![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by WhatToDoNext on July 27, 2008, at 16:00:26
I was put on Propanolol years ago for my anxiety. I have been on 20mg all along and recently, my HR started going up to the 140's and my cardiologist told me to switch to Inderal (Calcium Chanel Blocker). I told him, I'd rather go off as I'm on too many meds for a 39 y.o., he agreed and said it was up to me. I don't get Panic Attacks anymore so, I figured why be on it.
Two weeks ago, my Psych MD told me she wanted me off of my Xanax XR 1mg bid and to take Xanax fast acting 1mg x 4 /day instead as I told her it didn't seem to work as well as the fast acting for me. The only other meds I'm on are Zoloft 50mg and Klonopin 1mg bid.
I've been off the Beta Blocker for over 2 weeks, and the Xanax XR almost 2 weeks. My anxiety has been through the roof lately, about 5 x more than baseline. It was so bad, I thought about going to the Hospital. My symptoms were restlessness, agitation, sternal discomfort, and lots of Shortness of Breath. Also, headaches, dizzyness, and some nausea. I thought this was probably due to the switch in the Xanax. I decided I wanted off all meds period. Since I started taking meds, my anxiety has seemed to worsen. I want to see how I do med free.
Everywhere I read about Xanax w/d talks about how it's worse than coming off Heroin, etc. and my symptoms seem to fit. I'm very mind strong, but with the shortness of breath and all the other symptoms, I just couldn't take it anymore. I had recently come off Buspar, as it made my anxiety worse too. Other than that, no other med changes.
So, I've been going up and up on the fast acting Xanax and upped the Klonopin to 2mg bid on my own. Can't get in touch with pdoc. Very close to going to the ER, but I've never been hospitalized and scared to death to be around Schizophrenia patients and the like as I only suffer from anxiety. I don't have Panic Attacks anymore, just free floating anxiety, but again, it's been 5 x worse than it's ever been with this Shortness of Breath that just comes out of nowhere. I stopped drinking coffee the other day, as I usu. have a cup in the morning to offset all the sedation from the meds.
So I tried to drink a cup of coffee thinking maybe this was Caffeine w/d and to a very extreme. I did get a little relief, but within an hour, the Shortness of Breath came back on at a rate of about 45 breaths per minute. I'm thinking to myself, what could be causing this. I had tons of Xanax in me, and I even took 1mg of the long acting. I felt the sedation, but the anxiety was so bad. It felt like a constant panic attack. I came across some articles that talk about Beta Blocker withdrawal, but couldn't find anything about the shortness of breath except that some get it when starting a Beta Blocker. I did see some people get rebound tachycardia, which I didn't have, and some get anxiety and or rebound hypertension.
By process of Elimination, I lastly took 20mg of Propanolol as it's been about 2 weeks since my last dose and the literature says if you get w/d, then it usually comes on about 2 weeks after discontinuing the drug.
OUTCOME: After I took 20mg of Propanolol, Every symptom went away. Anxiety is gone, Shortness of breath is gone, I mean everything is gone.
I can't find anything on the net that talks about shortness of breath upon discontinuing a Beta Blocker. I am definately going back on it, but I wanted to see if anyone knows anything about this.
Trust me, when I say it was bad, IT WAS BAD....I am strong mentally and can usually handle the bad anxiety that has kept me out of work for a few months. This was like the worst thing I ever felt and I know now, the Propanolol was the culprit. I had double the Benzos in me, plus some Benadryl and a little coffee as I thought maybe I was going through caffeine withdrawl.
Please tell what the heck gives with this. Like I said, I can't find anything on Google that talks about anything close to this shortness of breath I've had over the past few days.
Thanks in advance,
Steve
Posted by bleauberry on July 27, 2008, at 16:52:35
In reply to Beta Blocker (Propanolol) question..W/D Issue, posted by WhatToDoNext on July 27, 2008, at 16:00:26
So sorry to hear your struggles. Glad you found the answer though.
Modern medicine is actually so new, what, a few decades? Much is not known. Hard to find answers sometimes.
I would hypothesize that all those years you were on the med, your body became accustomed to that molecule. The med became part of your biochemistry. Years of use are not going to be undone in a few weeks. The body is resilient, but not usually as fast as we would like. And who knows, the original reason you started taking the med might still exist.
If you really want off the med, for whatever reason, you might have to embark on a long weaning process, perhaps several months, gradually stepping down in tiny increments. I don't know if it is pill or capsule. Either way, there are easy ways to customize the size of doses so you can step down in tiny steps instead of being restricted to the dose sizes in the bottle.
Posted by Phillipa on July 27, 2008, at 16:56:11
In reply to Re: Beta Blocker (Propanolol) question..W/D Issue, posted by bleauberry on July 27, 2008, at 16:52:35
Sounds strange as Inderol and propanolol are the same med with propanolol being the generic version. Was the dose the same? I'd suggest an emergency call to the pdocs isn't someone covering for him? Maybe difference in binders and fillers are not the same? Just a thought and seriously best of luck Phillipa
Posted by Phillipa on July 27, 2008, at 16:58:36
In reply to Re: Beta Blocker (Propanolol) question..W/D Issue » bleauberry, posted by Phillipa on July 27, 2008, at 16:56:11
Oops not to bleuberry sorry. Phillipa
Posted by yxibow on July 27, 2008, at 17:11:04
In reply to Beta Blocker (Propanolol) question..W/D Issue, posted by WhatToDoNext on July 27, 2008, at 16:00:26
> I was put on Propanolol years ago for my anxiety. I have been on 20mg all along and recently, my HR started going up to the 140's and my cardiologist told me to switch to Inderal (Calcium Chanel Blocker). I told him, I'd rather go off as I'm on too many meds for a 39 y.o., he agreed and said it was up to me. I don't get Panic Attacks anymore so, I figured why be on it.
>
> Two weeks ago, my Psych MD told me she wanted me off of my Xanax XR 1mg bid and to take Xanax fast acting 1mg x 4 /day instead as I told her it didn't seem to work as well as the fast acting for me. The only other meds I'm on are Zoloft 50mg and Klonopin 1mg bid.
>
> I've been off the Beta Blocker for over 2 weeks, and the Xanax XR almost 2 weeks. My anxiety has been through the roof lately, about 5 x more than baseline. It was so bad, I thought about going to the Hospital. My symptoms were restlessness, agitation, sternal discomfort, and lots of Shortness of Breath. Also, headaches, dizzyness, and some nausea. I thought this was probably due to the switch in the Xanax. I decided I wanted off all meds period. Since I started taking meds, my anxiety has seemed to worsen. I want to see how I do med free.
>
> Everywhere I read about Xanax w/d talks about how it's worse than coming off Heroin, etc. and my symptoms seem to fit. I'm very mind strong, but with the shortness of breath and all the other symptoms, I just couldn't take it anymore. I had recently come off Buspar, as it made my anxiety worse too. Other than that, no other med changes.
>
> So, I've been going up and up on the fast acting Xanax and upped the Klonopin to 2mg bid on my own. Can't get in touch with pdoc. Very close to going to the ER, but I've never been hospitalized and scared to death to be around Schizophrenia patients and the like as I only suffer from anxiety. I don't have Panic Attacks anymore, just free floating anxiety, but again, it's been 5 x worse than it's ever been with this Shortness of Breath that just comes out of nowhere. I stopped drinking coffee the other day, as I usu. have a cup in the morning to offset all the sedation from the meds.
>
> So I tried to drink a cup of coffee thinking maybe this was Caffeine w/d and to a very extreme. I did get a little relief, but within an hour, the Shortness of Breath came back on at a rate of about 45 breaths per minute. I'm thinking to myself, what could be causing this. I had tons of Xanax in me, and I even took 1mg of the long acting. I felt the sedation, but the anxiety was so bad. It felt like a constant panic attack. I came across some articles that talk about Beta Blocker withdrawal, but couldn't find anything about the shortness of breath except that some get it when starting a Beta Blocker. I did see some people get rebound tachycardia, which I didn't have, and some get anxiety and or rebound hypertension.
>
> By process of Elimination, I lastly took 20mg of Propanolol as it's been about 2 weeks since my last dose and the literature says if you get w/d, then it usually comes on about 2 weeks after discontinuing the drug.
>
> OUTCOME: After I took 20mg of Propanolol, Every symptom went away. Anxiety is gone, Shortness of breath is gone, I mean everything is gone.
>
> I can't find anything on the net that talks about shortness of breath upon discontinuing a Beta Blocker. I am definately going back on it, but I wanted to see if anyone knows anything about this.
>
> Trust me, when I say it was bad, IT WAS BAD....I am strong mentally and can usually handle the bad anxiety that has kept me out of work for a few months. This was like the worst thing I ever felt and I know now, the Propanolol was the culprit. I had double the Benzos in me, plus some Benadryl and a little coffee as I thought maybe I was going through caffeine withdrawl.
>
> Please tell what the heck gives with this. Like I said, I can't find anything on Google that talks about anything close to this shortness of breath I've had over the past few days.
This isn't quite withdrawal --- it is and it isn't. If you've been on a beta blocker for a long time it isn't a good idea to drop it suddenly. What you're experiencing is a combination of your anxiety symptoms coming back and the effects of the sudden loss of a beta blocker.Beta blockers regulate other things -- primarily your heart (propranolol is used in psychiatry because it is a very old drug and "non-cardioselective" which means it doesnt affect the heart as much and is good for controlling fight or flight and the peripheral muscles.) However, old or not, cardioselective or not, it still affects your heart, which can explain the shortness of breath and all sorts of symptoms.
Its one that is hard to sort out -- yes, you're experiencing anxiety symptoms, but you're also experiencing rebound beta blocker withdrawal, which is potentially a BAD THING (I said potentially -- not life threatening as long as you take it easy and don't do things that strain your heart).
You might want to talk to your doctor about restarting it and slowing the elimination of it again. The worst rebounds though occur with blood pressure regulators like clonidine -- you must withdraw slowly.
-- I hope you feel betterJay
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.