Propanalol now asthma.

[dally]

Hi,
I have had panic attacks/anxiety for 30+ years. Phobic about taking meds, I've tried every type of self help. Nothing worked for me. Eventually with the help of an Occupational therapist, I did exposure therapy. Which has helped a little.

In order to cope with exposure therapy I was given valium and eventually became tolerant/addicted to it.

Latest med to 'help' me was propanalol. Now I have asthma and have been told not take propanalol. So for emergencies or attending appointments etc i have to take valium?

Does anyone know of any meds that have little/few or no side effects?

Terry...I specifically asked the GP for a beta blocker that could be used whilst having asthma. She said there were none.!!?? I do not want to have to rely on valium again. Arrrg

[iPodClassic]

Hi,
I have had panic attacks/anxiety for 30+ years. Phobic about taking meds, I've tried every type of self help. Nothing worked for me. Eventually with the help of an Occupational therapist, I did exposure therapy. Which has helped a little.

In order to cope with exposure therapy I was given valium and eventually became tolerant/addicted to it.

Latest med to 'help' me was propanalol. Now I have asthma and have been told not take propanalol. So for emergencies or attending appointments etc i have to take valium?

Does anyone know of any meds that have little/few or no side effects?

Terry...I specifically asked the GP for a beta blocker that could be used whilst having asthma. She said there were none.!!?? I do not want to have to rely on valium again. Arrrg




Hi. What do you need a beta blocker for?

[MyNameIsTerry]

Am I getting predictable, dally? :biggrin:

Well your GP is definitely incorrect there. For a start Shazamataz has asthma and her GP has prescribed her a specific one to cut down the risk with asthma, which is the acceptable treatment. She is in NZ though.

But, this is what the British National Formulary (BNF) say about beta blockers:

http://www.evidence.nhs.uk/formulary/bnf/current/2-cardiovascular-system/24-beta-adrenoceptor-blocking-drugs

Beta-blockers can precipitate bronchospasm and should therefore usually be avoided in patients with a history of asthma. When there is no suitable alternative, it may be necessary for a patient with well-controlled asthma, or chronic obstructive pulmonary disease (without significant reversible airways obstruction), to receive treatment with a beta-blocker for a co-existing condition (e.g. heart failure or following myocardial infarction). In this situation, a cardioselective beta-blocker should be selected and initiated at a low dose by a specialist; the patient should be closely monitored for adverse effects. Atenolol, bisoprolol, metoprolol, nebivolol, and (to a lesser extent) acebutolol, have less effect on the beta2 (bronchial) receptors and are, therefore, relatively cardioselective, but they are not cardiospecific. They have a lesser effect on airways resistance but are not free of this side-effect.

So, there are several there that she can prescribe you.

It should be noted that if you look on Drugs.com at each beta blocker you will see the same disease interaction warning for Propranalol as any of these but in the text it does say to use a specific type of beta blocker just as the BNF state. Drugs.com give a couple of examples and there are more on Wiki, but the BNF should be enough for her to prescribe them for you. These warnings always have a disclaimer in that a doctor can choose to prescribe where the benefit outweighs the risk. She just needs to keep an eye on your asthma and instruct you to do so, I would imagine.

It's not like all asthma is the same. If you were severe, then caution or referral to a specialist may be needed, but in well controlled asthma that's not the case.

Surely this is better than Diazepam?!!!

Is Buspirone worth a look? It has no interaction with asthma on Drugs.com. It does have a side effect profile but it's minor compared to antidepressants. It's not licenced beyond short term use because of a lack of clinical evidence but it may be an option to use at certain periods. I think you have to go on it for a couple of weeks first but if you have an event coming up, perhaps that's a workable solution? I know FMP takes it this way for his anxiety around his cancer check ups so he would be able to tell you more about that. There are some people on here who use it long term because their psychiatrists have prescribed it but otherwise threads about it may not get many hits.

I've never heard of anyone taking Buspirone as FMP does, you take it daily, but maybe there is something in there that can be exploited to help you?

[Pipkin]

It's always a risk taking beta blockers for anxiety when you have asthma. There are some that are less likely to exacerbate asthma symptoms but they don't work as well for anxiety. Having said that, I have asthma and take propranolol as needed with no adverse effects.

Hydroxyzine has a sedating effect and can be taken as needed. Other than that, you're pretty much talking about benzos which you probably want to avoid.

Pip

[dally]

Thank you so much for your replies.
iPod classic I need valium/propanalol as anti anxiety medication as I have agoraphobia and need it to help me get out of the house attend appointments and do exposure therapy.

I have a phobia (almost) of taking any meds as I seem to be so sensitive to side effects in almost any drug...except paracetamol, valium and immodium.

I tried a few antidepressants YEARS ago, and I was physically ill for days on only a couple of doses. My GP said I'd feel better after 6 weeks,!!! I couldn't manage 2DAYS.
I know they work for some people but I'm not mentally strong enough to cope with the start up side effects for weeks. And I've read MANY stories on here about ADs not even working after this period AND doubling the dose?!

To continue with any sort of therapy for my agoraphobia, I need a med that I can take only when I'm going out OR if I'm having a severe panic attack.

FMP. Do you take busropine on a weekly basis . Have you every taken it as a once off dose?
Are there side effects?

Terry thanks for the info. My GP was adamant I could not take ANY beta blockers and said none were suitable for asthma sufferers.
BTW. I have never had Asthma or lung problems before propanalol.
I will look into hydrophone.

Sedating aihistamines are not suitable as I don't want to be drowsy when attempting exposure therapy and obviously never if I have to drive

Thank you all so much for taking the time to reply

[MyNameIsTerry]

A PubMed meta analysis of studies on that database showing that these agents don't have much if an effect on asthma. The idea being to investigate whether they could start using them to help with asthma:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3709648/

A clinical trial by one of our universities into whether beta blockers could replace use of one of the asthma Preventers:

https://clinicaltrials.gov/ct2/show/NCT010748533

So, if your GP believes they should not be used, she must be at odds with the researchers of all these studies who are trying to get them to be used instead. Plus she is contradicting the BNF, the national drugs guidance to doctors.

NHS Choices also disagree:

http://www.nhs.uk/Conditions/Beta-blockers/Pages/Special-considerations.aspx

When to avoid them

You should usually avoid taking beta-blockers if you have:
•a history of asthma – beta-blockers are occasionally used in people with these conditions, but only under careful supervision

And the GP Notebook doesn't state they shouldn't be used either:

http://www.gpnotebook.co.uk/simplepage.cfm?ID=x20140107224421216972