I’m a 47 year old male, in good health. I started having panic attacks about 3 years ago, and I was put on Metoprolol to help with rapid heartbeat from the anxiety. I was also diagnosed with high blood pressure, and so I was advised to continue the Metoprolol and start taking Lotrel. I was also started on Clonazepam for the anxiety. Lots of tests on my heart. Absolutely no problems, except occasional PAC’s (benign). My blood pressure has been well controlled. Recently, I got fed up with the side effects from the Metoprolol, especially the sleep issues. So my cardiologist put me on Bystolic 5 mg, instead of the Metoprolol. Bystolic is supposed to have fewer side effects, but for me it’s the same. So I called him back and told him I wanted to get off the beta blockers completely. He told me it would be OK to just stop taking the Bystolic. He said he had me on it more for the palpitations than for my blood pressure and that the Lotrel alone would control my blood pressure. I asked if I should transition off the Bystolic, and he said it wasn’t necessary. This seems strange to me, as everything I’ve read says don’t just stop taking beta blockers. Any advice? Has anyone just stopped taking beta blockers with good results? Any experience with transitioning off a beta blocker?
Re: Need Advice For Transitioning Off Beta Blocker
Soccerdad,
my doctor, like yours, asked me to simply stop taking my alpha/beta blocker Labetalol last year. I was on a fairly large dose of 800 mg of the drug and had been for some time. When I voiced my doubts about quitting the beta blocker cold turkey, he told me to cut the dose in 1/2 for a week and then stop the drug altogether. I followed his "revised" instructions. I feel I should have gone differently about the withdrawal and taken longer than just one week. My withdrawal symptoms included a constant headache that lasted for almost three months, irregular heart beat, frequent chest pain and palpitations for several weeks afterward. The unrelenting headache was the worst of my symptoms. Most people do not have any problems stopping the beta blockers, especially if it is done properly. Our bodies' response to the discontinuation of the drug is based on several factors - the length of therapy with the beta blocker, the dose, overall health status, coexisting diseases and the body's tolerance of the drug.
Your dose of 5mg Bystolic is a small one, with normal dosing reaching up to 40mg. There is no coronary artery disease. The chances of adverse reactions are therefore small. No matter, a beta blocker should be tapered over one or two weeks just to be sure. Good luck with that and the blood pressure control!
Re: Need Advice For Transitioning Off Beta Blocker
My husband was on Toprol for one week at the smallest dose. He had horrible heart palpitations etc for about 2-3 wks. He stopped cold turkey. I could feel his agitations & palps sleeping next to him.
I once read an article by an ER Dr who said rebound hypertension in the ER is often caused by withdrawal b/p meds.
Since you already have had panic attacks, I think the safest route is to slowly get off the med. I would take a month myself.
I tried to cut down on my Labetalol (an alpha/beta blocker) & I didn't like my heart feeling like it was coming out of my chest.
I got off of clonidine which is the worst to withdraw from. I took two months but still got some high b/p's.
Re: Need Advice For Transitioning Off Beta Blocker
Why don't you try TOPROL XL instead of the METOPROLOL. TOPROL XL is a slightly different formulation which is Extended Release. METOPROLOL is an older formulation and immediate release. It could make a difference. Also, request the brand drug not generic. Generic (TOPROL/Metoprololol) has been having negative effects on way too many people. Another suggestion is to take 2.5 mg (break the pill in half). This works just as well as the 5 mg dose in controlling the heart rate and slightly less in controlling blood pressure.
I hope this information helps..
Last edited by mod-anon; 12-05-2008 at 09:19 AM.
Reason: Please use the Quick Reply button instead of Quote Reply.
Re: Need Advice For Transitioning Off Beta Blocker
Man, i hoep you didn't just stop. Just 6 months of only taking 50 mg once a day of metoprolol caused me rapid heartbeat and elevated blood pressure when i stopped it. My neprhologist said i could transition right to a different beta-blocker known as labetalol. it's a apha /beta-blocker. Boy was he wrong! That or the dose didn't equal out to what i was currenty taking of the metoprolol. around 5 days in the rapid heart beat and elevated BP showed up, so the next day i just started taking my metoprolol again. I called them too making sure it was ok if i switched back.. they didn't call me back until 5 days later!
I worked out too during those 5 days, then i read that you shouldn't and take it easy on your heart if you stop taking them, glad they didn't tell me that also!
Re: Need Advice For Transitioning Off Beta Blocker
what really helped me getting off the awful Beta Blocker, at least awful for me, is Magnesium supplements. and Although that I have taken the worst bioavaliable form of Magnesium, Oxide, it had a great effect on me. It lowered my heart rate, it's anti-anxiety and I just can't understand why drs don't try it instead of Beta-Blocker for healthy individuals with rapid heart rate???
Re: Need Advice For Transitioning Off Beta Blocker
I'm curious too Soccar dad as I too am about to taper off Bystolic (5mg). My doctor wants me to start taking the pill every other day for a week and a half and then every third day for a week and a half and then quit. What were your symptoms or results while tapering off? I am not on any other bp meds and in very good health with the exception of some labile blood pressure (white coat syndrome). thanks, Harper-Cole
Re: Need Advice For Transitioning Off Beta Blocker
Update: I've been tapering off of Bystolic since Saturday night (1/16/10). Went from 5MG once a night to 2.5MG once a night. Will continue this dosage for 1 1/2 weeks then go to everyother day for 1 1/2 wks; then every 3rd day for 1 1/2 weeks and then stop. So far no real noticeable difference or withdrawal symptoms--possible exception of a little more anxiety and one time feeling of tightness in chest back that turned out to be indigestion. Will attempt to work out tonight at half the intensity as when on 5MG dosage and see how it goes. Nothing really hard but I am climbing the walls to get back to the gym--addicted gym rat! Will keep you all posted for reference as to any withdrawal symptoms I get. Thanks, Jack HARCLE12
Re: Need Advice For Transitioning Off Beta Blocker
1-21-2010 update on withdrawal symptoms from Bystolic: I've been tapering off of Bystolic since Saturday night (1/16/10). I want to give this update log until I'm off so others can see what withdrawals if any i have had coming off the drug.
So far other than a little self imposed anxiety, I've had no withdrawal symptoms. Actually went to the gym last night (tonight too) and did a light workout including 20 minutes of cardio (tried to keep my heart rate very low--not going over 100)on machine, 250 crunch situps on both a crunch table and crunch chair, and arms (biceps and triceps) and some back exercises. No signs of stress on heart or body and no with drawal symptoms what so ever. However, i am only in the first stage of tapering off so I'm still causious. I am down to 2.5 MG of Bystolic once a night and will start skipping every other day next week. My BP remains the same and my resting heart rate is still in the high 50's (same as it was at 10MGs and 5MGs of Bystolic) and only a few missed heart beats as always. I will continue to post withdrawal log until I'm off of the drug completely in hopes that it will be of some help to others going through it. Jack
HARCLE12
Re: Need Advice For Transitioning Off Beta Blocker
harcle - It sounds like your doing great weaning off Bystolic. I think the negative reactions are much worse depending on the beta blocker and the amount of time they were taken. Propranol and Metoprolol have the largest effect on adrenalin. They cross the blood and brain barrier, which is what they were designed to do. The adrenalin surge is what causes hypertension in most of us. It's very possible with exercise and proper diet, you will not need any medications to control your blood pressure. Exercise is probably the best way to improve the adrenalin rush. Good luck and continue the good work.
Re: Need Advice For Transitioning Off Beta Blocker
Thanks Ace! worked out again last night and took HR up to 111 for 20 mins. No adverse reactions or feelings. I know the mfg suggests "no strenuous activity" while tapering off, my guess it is more for people with corinary heart disease than someone like me who has high exercise tolerance. Also, while on the 5mg of Bystolic as well as Atenolol prior to that, I worked out hard every day and managed to keep my max HR around 127-130 while on the beta blocker, so going down to 2.5MG doesn't seem to make much difference, I just haven't elected to push it higher yet--maybe tonight. post workout BP low reading was 124/72 with pulse of 56, so it's going well. Only noticeable thing is slight anxiety which is most likely self imposed! --(.025mg of Ativan takes care of that-lol)! Will keep the posting up to help others when tapering off. I really appreciate your support and advice. It means a lot to have someone else that's gone through it to offer advice and encouragement. Jack
Re: Need Advice For Transitioning Off Beta Blocker
harcle - Anxiety is one of the many withdrawal reactions. I don't believe it's entirely self imposed. Beta blockers work to dampen nervous reactions and blunt the effects of excess adrenalin. It's a readjustment period to deal with stress related situations without drugs. It's similar in part to alcohol withdrawl for a heavy drinker. Thanks for the postings and the updates.
Re: Need Advice For Transitioning Off Beta Blocker
Ace28- I agree. Though as you well know anxiety can be driven up by worry,etc and likewise, lowered by relaxiation and deep breathing/working out, and of course a little Ativan never hurts at times like these. But honestly, I feel amazingly ok considering my fears prior to starting. Looking back on it, I never felt different going from 50mg of Atenolol to 25mg or when switching over to Bystolic-first 10mg then down to 5mgs and now 2.5 mgs. Probably will be more severe once I go to the skip-a-day then 3 day program. Will most likely do that after 2 wks of being on the 2.5mg dosage.
Re: Need Advice For Transitioning Off Beta Blocker
Saturday evening Update--just left gym. took HR even higher and the only thing I noticed was some exercised induced PVC's. Max HR was around 115 with avg of 104 for 23 minutes. BP at home 10 mins after work out was 123/71-p-56. No gym tomorrow but will try and run it up to 120's on Monday. Still no noticeable withdrawal symptoms but again, I'm still on 2.5mg of bystolic once a day, so the real test will be the end of next week when I start the every other day routine. Jack
Re: Need Advice For Transitioning Off Beta Blocker
I haven't posted my updates for a few days thanks to being down with a nasty head cold. All is pretty much the same and I start skipping a day with Bystolic for a week, starting Saturday night. Then every other day for a week. Then stopping completely.
The only withdrawal symptoms that I noticed at all from the reduction in dosage, and I'm not sure thats what caused it, was a few days of some anxiety and a few missed heart beats (pvc's) which is no big deal. I've only had a couple of higher BP readings and they are always on the first reading and drop immediately down on 2nd and 3rd reading. Example this morning while rushing around I decided to see how much adrenalin was pumping and took it at once after sitting down-result was 158/67 Pulse 58. I took it 2 minutes later after sitting down quietly and it dropped at once to 133/68, then below 130, so I'm not at all worried. Average BP over the last 2 weeks of dose reduction was 131/70. See doctor tomorrow am and will get lab results to see if Bystolic raised my cholesterol or blood sugar at all. So far so good and I haven't noticed much difference between 5 mgs and 2.5 mgs of Bystolic. I will post tomorrow or over the weekend with updates. Jack
Re: Need Advice For Transitioning Off Beta Blocker
Thanks for continuing to share your experience with beta blocker withdrawal.
Your blood pressure seems pretty good. Your top number in the morning is high, but not too bad considering you were rushing. Still, consider how many times during the day you get nervous or get an adrenalin rush. The top number (I believe) should be better controlled, regardless of rushing etc...
In regard to lab results, Bystolic seemed to worsen most of my test results.
My glucose rose 10 points, White blood cell levels increased, cholesterol up by 25 + points, and HDL was lower. I'm pretty convinced this pill has negative effects on blood test results, unless you increase cholesterol medications. For about 2 + months last year, I switched to another beta blocker called Betaxolol, When I had my last blood test all my numbers returned closer to normal, only a slight increase in triglycerides. Cholesterol drooped 30 points, Glucose dropped 12 points, HDL was the same. Aside from the negative blood test results, Bystolic is probably still the best and most tolerable beta blocker. It's mode of action seems to target inflammation, and artery function more effectively than most HBP medications. Your blood test results should be pretty good because you are on a very low dose of Bystolic, and you've been exercising pretty intensely.
P.S. Let me know if the blood tests improved with the exercise regimen...
Last edited by mod-anon; 01-29-2010 at 11:49 AM.
Reason: Please use the Quick Reply button instead of Quote Reply.
Re: Need Advice For Transitioning Off Beta Blocker
Hello Ace and other readers. Here's the update. I had my doctor's visit this morning and went over the labs I had done last week. Labs first: The only noticeable increase was in the glucose level which as you mention most likely is due to the Bystolic and Atenolol prior to it. My normal level is below 99 and it was 119--Doctor thought it was nothing to worry about as it was most likely due to the nearly 2 years of beta blockers. Cholesterol was still low-118-Ratio 2.5- Triglycerides were up from 38 to 59--might be due to the Bystolic, not sure still very low. Homohysteine level was at top level of 11.9 (actually top level is 11.4 but not enough to worry about).
Will be off of Bystolic completely by Feb 13th which is my stop date. Should be fine. My avg BP is 131/70 and my doctor is convinced that my "Labile" BP is due to anxiety (I'm in the financial service industry/insurance think AIG ) and that my normal low readings are very good. Last night it was 121/68--for age 64 (soon to be 65) its not bad. He believes that the higher reading the other day was due to a severe sinus infection and ear infection and that plus no sleep/anxiety probably caused the spike--I think it's nothing more than white-coat/cuff syndrome! I even scare myself when taking it-LOL.
Lastly, still no side effects and I plan on going back to the gym tonight as I've taken a couple days off due to the sinus infection/cold. Next week and the week after will tell the tale as I start to skip a day tomorron night and then the following week, one pill every other day. I also plan to work out continuiously but take it easy as I am aware that HR could be eratic once I stop. Will keep you posted and once again, I really appreciate your support!
Re: Need Advice For Transitioning Off Beta Blocker
PS: did I mention that i now have to also take Augmentin for the sinus infection. First prescribed Levequlin but I passed on it as it is ver costly and can cause some major problems to your tendons and joints, like snapping them! Same with Cipro-never work out while on either drug!
Later-Jack
) and that my normal low readings are very good. Last night it was 121/68--for age 64 (soon to be 65) its not bad. He believes that the higher reading the other day was due to a severe sinus infection and ear infection and that plus no sleep/anxiety probably caused the spike--I think it's nothing more than white-coat/cuff syndrome! I even scare myself when taking it-LOL. 
