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Re: Propranolol safe for long term use }} linkadge

Posted by sdb on December 12, 2006, at 19:45:51

In reply to Re: Propranolol safe for long term use with normal BP? » linkadge, posted by madeline on December 12, 2006, at 17:18:17

> In my opinion, it is.
>
> If I had chronic anxiety, the beta blockers would be my drug of choice.
>
> What dose are you on?
>
> Maddie

Propranolol crosses the blood-brain barrier much more easily than nadolol and it has a short half-life. Because it can block many central beta-receptors it can make you sedated, probably more depressed. Unfortunately propranolol increases ldl but interestingly lowers intima/media thickness of a blood vessel, like nadolol does. Nadolol has very similar beta1/beta2-blocking properties, the substance itself a long-half life (one pill lasts for 24h) and is <not> metabolized by the liver.

Nadolol is not that effective to lower blood pressure in moderate dosages. But it is proven by
many studies to be very effective in blocking adrenaline. Nadolol is approved for long-term usage, propranolol can probably mess more because it is too cardiodepressant if you take that for a longer time.

If you take nadolol only once you should take probably 40mg and 3-4 hours before an event because of its long half life.

I am sure that there is a cheap APO generic available in CA.

I have a lot of copied stuff in pdf-file format from many studies eg. effectiveness to block adreneline, heart-failure, hyptertension and what's probably more interesting for you betablockers effectiveness and comparison in performance anxiety (adrenaline rush).

Take care if you have asthma or known heart problems.

If you want I will send it to you per e-mail (some Mbytes)

kind regards

sdb

ps. sjw is a drug that can work and it's definitely not a placebo!

http://www.rxlist.com/cgi/generic3/nadolol_cp.htm

some abstracts; the lipworth study compares some betablockers efficacy in blocking adrenaline (isoprenaline is used for tests because of adrenaline's short half-life but it does more or less the same)

Am Heart J. 1984 Oct;108(4 Pt 2):1150-5. Links
Beneficial effect of nadolol on anxiety-induced disturbances of performance in musicians: a comparison with diazepam and placebo.

* James I,
* Savage I.

The effects of 40 mg nadolol versus 2 mg diazepam on performance anxiety of 33 young music students were determined. The study had a double-blind, crossover design and was placebo controlled. Nadolol attenuated the rise in pulse rate caused by anxiety and improved those aspects of string playing that can be adversely affected by tremor. There was also a tendency for other functions requiring coordination and judgment to improve. No effect on anxiety was noted for nadolol or for 2 mg diazepam. Diazepam, however, did cause some minor deterioration of performance that was not related to anxiety change. These findings, taken with others, suggest that beta-adrenoceptor-blocking drugs such as nadolol have an important role in the correction of anxiety-induced disturbances of performance. Indeed, their use under such circumstances probably is preferable to that of the benzodiazepines.

PMID: 6148877 [PubMed - indexed for MEDLINE]

A dose-ranging study to evaluate the beta 1-adrenoceptor selectivity of bisoprolol.

* Lipworth BJ,
* Irvine NA,
* McDevitt DG.

Department of Clinical Pharmacology, Ninewells Hospital and Medical School, Dundee, UK.

A dose-ranging study was performed to compare the beta 1-adrenoceptor selectivity of bisoprolol with that of atenolol and nadolol. Seven normal subjects (mean age 26 y) were given single oral doses of bisoprolol 5 mg (B5), 10 mg (B10), 20 mg (B20); atenolol 50 mg (A50), 100 mg (A100); nadolol 40 mg (N40); and placebo (PL), in a single blind randomised cross-over design. Beta 2-adrenoceptor responses were assessed by attenuation of finger tremor and cardiovascular responses to graded isoprenaline infusions. Dose-response curves were constructed, and doses of isoprenaline required to increase finger tremor by 100% (IT100), heart rate by 25 beats/min (IH25), SBP by 25 mmHg (IS25), cardiac output by 35% (IC35), and decrease DBP by 10 mmHg (ID10), after each treatment were calculated. These indices were compared with placebo response and expressed as dose-ratios. Exercise heart rate (EHR) was used to assess beta 1-adrenoceptor blockade. There were dose-related increases in plasma concentrations of bisoprolol and atenolol. Reduction of EHR was significantly less with B5 (16.8%) in comparison with all other treatments: B10 21.9%, B20 23.1%; A50 22.5%, A100 22.6%; N40 22.9%. There were small but significant reductions in isoprenaline-induced tachycardia with bisoprolol and atenolol, although mean dose-ratios were considerably less in comparison with N40 (IH25 dose-ratios): B5 2.55, B10 3.18, B20 3.93, A50 2.91, A100 4.89, N40 17.23. There were similar patterns for the other isoprenaline responses. These results show that conventional doses of bisoprolol (10 mg) and atenolol (50 mg) produced equal antagonism of beta 1 and beta 2-adrenoceptors, and therefore possess equal degrees of beta 1-adrenoceptor selectivity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID: 1676675 [PubMed - indexed for MEDLINE]


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URL: http://www.dr-bob.org/babble/20061212/msgs/712999.html