# Long term propanolol use



## Positive (Jun 29, 2009)

I've been using this, and notice, each week, I start off the Monday w/ 5MG and then tweak it down to 2.5MG for every day till about Friday. I've saved the Ativan for situational instances.

I do notice recently that the Propanolol is making my brain feel weird.

USAGE:
Propanolol for the past 2 years, for about 5x a week.
Ativan for the past 1 year, about 1x-2x a month.

Any ideas? I worry about my intake.


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## puppy (Jun 27, 2012)

Maybe switch to metoprolol? I believe it has less of a tendency to cross the blood-brain barrier.


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## ricca91 (Mar 11, 2012)

puppy said:


> Maybe switch to metoprolol? I believe it has less of a tendency to cross the blood-brain barrier.


Yeah, metoprolol is definitely the love of my life! The difference between it and propranolol is that the latter is nonselective, meaning it acts on beta 1 and 2 adrenergic receptors, while metoprolol is "selective", meaning it prefers the beta 1 over the beta 2 receptor. This selectivity is lost as the dose goes up.

Beta 1 receptors are found mainly in the heart, and they mediate the strength, frequency of the contractions as well as the excitability of the heart cells. Blocking it slows your heart rate and the heart contracts with less strenght. This brings (much) relief in stressful situations.

Beta 2 antagonism is not useful in these cases and conributes to some side effects typical of beta blockers (although much controversy is present) such as precipitation of asthma attacks in asthmatics, weight gain, dyslipidemia and diabetes, among others.

Remember that beta blockers are very old meds, therefore quite safe uf you don't have certain heart conditions and they reduce mortality in many people. I consider that the benefits largely outweigh the risks.

Regarding BBB penetration, metoprolol crosses it very well almost as well as propranolol. I think anecdotically, beta blockers which do that tend to be "true" anxiolytics, since they calm down the brain a bit as well as the physical symptoms.

However they can cause fatigue, insomnia, vivid dreams and depression. Clinical studies however, didn't find any proof of that.

Atenolol is a beta 1 selective beta blocker which doesn't cross the BBB. You could try it and see if it works. Also, because of its long half life you can take it one time per day.

In my case, I take a standard therapeutic dose of metoprolol, 100 mg XL. But I also have very debilitating tachycardia and borderline hypertension (and I'm 20 yo), so I am the perfect candidate for a beta blocker. I love it and I don't feel any side effects.

Cheers!


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## Johnnny (Oct 3, 2012)

ricca91 said:


> Yeah, metoprolol is definitely the love of my life! The difference between it and propranolol is that the latter is nonselective, meaning it acts on beta 1 and 2 adrenergic receptors, while metoprolol is "selective", meaning it prefers the beta 1 over the beta 2 receptor. This selectivity is lost as the dose goes up.
> 
> Beta 1 receptors are found mainly in the heart, and they mediate the strength, frequency of the contractions as well as the excitability of the heart cells. Blocking it slows your heart rate and the heart contracts with less strenght. This brings (much) relief in stressful situations.
> 
> ...


Very well said, however up until the point of atenolol. In our cardiac office, we were on a "mission" to take people off atenolol. It was the most insidious drug in terms of side effects of any cardiac medication.
In terms of depression, fatigue, vivid nightmares etc.. 
We switched everyone to bystolic, a very selective beta blocker.
And we kept a tally, it was about 7/10 who came back saying WOW, I feel so much better and then about 4 of those people saying it was a "dramatic" change in their life. 
3/10 came back saying "I didnt notice a difference and bystolic costs 50$ a month and atenolol was 4$".
Metoprolol is not as bad in terms of depression and side effects as atenolol. 
So if taking for the extra-cardiac benefits of an adrenaline-blocker in terms of anxiety. Then metoprolol isnt a bad choice. It certainly helps people with essential tremors.

I've noticed in my short time here alot of reference to the blood-brain barrier. It's a bit of nonsense in the organic bio-chemistry world as well as actually in the medical world in which I live. 
Atenolol is by far the worse as far as Ive seen in middle-age and elderly patients. I'd have to look it up if you are correct that it doesnt cross the blood-brain barrier. I can tell you though from experience, that atenolol insidious side effects to personality, depression, fatigue etc... is slow and went for years to be unrecognized. That all involves the brain or some mechanism feedback thereof. 
It wasnt until the new super-selective bystolic came onto the scene that the atenolol syndrome was truly highlighted. Where patients came back that they were bowling again, had their life back.

So if it does cross the BBB I dont know why it causes brains to be so depressed.

But like I said, I liked your ephedrine posts and I like 'most' of what you said lol up until atenolol.
If you can afford the bystolic, I think that maybe a better option than metolprolol xl
But also you lose the anxiety relieving effects- why concert pianists (and cardiologists) take a beta-blocker before a performance or public speaking.
It does however mitigate the depressive effects of betablockers.

As far as the tachycardia, is it just a fast heart rate or actually something like supraventricular tachycardia, atrial fibrillation type stuff.
Or PVCs


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## little toaster (Jul 5, 2012)

As long as you don't skip by forgetting I think it's fine, as you probably know already.

The stuff with dreams happens to everyone. I've had it happen to me every time I took it in the afternoon or the evening.


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## wrongnumber (May 24, 2009)

What are you using it for? If it's for anxiety I think it's best to use it prn.

*Edit*
Just noticed how tiny your dose is. I've no idea how you can feel any effect at all with that.


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## little toaster (Jul 5, 2012)

wrongnumber said:


> Just noticed how tiny your dose is. I've no idea how you can feel any effect at all with that.


I felt enough effects with a 10 mg dose. Too much with 40 mg.


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## wrongnumber (May 24, 2009)

little toaster said:


> I felt enough effects with a 10 mg dose. Too much with 40 mg.


That's significantly greater than 2.5 - 5 mg though. At that dose I wonder if there's any point taking it unless one is getting a placebo effect? I'm a lightweight female and need at least 40 mg to feel any difference.


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## ricca91 (Mar 11, 2012)

Johnnny said:


> Very well said, however up until the point of atenolol. In our cardiac office, we were on a "mission" to take people off atenolol. It was the most insidious drug in terms of side effects of any cardiac medication.
> In terms of depression, fatigue, vivid nightmares etc..
> We switched everyone to bystolic, a very selective beta blocker.
> And we kept a tally, it was about 7/10 who came back saying WOW, I feel so much better and then about 4 of those people saying it was a "dramatic" change in their life.
> ...


Oh, ok, thanks for the info! I thought atenolol wad quite.benign in terms of neurological/psychiatric symptoms.

Yes, bistolic is one of the most cardioselective beta blocker! I howevwr prefer metoprolol because of its BBB penetration (for me it's a positive thing) and partial relief of essential tremor!

It really works well for my hypertension and tachycardia, which fortunately is sinus tach and not something more serious. However it ia very annoying since I have palpitation and I can only focus my attention to my heartbeat... it really is a very unpleasant sensation...

Cheers!


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## Positive (Jun 29, 2009)

Sorry, I didn't get a chance to respond. I fell ill from something.

Anyhow, I only use the propanolol during weekdays. During the end of the week, I try to reduce the dosage.

I used propanolol for my daily med against anxiety, but if i really need it, I'll take a small benzo.


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## Positive (Jun 29, 2009)

Just a bump, I notice this drug actually affecting me a lot stronger. I'm not sure what it is, but I now feel the effects of it at .25MG for 3-4 days.

I currently take .25MG on Monday and can feel the drug in my system and brain well into Thursday. Did my brain chemistry get altered?


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## Positive (Jun 29, 2009)

bump


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## Positive (Jun 29, 2009)

any body. seriously. i feel like at .25mg tgis drug affectd my brain for a good 5-10 days

what is up?


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## Implicate (Feb 1, 2011)

When I was on a larger dose (60mg x1 nightly) to help control migraines I had very vivid dreams. The dreams were trippy (for lack of a better word) but not nightmares and did not affect my sleep, and to be honest I actually kind of liked dreaming, so it was fine for me.

When I was on a lower dose three times a day I only really found fatigue to be an issue.

Take your concerns to your doctor and discuss it with him or her. If the side effects are not tolerable for you there are other medications that could provide you a benefit without the side effects.


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## Wide Awake Nightmare (Dec 12, 2012)

I was on 80mg a day. I just stopped taking it after a year or so...not sure if that's good or bad.


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## Positive (Jun 29, 2009)

Once in a while bump.


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