Problems with Atenolol Discontinuation - Heart Disorders Message Board

donsabi · 09-24-2003, 03:28 PM

Recently my GP tried to changed my medication from Tenormin 25mg, (Atenolol), to Toprol XL 25mg because of my fatigue and lightheadedness. After a few days my BP was varying from 110/60 to 185/110 and then stabilized. After five days on Toprol 25mg I began having anxiety attacks and after seven days was having panic attacks. I have discontinued the Toprol and I am taking Tenormin, (Atenolol), once more. The anxiety/panic attacks have ended but I am back to fatigue and lightheadedness. I have been on Tenormin for ten years and this happened once before while trying to discontinue Tenormin.

Has anyone had similar experiences with this medication?

zuzu8 · 09-26-2003, 03:50 AM

Donsabi- I don't know your medical history, but did your doctor have you discontinue the atenolol abruptly after ten years??
All people, particularly anyone with coronary artery disease, who are being treated with atenolol, should be advised AGAINST abrupt discontinuation of therapy, because severe exacerbation of angina and the occurrence of myocardial infarction and ventricular arrhythmias have been reported in angina patients following the abrupt discontinuation of therapy with beta-blockers.
As for your panic attacks, I'm wondering if your they were really panic.... but rather that you were having thyroid-related tachycardia.....Beta-adrenergic blockade may mask certain clinical signs (e.g., tachycardia) of hyperthyroidism.

Another possibility....Are you hypoglycemic? Beta-blockers may mask tachycardia occurring with hypoglycemia, and when stopped, the heart races, due to the hypoglycemia.

zuzu xx

donsabi · 09-26-2003, 05:46 AM

Zuzu8,
Thanks for the reply.

I am back on the Tenormin 25mg for four days now and I feel much better. I am taking the med at night and that seems to work better for me. I have had a prior MI, thirteen years ago, and have multiple blockages with good collaterals. I am 60 years old. I had the cardiolite stress test in March and a cardiac cath. in July and docs continue to treat with meds. While during there periods of anxiety my highest BP was 152/92@81bpm, not much higher that it normally is. My thyroid is in balance and all labs look OK. I do have Hashimoto's Thyroiditis.
I managed to get an appointment with my cardiologist, or at least his assistant, today maybe they will have a better answer.

[This message has been edited by donsabi (edited 09-26-2003).]

zuzu8 · 09-26-2003, 09:22 PM

Donsabi-
I'm sorry you are dealing with these side effects of Tenormin... Please keep us updated as to what the cardio has to say. Is it possible to reduce your dosage? Or take it in divided doses, which does seem to help a lot of people.
Also, you might want to discuss other BP med options with your doc. I now know your cardiac history but obviously am not a cardiologist.
I do know that the beta blockers that you are on are often the drug of choice for people w/a history of heart problems. But not always... so I don't know what the answer from him might be...but for hypertension alone, the angiotensin 2 receptor blockers (ARBs such as Diovan, Atacand, Benicar) seem to have the least side effects.
zuzu xxx

[This message has been edited by zuzu8 (edited 09-26-2003).]

donsabi · 09-27-2003, 07:54 AM

Zuzu8,
I met with a nurse practitioner and not my cardiologist yesterday and I was impressed with her knowledge and best of all she listened to what I had to say. She said that not all beta blockers work the same way and went on to explain why she thought the anxiety was present after discontinuing the Tenormin. Actually that was more than I wanted to know, but with my history she thought Tenormin was the preferred medication. As you have, she suggested that I divide the dose in two, but I only take 25mg and I now seem to be having some success taking it before bedtime. Because my BP is a little high she put me on Altace. I told her I was reluctant to add new meds and she told me to call her next week to let her know how things were working out. She also said there are other medications if Altace doesn’t do well with me. BTW, BP is down 20/20 on the first day. I do feel a little foggy with the Altace but I understand that should pass in a about 10 days.

Thanks,
Don
P.S. I think I am going to trade my doctors for nurse practitioners.