Posted by vbAgent on December 2, 2005, at 0:13:26
In reply to Stimulant + Beta Blocker, posted by mike99 on November 28, 2005, at 18:42:18
> Does anyone have experience or helpful info regarding taking a beta-blocker to counter a stimulant--especially with regard to chest pain?
>
> 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.
>
> Either way, I simply refuse to take anything that causes me chest discomfort. However stimulants are the only things that will touch my ADHD.
>
> My understanding is that beta blockers are more effective for tachycardia whereas nitrates (nitroglycerin) are better for chest pain.
>
> 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).
>
> 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.
>
>
>
> My apologies for rambling on...so I'm just going to throw out a few questions:
>
>
> 1. Is a beta-blocker likely to protect my heart from angina/damage?Yes.
> 2. If so what dosage would be appropriate for Dexedrine 10 mg/dy or Ritalin 40 mg/dy?
Only after using trial and error to find the optimal drug and dose. Discuss this with your doctor.
> 3. Can anyone recommend any particular beta-blocker (i.e. a cardioselective such as atenolol).Metoprolol (aka Toprol or Toprol XL).
> 4. Would a beta blocker cause my blood pressure to drop below safe as it is normally around 105/65?Hypotension may present a problem, but I think it's unlikely as long as you're prescribed something in the lower dose range, like 25-75mg.
> 5. Would it affect my athletic performance (I exercise vigorously)?Yes, via a dose-related response. It may reduce your Resting HR, Exercising HR and Maximal Exercise HR.
> 6. Are ED and depression likely?
Maybe yes, maybe no...but probably not if you're prescribed a low dose.
> 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.I don't think tolerance is a factor you need to consider here.
> Thanks for any input.FYI: Beta-blockers are different from another commonly prescribed antihypertensive called ACE inhibitors. ACE inhibitors prevent the formation of a potent hormone that constricts blood vessels. The end result is that blood vessels dilate, and blood pressure decreases in response.
Now, beta-blockers effectively antagonizes beta-adrenergic receptors and limit sympathetic nervous system output/stimulation. In other words, they block the effects of catecholamines (epinephrine, norepinephrine, dopamine) throughout the body. Hence the reason that beta-blockers reduce the heart's workload.
poster:vbAgent
thread:583104
URL: http://www.dr-bob.org/babble/20051126/msgs/584400.html