Posted by rphstudent on November 29, 2005, at 22:46:47
In reply to Stimulant + Beta Blocker, posted by mike99 on November 28, 2005, at 18:42:18
Please do not combine any amphetamine or methylphenidate or sympathomimetic agent with a beta-blocker. These type of stimulants produce action at both alpha and beta adrenergic receptors (i.e. increased heart rate and blood pressure among other things). They also work in concert, so blocking beta allows alpha to act unopposed and often leads to a dangerously high blood pressure and/or high pulse rate. If you must consider a beta-blocker, disucss one like labetolol which also has alpha blocking effects with both your pdoc and cardiologist/internist and pharmacist.
Best wishes.
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> Does anyone have experience or helpful info regarding taking a beta-blocker to counter a stimulant--especially with regard to chest pain?
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> Ritalin causes me rather severe chest pain. Dex and Adderall also cause me chest pain but much more fleeting and less intense (opposite of what I'd expect since Ritalin is supposed to be less stimulating than amphetamine, but I digress). This occurs at very low doses (2.5 mg Dex, 5 mg Ritalin). Both also increase my heart rate more than I'd like, but not excessively---chest pain is the main problem.
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> Either way, I simply refuse to take anything that causes me chest discomfort. However stimulants are the only things that will touch my ADHD.
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> My understanding is that beta blockers are more effective for tachycardia whereas nitrates (nitroglycerin) are better for chest pain.
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> I've had my heart checked by more cardiologists than I care to admit and it's (thankfully) normal except for mild mitral valve prolapse. However for some reason even miniscule doses of stimulants cause me chest discomfort. (BTW I once took 50 mg of Zoloft and had the most intense chest pain I've ever experienced and so never took it again).
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> I've been very reluctive to try a beta blocker with dex or ritalin, but am now considering it and so would appreciate any feedback on this.
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> My apologies for rambling on...so I'm just going to throw out a few questions:
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> 1. Is a beta-blocker likely to protect my heart from angina/damage?
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> 2. If so what dosage would be appropriate for Dexedrine 10 mg/dy or Ritalin 40 mg/dy?
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> 3. Can anyone recommend any particular beta-blocker (i.e. a cardioselective such as atenolol).
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> 4. Would a beta blocker cause my blood pressure to drop below safe as it is normally around 105/65?
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> 5. Would it affect my athletic performance (I exercise vigorously)?
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> 6. Are ED and depression likely?
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> 7. Perhaps my biggest concern aside from effectiveness is tolerance--- I'm only 28 and do not want to start a beta blocker if I'm going to have to increase the dosage over the years.
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> Thanks for any input.
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poster:rphstudent
thread:583104
URL: http://www.dr-bob.org/babble/20051126/msgs/583541.html