 1/2 thinking to get 3/4 pill by taking 1/2 plus 1/4.No, no, no! I got hit hard with double time release for the first few days. It didn't take me long - 2 days - to call my pharmacist and validate my idea that I had goofed big time. Just a heads up.
I wrote down the side effects of Topril that affected me. These were subtle for me that's why I stayed on it do long...also I wasn't in the best shape to defend myself when I was put on it. I had just had my first angina attack and then had a botched arm angioplasty and a brachial artery surgery that has left me with permanent numbness in my left hand (nerve damage during surgery)and 80% blockage due to scar tissue in the main artery taking blood to my hand.Here are the symptoms of metoprolol that had hold of me.lightheaded, swelling of ankles and feet, depression, cold hands and feet, tired, anxiety and nervousness. fuzzy thinking, forgetfulness, fatigue, impaired thinking or reactions.
I am hypothyroid too and did you know Topril and it's generic messed  with your thyroid. I have had awful adult acne and my hair has been falling out. I'm going to see if that stops. In spite of my obesity, I've been healthy all my life too. Here are other interactions, it interacts with diabetic meds, asthma, water pills, and more. Look this up for those of you who are thinking about weaning off. I asked my doctors questions they didn't answer. Get someone who will take the time to answer you.
   You mentioned you had heaviness in chest. I hope that isn't angina. "Dr said to reduce dosage 1/4 pill a week... well no way- did not work for me. I had shakiness, anxiety, heart racing, ect... felt terrible." Know how you feel.  I am glad 1/4 is working for you. I don't know what I'll do when I get there. I think I'll keep on going but who knows. "my naturopath dr said it is like getting off cocaine"- I do have experience with this and there is no comparison. Totally different drugs and experiences on and off.
"your body has become used to it so it needs time to adjust. " I really really believe that and I'm giving my body as much time as it needs although I'm shooting for 1/4 dose down each month. Faster than that would be way to fast for my body But I have to say this. Even with the small change I've made I'm happier, my feet and hands are warmer, I have fewer memory loss experiences, I'm sharper thinking.My feet and face aren't swelling as often, I've lost 9 lbs, which may have been water weight, I am definitely less depressed. I am anxious but I've always had low grade anxiety and my family is going through some really rough stuff right now.Forgetfulness is getting better. I used to call my sister to tell her something and had to call back because I totally forgot.
That's my good news. After 3 weeks my heart isn't racing. It stopped or slowed down the first week but I had to keep myself calm and out of stressful situations.
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1102682 tn?1260838475
Now I've read your comment and just want to thank you so much for your research and helpful advice. A friend of mine and I are what I can "body sensitive" which means we re more aware of small changes in our bodies. I think that's why I'm going so slow. I don't want to feel all the extreme things that happen when you start to wean yourself. I want to be as high functioning as possible as I go through this and for me one week at a time is very unrealistic. The heart beating harder when I exercised even getting up from bed to go o the BR. The headaches which were located all over but especially behind my eyes. The wave of anxiety no a panic attack but just a mild and noticeable wave.
What has help so much is the positive changes. I thought my feet and legs were cold because of diabetes. My feet are not like icicles now and my lower legs which were cold aren't anymore. That's big. My feet are still cold but are 1/2 way warmer than before. Mostly I like having me back. I have more energy, don't need to sleep as long. I have had SAD in winter but never ongoing depression. I treat SAD with Vitamin D3 specifically from Wellness Pharmacy in Alabama - I tried other D3's that didn't have the effectiveness of this pharmaceutical grade D3. I treat angina successfully with omega 3 fish oil and vitamin E with mixed tocopherols.  When I'm off this I'll only be on Armour Thyroid!!! Not bad for a 61 year old. I'll probably also be on a pill for my diabetes but I'm hoping weight loss will address that problem.
Let us know in January when you start and we'll be there for you. I'll let you know when I end which should be in late January or early February.
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967168 tn?1477584489
This is a very interesting question I've pondered myself. I finally just said I'm sick and tired of feeling "sick" not able to function, so I started researching about the effects of going off my meds and decided to try it to see how I felt.

When my dr doubled my bb and upped my med for NCS/OI - I gained weight, felt miserable and almost to the point of non functioning I couldn't stand it.  I've only been on meds since August 09, so maybe it was a bit easier for me, but I feel about 75% better already.  The first few days were rough to say the least, but I'm learning to cope with the way I feel at certain times and doing deconditioning for my NCS/OI problems.

I don't know if this would work for everyone, but for me it is working and I have my meds in the cabinet if I feel worse.  I go back Dec 1st to my EP for another checkup and can't wait to see if he thinks I'm ok without meds.
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1102682 tn?1260838475
I really think a lot of modern medicines are wonderful for people who really need them but in my case giving me Toprol for such light problems was over kill (excuse the expression).
New development. Last night when I went to take my 3/4 pill, I didn't have any cut that size so I took 1/2. Had very mild noticeable heart beats 1x and mild but noticeable anxiety raction but no headaches or other signs of weaning so I've decided to start the weaning at the 1/2 pill level now rather than wait a week or so. I looked back on my calendar and I officiall started the 3/4 on Nov 4 so 3 weeks ago. I plan on staying on 1/2 dose until New Years day but my change in 3 weeks.
Lisa let us know what your doc said. I'm so glad you're feeling better. I see my cardiologist Dec 23. I am taking fish oil, drinking tension tamer tea and trying to stay away from stress as much as possible. I'm taking this whole transition very carefully because I don't want to go back on Topril
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Avatar universal
Hi!! Good luck in your weaning process. For me the withdrawal effects got worse day 3-5 days after cutting back doseage. Then after 1 1/2 weeks got I felt better again. Hang tough.... it is so hard to do. I manage my symptoms with natural meds such as l-theanine and passion flower flower liquid extract.
And I too believe these are good meds and really help some people. The atenolol really helped me when I could not get my SVT under control with all other methods and meds, it was the thing that worked and gave me back my life/sanity. If I had to use it again I would if I felt is was absolutely necessary for maintaining a healthy lifestyle.
  Lisa,
Do be careful in weaning til you consult your dr . I know you are eager to get off of it  if possible- I have been there too. But it is always best to consult your dr so he is on board with your plan and you can work together. I wish you all the best!!
Please all keep us posted on your good news!! Can not wait to hear we start 2010 without or very small doses of betablockers and feel SO much better!!!!!!!!!!
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Avatar universal
because of being on betablockers for longtime you have probably become more sensitive to the effect of adrenalin on your heartrate,
thus little amounts of anxiety affect your heartrate more than normal people... which might cause you to become more anxious and eventually panic.

i am very sensitive to caffeine, betablockers and my own bodies adrenalin so little amounts of adrenalin make my heartrate skyrocket.
for this reason i must always remain reallllllyyyyyy caallmmm.

vippassana meditation helps me do this.
http://www.urbandharma.org/udharma4/mpe.html

i recommend everyone with anxiety or depression to look into it
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Avatar universal
oh by the way,
the good effects of it only work as long as you stay mindful.

if you allow your mind to drift off, the stress/anxiety can act up again.
but if you lost your mindfullness you can always pick it back up ;)
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967168 tn?1477584489
I am pretty sure my dr is going to not agree with me on meds; but I really question medication methods and have really never taken anything for very long.

It makes no sense to me that 1 med makes my BP/HR lower and I have to have another to raise them - all to feel miserable and not even be able to function.  I made sure I went off them while my husband is on vacation in case anything happened or it made me feel bad.

Has anyone done alternative medication for heart or nervous system problems? I would love to hear if you have so I can talk to my dr Tuesday and see what he thinks.

I've been reading some interesting research on the effects of Acupuncture [sp] and other methods for helping ANS disorders.
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1102682 tn?1260838475
This is actually for all responses. I am on my second day at 1/2 dose and the headaches behind my eyes have begun but they are way less painful than when I started going down from full dose of 25mg/d. The heart palpitations and the anxiety reaction are also much easier at this point so slow wean is the way for me to go.

I have been into natural medicine since the early 1970's and used to cure headaches with foot massage way before massage was as popular as it is today but I lost track of that way of treatment for many years and am just getting back to it. I want to be on as few pills as possible even if that means I live a shorter period of time when I'm say 80.

My nurse practitioner is just learning about natural medicine but she is watching me as I wean myself. My cardiologist wanted me to lose more weight first but he's watching me as I take Niacin for cholesterol and is even watching me re chelation if I go that way.

One thing at a time. I'll start Niacin next month. My sister's cholesterol really responded to it at the 1500 dose which she slowly worked up to . I'm taking 300 now which is a drop in the bucket but I will be going up to 500 soon. After Niacin I'll look into chelation next year.
Thanks for support. I'm writing here because I know how much it helped me when I first looked into weaning myself to read what other people had gone through.

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1102682 tn?1260838475
Just another update. I think I am on day 3 at 1/2 dose of 12.5 mg. What I noticed is that I was under extreme stress yesterday...my nephew may be going to jail for violating a no contact order. I live a good a peaceful life but he doesn't and I have been in the past very codependent with him and with his mother but 3 years ago I started recovery and I'm working hard to not carry his choices and his consequences. Anyway the heart did beat hard a times but by repeating to my self How's my Life? and being able to answer pretty good, I kept heart and mind in perspective. Of course I prayed a lot too. But the physical inside was I have had very dry skin for several years. After washing with this special soap that drys it further - I put on a face cream to help with dryness. Yesterday before going to Thanksgiving with my family, I didn't have to put the cream on. My hands are less dry, I had pistachios before bed - a lot of them - and no dry mouth during the night. Shortly after I became diabetic or at least was diagnosed as such, I got dry mouth and so attributed it to diabetes. I very well could be because of Toprol. This is getting interesting. I hope this is helping someone besides me.
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