Urgent advice needed

[Helencollins]

Beta blocker fears health anxiety
Hi there,

Been great reading all your posts and knowing I'm not alone. I developed health anxiety a while ago and it's literally changed my life for the worse, I can't enjoy social events anymore without at least a few moments that I think I am dying,.

My problem is 2 fold...I can identify a lot of my symptoms as health anxiety but I also have GENUINE reasons for fears, I had a hospital admission about 7 years ago (way before I worried about anything!) for a posterial nose bleed, linked to high blood pressure, I am very overweight and drink and smoke....so yeah feel like a stroke waiting to happen! I have tried to make changes but since this anxiety took over my life a year ago these things are harder to give up as they relieve the tension!!

My new gp has been great but despite showing him a weeks worth of scarily high BP results he is convinced it's anxiety related (I have developed a phobia or doctors and being hospitalised and physically shake in his office but these readings were taken at home when calm) he insists that you are never truly calm when suffering from anxiety and is very reluctant to prescribe front line bp meds (after the hospital incident my bp at my surgery a few days later was perfect) but my ankles swell after sitting down all day, go down overnight and not at all at weekends. I told him this and he said it's water retention and nothing to worry about, probably related to the extra weight I'm carrying, and didn't prescribe a diuretic! I have convinced myself I have heart failure. I had a full battery of tests including an ECG liver and kidney function last year and All came back fine, but I do get breathless climbing stairs (another phobia I now have) but could just be normal because I'm out of shape...

Anyway, he said propananol 80mg slow release will help bp
And anxiety, I've had them for a week and too scared to take them. What if my bp is normal when I'm
Not anxious and I send my heart rate too low? Also for my mind a couple of glasses of wine a night has become something I need, please no judgement I know that's not healthy but will I be okay to keep doing that?

Just wondered do you think I should take these and if they will help?

It was interesting at the surgery, I wanted bp meds which he refused, he offered anti anxiety meds which i refused and we ended up on the propanalol 80mg. I am 32 by the way

[Daisy Sue]

Hi Helen... I think we all reach a point where we really want to make changes, and until you get to that point, all the sensible advice doesn't actually hit home - hopefully you'll get there yourself soon, and once you start you'll realise that you can actually achieve your goals. Don't be too hard on yourself, we all have weaknesses, but it's probably time to start planning how you'll reach that decision point yourself.

Re the tablets, I've had the same fear - I think in your shoes, I'd probably try a very small dose to start with, cut the tablets in half or even quarters and see how they affect you. I do that with most new meds anyway - feel safer

[Booboojenny]

Helen sorry to hear you are feeling anxious, I take propanalol but I don't drink Alcohol so can't advice you on that one, probably best to o back to your doctor if your unsure and check with him ..take care

[Helencollins]

Thank you both for your kind words.

I'm also on the waiting List for CBT... And boy is it a wait on the nhs! 4 months and counting!!

But I'm reading and trying breathing exercises and trying
To make changes bit it's all so much, I feel so sorry for myself sometimes that this disease has stolen my personality :-(

---------- Post added at 01:18 ---------- Previous post was at 01:16 ----------

Also I asked my doctor if I needed to avoid anything and he said no. Posts on here say a little alcohol is fine but the sheet in my pack says avoid alcohol?!

[Daisy Sue]

I think I'd avoid alcohol with the tabs, at least until you know how they're going to affect you - you can get alcohol free beer or wine if you do fancy a 'grown up drink' in the meantime. Give it a week then maybe ring a pharmacist and see what they advise regarding any or how much alcohol is ok with those meds?

[Helencollins]

Thanks everyone. I'm at home alone today and feeling quite relaxed, I tend to be more panicky at work. Do you think I should take my first one? Or should I wait until there's someone around in case I have a bad reaction? Feel like I keep making excuses to start though!

---------- Post added at 17:08 ---------- Previous post was at 13:44 ----------

Thanks all, I will take my first one soon and then just try and forget about it for a few hours and see how I feel. Appreciate the advice. Anymore from anyone else is welcome :-)

[Daisy Sue]

Hiya.. did you take it? And how do you feel?

[Svojski85]

Hi Helen, I don't know if you will appreciate my full response, but some other readers might find my full response reassuring.

Propranolol (first discovered in 1964) is the ultimate drug for the 21st century as it blocks production of adrenaline in your body. When we experience any form of stress, our fight and flight responsiveness kicks in, our "brain" can start feeling not easy and at danger, so he makes an order to flow adrenaline in your body... As you probably know, adrenaline in our body is directly responsible for our heart beat, contraction of lungs aka our breathing, and our sweat production. The more adrenaline in your blood, the more heart beat, the more heavy breathing, the more sweat. This is our very primal inheritance from our forefathers when we were getting ready to kill a mammoth in a battle, for example . In our modern 21st century life though, we either flee such confrontations or we somewhat face these. If we face them, we are then being challenged in many ways further, so the stress is still there until you resolve the situation (or flee). This is the nature of working for some company which 99% of us do these days. Sometimes we are put in adverse situations at our work, which we can't possibly resolve. Other situations involve breakdowns of families and partnerships which is also a very common occurrence.

Propranolol can however block your adrenaline "stress" reaction to such an extent that you should not be feeling the every-day pressures nor should you develop any panicky feelings. The Big Pharma gods however know this, they know that there could potentially be a great demand for this drug and that this drug could effectively wipe out all need for counseling, most cases of depressions and most cases of anxieties, so they discontinued what would be just a single pill to be taken in the morning (INDERAL LA by AstraZeneca) and which lasts the whole day, between 10-20 hours. How (not) convenient for the UK people!

Now, since AstraZeneca discontinued that pill, the UK patient does not have that anymore. There are some inferior alternatives though (the apparently whole-day propranolol called Bedranol by Sandoz or called Beta Prograne by Tilomed, and some short-effect pills) but these are not that "potent" or shall I say, effective as once the mighty INDERAL LA was. It takes them too many hours to kick in (up to 5 hours), and the effect does not last the whole day (rather 12 hours, minus 5 hours of the drug peaking in your system, hence 7 effective hours at most).

You will have to find your dosage which will work for you and your body; it could be between 10mg to 320mg, but you should consult your experience with this drug with your doctor. Of course, propranolol cannot cure psychosis or schizofrenia, but it serves well for people with different neurotic problems (some forms of anxiety-related depressions and for general anxiety), i.e. when you are not disilusional but you simply feel at great discomfort from emotional fear and anxiety in you.

Also, a low dosage of propranolol (I'd say in the region between 10mg-40mg) could work as prevention of a heart attack, and according to Dr Roger Pitman of Harvard Medical School, propranolol in the effective dose between 160mg-320mg can manage PTSD patients.

As for generalized anxieties, the effective plasma concentration level of propranolol in your blood stream has to be around 40-160mg, for the whole day effectively, for propranolol to have its beneficial effects. This is highly individual as well as we all fear different things

It is however very important to mention that when you doctor is arriving at your dosage, he must know the individual parameters of each propranolol drug (or any other drug, as the need might be). There are currently roughly 5 propranolol options sold here in the UK (www.medicines.org.uk). They are:

propranolol oral solution by Syprol 5mg, 10mg, 40mg and 50mg
propranolol capsules by Sandoz 80mg and 160mg (aka Bedranol SR)
propranolol capsules by Tilomed 160mg (aka Beta Prograne)
propranolol tablets by Accord 10mg, 40mg, 80mg
propranolol tablets by Actavis 10mg, 40mg, 80mg, 160mg

As regards the Sandoz-made propranolol called BEDRANOL SR, Sandoz claim that their propranolol (80mg and 160mg) should peak (i.e. start working in your body) within 1-2 hours. They are trying to copy-cat the effects of INDERAL (discontinued recently by AstraZeneca), however in BEDRANOL SR they are not using the same modern cooking ingredients as INDERAL did, they are relying on cooking ingredient first used in 1950s that merely enhances the drug taste (sucrose, i.e. sugar), so they can't possibly achieve the same results as the mighty INDERAL LA had. Therefore, having tried this propranolol by Sandoz myself for good 4 weeks, I can testify in any court that Sandoz propranolol is a scam! So, stay away from it; their claims are false.

In other example, you can also use the tablets (not capsules). They peak (i.e. start working in your body) within 1-2 hours since they contain what is called hypromellose coating. This is an important cooking ingredient discovered in the 70s, and has been used in drug preparations since then. In cases of using these pills, I would argue that you actually can rely on its therapeutic effect to start working within 1 hour. The only question is then the effective plasma concentration of this type of propranolol in your blood stream, so that can be highly individual; some people need 10mg (and the rest of anxiety goes away by placebo effect), other people (like me) need between 160mg-320mg for their anxiety to go away completely. The "big pharma" trick is in that the pills are effective only for between 3-6 hours, including the peaking period of 1-2 hours which you need to discount from this effective period. Therefore, a pill can dissipate in your body very quickly, I'd say within 3 hours if you are perhaps slightly overweight man with propranolol tolerance. Less weight (in a woman, for example) means it could last little more.

Therefore, your dosage will be highly individual, you should perhaps try out different dosages until you feel comfortable, not exceeding thereby the maximum dosage of 320mg, or your heat beat could go away forever (no joke).

Remember, that at arriving at the correct dosage for your body, you need to take into account that it can take up to 5 hours in some cases for one propranolol to start working inside your body (i.e. the so-called peak; more information in your drug leaflet).