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How safe/recommended are beta blockers? Al...

Eugene's Photo Eugene 11 Nov 2008

Hi. I am generally healthy except my BP can be 145/80 for no reason. I also get nervous easily and i have performance anxiety. My heart rate is also not that low.

So i decided to try beta blockers - propanolol. I took them for a month. Stress is reduced significantly. No anxiety. Heart rate and pressure is perfect. Today i ran out of the pills and i was thinking that it is time to research about adverse effects of long term use.

Can anyone give me some good information about beta blockers? Pros and cons? Do you think they are worth it?

Thanks!
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meatwad's Photo meatwad 11 Nov 2008

Hi. I am generally healthy except my BP can be 145/80 for no reason. I also get nervous easily and i have performance anxiety. My heart rate is also not that low.

So i decided to try beta blockers - propanolol. I took them for a month. Stress is reduced significantly. No anxiety. Heart rate and pressure is perfect. Today i ran out of the pills and i was thinking that it is time to research about adverse effects of long term use.

Can anyone give me some good information about beta blockers? Pros and cons? Do you think they are worth it?

Thanks!


Use google. Good to know how they act on the body. Your putting a band aid on a larger problem (ie constant catecholamine release causing increased bp, dilated venous/arteries/blood supply) etc etc.
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Eugene's Photo Eugene 11 Nov 2008

Can you elaborate on the catecholamine?
Edited by Eugene, 11 November 2008 - 02:48 AM.
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Eugene's Photo Eugene 11 Nov 2008

Can you elaborate on the catecholamine?


Never mind i got what you meant. : )

What should i ask my doctor to check for? Adrenal problems?
Edited by Eugene, 11 November 2008 - 02:51 AM.
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Eugene's Photo Eugene 11 Nov 2008

BTW, I had my kidneys and heart checked out and they were perfectly fine.
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shaggy's Photo shaggy 11 Nov 2008

Propranalol is a very crude beta blocker to control hypertension.... Been around for ages, good safety profile but loads of sides.

If you must take a beta blocker for hypertension I would most definitely choose carvedilol, very effective, low sides and a host of other benefits to boot.

As others have suggested though, this controls the symptoms but not the root cause.

Good luck!
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Eugene's Photo Eugene 11 Nov 2008

Oops i was taking atenolol : ) I confused the names : (
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nameless's Photo nameless 11 Nov 2008

Oops i was taking atenolol : ) I confused the names : (



You may find this study useful:
Reducing Heart Rate in Hypertension Is Harmful -- or Is It Just Atenolol?
http://www.medscape....warticle/582499


If you require a beta blocker, I suggest Carvedilol too. There are other alternatives for high blood pressure, including ace inhibitors and arbs, although they won't really lower heart rate. Some, such as Altace, has been shown to reduce risk of heart attack too. This may be a class effect, or not... I'm not sure if that's been studied in detail yet. But since you mentioned a high heart rate, you might want to ask your doctor about carvedilol/coreg.

You can also try supplements. Magnesium might help some. Aged Garlic + C might help. Exercise should help too. And an occasional BP of 145/80 isn't actually so bad, if you are just talking about rare stressful situations. Everybody's pulse and blood pressure rises on occasion. I get white coat syndrome myself, so even though my BP is fine at home, going to the doctor usually moves me into the 135/80-85ish range.

But if you are talking about a sustained high blood pressure/pulse, it should be dealt with.
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stuartes's Photo stuartes 12 Nov 2008

Propranalol is a very crude beta blocker to control hypertension.... Been around for ages, good safety profile but loads of sides.

If you must take a beta blocker for hypertension I would most definitely choose carvedilol, very effective, low sides and a host of other benefits to boot.

As others have suggested though, this controls the symptoms but not the root cause.

Good luck!

What is the general consensus opinion for the use of beta blockers for anxiety? It would seem that something like propranalol with the longest safest track record would be a good place to start unless a particular beta blocker is already a known better alternative.
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Lufega's Photo Lufega 15 Nov 2008

B-blockers will cause upregulation of the receptors. So if you suddenly stop the medicine, your cell has produced more B-receptors and have become many times more sensitive. You might feel as it the anxiety and pressure came back with a vengeance. That's called the rebound effect. Pretty crazy stuff.

That said, I haven't found anything that control anxiety, tremors and blood pressure better than a beta-blocker. However, they also cause exercise intolerance, sexual problems, etc. For that reason, I only use 10 mg once in a blue moon, if I have to do a presentation or something.
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shaggy's Photo shaggy 16 Nov 2008

B-blockers will cause upregulation of the receptors. So if you suddenly stop the medicine, your cell has produced more B-receptors and have become many times more sensitive. You might feel as it the anxiety and pressure came back with a vengeance. That's called the rebound effect. Pretty crazy stuff.

That said, I haven't found anything that control anxiety, tremors and blood pressure better than a beta-blocker. However, they also cause exercise intolerance, sexual problems, etc. For that reason, I only use 10 mg once in a blue moon, if I have to do a presentation or something.


Carvedilol does not cause upregulation of the receptors or the symptoms you list.
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Mouser's Photo Mouser 24 Nov 2008

How about using beta-blockers to improve sleep (I'm talking about sleep consolidation, not help with getting to sleep)? I know there are a lot of other things to try first - I've tried them all. What has worked best, but not well enough, is temazepam. So if anxiety is the problem, would a beta-blocker be worth trying?
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sentinel's Photo sentinel 24 Nov 2008

A safe alternative for "stress management" is L-theanine. It's healthy, helps anxiety and avaliable without prescription.
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Atropy's Photo Atropy 13 Dec 2013

A safe alternative for "stress management" is L-theanine. It's healthy, helps anxiety and avaliable without prescription.


I agree with trying L-theanine instead,however,I find tolerance sets in fast with normal 150mg to 200mg dosages.But I am aware that people go crazy with the dosage.
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opales's Photo opales 13 Dec 2013

How about using beta-blockers to improve sleep (I'm talking about sleep consolidation, not help with getting to sleep)? I know there are a lot of other things to try first - I've tried them all. What has worked best, but not well enough, is temazepam. So if anxiety is the problem, would a beta-blocker be worth trying?



Betablockers are known to inhibit melatonin secretion, and sleep problems are a known side effect, so I would think they are counterproductive for this purpose. Mirtazapine+melatonin=magic
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Sciencyst's Photo Sciencyst 28 Dec 2013

Chamomile and bacopa, IIRC, have beta blocking properties.
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kai2's Photo kai2 28 Dec 2013

Hi opales,

Thanks for noting that beta blockers are known to inhibit melatonin secretion. FWIW, I've heard this being the case specifically with propranolol. This seems like a side that Mouser would not want, especially if they already have sleep challenges. Could this side be fully offset by supplementing with melatonin?

As for mirtazapine, that can be a very dangerous drug in at least two ways:

1. it can cause severe restless legs (which doesn't sound like much, unless you've had a bad case of them, in which case you may realize that they can make it very difficult to fall asleep...and probably wreck your sleep quality by manifesting as PLMD during the night)

2. it has been described by some as eliciting a crazy level of "munchies." people have spoken of mirtazapine making them want to mainline sugar

Like everything else, the effects vary from person to person, and I'm sure mirtazapine is a wonder drug for many, but anyone considering its use would be well-served to consider the potential downsides.

Maybe adding in melatonin changes everything for the positive, though. Stacking magnesium with the mirtazapine might have an interesting result, too. Whatever works!
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Sillewater's Photo Sillewater 28 Dec 2013

Anxiety and mood related issues are sometimes treated with anti-depressants to good effect.
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sonshoku's Photo sonshoku 29 Dec 2013

Try inositol powder
, and drink high dose liquid fish oil (since the caps needs too much to replicate 1 spoon)

drink like 1-2 tbs of fishoil lol
Edited by sonshoku, 29 December 2013 - 05:47 PM.
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KimberCT's Photo KimberCT 30 Dec 2013

Having tried all the beta-blockers mentioned above, the only one I've found that doesn't seem to cause tolerance would be nebivolol. It also has weak affinity for the B2-receptor, so it doesn't suppress melatonin release like the others can.
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protoject's Photo protoject 04 Apr 2014

nebivolol.. it doesn't suppress melatonin release like the others can.


Hey KimberCt,

I hope that you are right, but regardless of melatonin suppression could it still cause insomnia? I was searching for patient reviews on drugs.com / rxlist and probably some other sites and a good number of them were saying it caused insomnia. I really want to try a beta blocker at some point but can't have those kinds of side effects.
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KimberCT's Photo KimberCT 04 Apr 2014

Never a problem for me, but I take it in the morning. I'd bet those reviews are dosing right before bed.
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shaggy's Photo shaggy 05 Apr 2014

Yeah.. I've moved over to nebivolol now when I need a beta blocker for my anxiety. Works pretty well, I dose in the evening and sleep fine.
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Mouser's Photo Mouser 05 Apr 2014

Hi opales,

Thanks for noting that beta blockers are known to inhibit melatonin secretion. FWIW, I've heard this being the case specifically with propranolol. This seems like a side that Mouser would not want, especially if they already have sleep challenges. Could this side be fully offset by supplementing with melatonin?

As for mirtazapine, that can be a very dangerous drug in at least two ways:

1. it can cause severe restless legs (which doesn't sound like much, unless you've had a bad case of them, in which case you may realize that they can make it very difficult to fall asleep...and probably wreck your sleep quality by manifesting as PLMD during the night)

2. it has been described by some as eliciting a crazy level of "munchies." people have spoken of mirtazapine making them want to mainline sugar...


Have experience with mirtazapine. I did not experience a change in hunger, or really even weight. What I believe it did do was raise LDL count and type to very high and possibly dangerous levels. The fact that this happened without eating differently is the scary part. Doctors I've asked say no one is sure if the weight gain and metabolic changes experienced by many on the drug are due to an increase in appetite, or if the change is on a deeper metabolic level. It sounds the common thinking is towards the appetite explanation. But my experience suggest the latter.

The good news is the scary LDL numbers were halved two months after stopping mirtazapine, with doing little of anything else besides increased excersise. It's a shame because mirtazapine did work very well in helping with sleep, and therefore daytime tiredness. (This is after getting past a week or two introduction period where you may feel like you've got the flu - it can make you that tired, at first.)
Edited by Mouser, 05 April 2014 - 09:21 PM.
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protoject's Photo protoject 06 Apr 2014

Never a problem for me, but I take it in the morning. I'd bet those reviews are dosing right before bed.


Wow, amazing. Thanks for the info. I'm going to look into getting this so that I don't die early from a chronically fast heart.
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shaggy's Photo shaggy 08 Apr 2014

Took 15mg of mirtazapine for 4 years on and off and it has had no effect on my lipid panel. My hdl is much more than my ldl which according to the experts is desirable.
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blood's Photo blood 08 Apr 2014

Having tried all the beta-blockers mentioned above, the only one I've found that doesn't seem to cause tolerance would be nebivolol. It also has weak affinity for the B2-receptor, so it doesn't suppress melatonin release like the others can.

 

Can you explain what you mean by tolerance (in respect to beta-blockers)? Do you mean they stop working in some way?

 

Curious, are you taking nebivolol for BP or other reasons?

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shaggy's Photo shaggy 09 Apr 2014

Most beta blockers cause an up regulation of the body's receptors. .Nebivolol and carvedilol are not thought to do this. They also don't negatively affect lipids or melatonin secretion either like others either.
Edited by shaggy, 09 April 2014 - 06:34 AM.
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