Cant figure out if propranolol is making me better or worse!

[Tabularasa]

I had a major episode of anxiety three weeks ago and the doctor suggested 40mg of propranolol twice a day. I took the first one and couldn't believe how calm I felt after about 2 hours.

The first week was ok, strange side effects made me a bit like a zombie for the first hour after taking and I also had horrid nightmares that woke me up and scared the life out of me. Second week it settled down, no panic attacks, no chest pains, no blurry vision etc. I slept in one weekend and forgot to take my tablet and noticed that I felt much better that day but didn't really pay much attention.

By the beginning of the third week (Saturday just passed) I started with stabby chest pains, pains in my left arm, pains up my neck and across my left jawbone, dizziness, I couldn't sleep on my side and when I lay down I got strong chest pains. The nightmares came back and I didn't sleep properly for 3 days.

I thought about the day when I didn't take it for 24 hours and wondered if the propranolol is actually causing all of these effects. So, yesterday after taking my pill, I sat in constant agony for 5 hours with relentless chest pain. Once the tablet had worn off (I think) the pain faded and I decided to conduct an experiment.

I have now not taken the tablet for almost 36 hours and I haven't had any chest pains, ive had just one episode of palpitation, no pains in my arm or jaw or neck, no blurry vision or anything.

I'm so confused now. Did the propranolol make me worse? Can it do those things? I have tried to get a docs apt for 2 days now and they keep saying no appts - ive asked for my doctor to call me today and im still waiting.

Resting pulse on propranolol is 42bpm - resting pulse today is 61bpm which I note is very healthy (Im 24yo female)... Only thing ive noticed today is the pressure in my face has come back which I hadn't had on the propranolol.

Any views, comments, advice?

[Svojski85]

With beta blockers, i.e. substances decreasing the heart rate, including propranolol, your doctor should always be aware of your resting heart pulse which should never fall bellow 50-55 bpm. For example, with oxprenolol (which is an almost identical beta blocker to propranolol), the actual patient leaflet says that you should not fall bellow such threshold. See here, par. 4.2:

http://www.medicines.org.uk/emc/medicine/1326

Conclusively, if the dosage of propranolol (40mg twice a day) is causing you a resting heartbeat of 46bpm, then it inevitably causes you this chest pressure as the heart is not managing to pump through all the blood crossing it, so there are second-long pauses in which the blood accumulates in hearth and is not transferred nowhere, hence the pain.

In your case, I would see the doctor and I would report back to him this low resting heart rate. I would ask him if it would be a better idea to move you onto 20mg x3 day or 20mg x2 day, until the problematic ache stops. I would also discontinue the 40mg propranolol until then, especially I would not take it for night time.

[Tabularasa]

Thank you for your reply. I had no idea that a bpm could be too low. Wow so mine was really slow!! It was anywhere between 41-50 during taking the propranolol. I finally got to talk to my doctor at 6pm and he said that my side effects are all from the med and I need to stop taking it. I told him I stopped yday and he said 'good'...

Now I've just gotta see how the next few days go I guess...