toprol-xl and low heart rate - High & Low Blood Pressure Message Board

crazyhorse61 · 05-23-2003, 01:50 PM

Hi all,Ive got a problem,Ive got panic and anxiety and my bp is high.now,internal med.doc and phys.say its from the panic my new fam md wants to talk to me about it.Im devistated by this disease,Im a former army ranger and combat vet,a construction worker and biker.I thought I was a picture perfect male,but I was wrong.The worst is that my heart just suddenly takes off from my normal low 60bpm to between 80-100 once 165.ive worn a holter and had 12 ekgs in 2 months at the er.all normal Ive had bloodwork all normal including chloresteral.when I have a panic attack eventualy my heart rate goes down evenyualy.but when it takes off somtimes it lasts for hours.is this still anxiety? is it safe to take my toprol-xl .50 with a resting rate of 60?I havnt taken the klonopin or paxil yet because there is a chance that they too can cause a rapid heart rate.Ive dropped 32lbs in 4 months without working out and before I was sick I worked out all the time.I told my docs I lost all the weight twitching and sweating,they laughed but I didnt.Anybody got any help to offer,Id appreciate it.

zuzu8 · 05-24-2003, 09:19 PM

Hi Crazyhorse,
Need a little more information.
What are your blood pressure readings and how many times did your doctor check your BP before deciding you needed Toprol? No one should be put on meds based on just a couple of readings.

Seems to me that it would be good to get the panic under control first before going onto BP meds.

Yes, panic and anxiety can really get your pulse racing and yes, it can last for hours.

I'm a little confused: You say you've got an internist and psychiatrist both telling you your elevated BP is panic, but now there's a NEW MD (?) who wants you on BP meds? Where has the first doc gone?

Again, what's your untreated BP?

zuzu xxx

crazyhorse61 · 05-25-2003, 04:38 PM

yeah,the new doc is new family md,she wants me to wait till she gets my records b4 deciding on bp meds.the shrink says dont take them and as for my bp its 140/100 or 140/90 allways in that are,im sure glad you tpld me about the heart rate,thats been the scarryest thing and it seems diffrent than the panic,it just happens when im not feeling anxiety or panic.have you had this

zuzu8 · 05-25-2003, 09:26 PM

Hi- crazyhorse- I saw your post on the Heart Disorders Board as well, which has a little more info including the fact that you are agoraphobic.

As I said there, it really sounds to me like your priority should be to deal with the agoraphobia/panic/anxiety BIGTIME, before you get involved with BP meds. You have a healthy heart and overall are a healthy person as all the tests show. PLUS, as you said on the Heart Board, you have probably inherited great genes!

This sounds like major panic disorder. And, as your shrink probably has told you, it would be interesting and helpful to see what happens with your BP and heartrate once you have some of this panic under control.

Have you ever taken paxil or klonopin before?
Paxil does NOT generally produce clinically significant changes in blood pressure, heart rate, or ECG. So don't worry about it sending your heart racing.

Klonopin can be sedating for some people and also lower BP sometimes. Everyone reacts differently to various meds, but neither of these 2 drugs have palpitation as a frequent side effect.
On the other board, you say your BP has previously been 120/80 but lately it's elevated. Again, panic could definitely be the cause of this and you may not need BP meds at all if you take the paxil and/or klonopin.

It's a good idea to sit down with you new doctor when she gets your records, and thoroughly go over all your options with her.

Let us know how things go, and don't forget the REALITY of the situation is that all your ekgs, holter monitor, bloods, etc have been great, and you come from a long-lived family to boot.

Panic disorder can be crippling and paralyzing, I know...But with the help of your doctors and therapist, I'm willing to bet you're going to feel better soon.

P.S. It would be a good idea for your doctors to confer with your psychiatrist if that's at all possible...so they all can agree on a plan of action for you.

P.P.S. I'm going to remind you one more time also:
Even when you don't consciously feel panicky or anxious in the moment, you can still have physiological responses such as palpitation and tachycardia (racing heartbeat) which don't seem to be connected to anything you are thinking at the time.

Hope to hear from you soon,

zuzu xxxx

[This message has been edited by zuzu8 (edited 05-26-2003).]

CobaltBlue · 05-27-2003, 06:01 AM

Crazyhorse,

One of the interesting aspects of beta blockers in me was that it tended to have a "calming" effect. The bad part is I also one of those persons for which beta blockers tends to obliterate libido.

When I came off of the beta blocker, my anxiety increased significantly to a point where I was prescribed Paxil. I took it for a short time but did not care for its affect on me either. In time, the anxiety has subsided.

Back to your question on beta blockers. My resting heart rate, prior to exercise and a beta blocker was in the low 60s. Currently, not on a beta blocker with daily exercise, my rate in the low 50s.

While on Toprol XL, my heart rate ran between 37-45 bpm. I really didn't notice any problems, except for a little tiredness in the afternoons while working at my desk. I would have to get up and move around a little.

Basically, they will prescribe beta blockers to the maximal dosage they can until side effects are apparent. As long as you feel alright with your heart rate in the 60s, and its helping out with your blood pressure, then its a good thing in my opinion.

Ulrich