Propranolol instant release - so far so good!

[Carrera74]

Hi everyone
Just wanted to give an update so that anyone who finds themselves in a similiar situation to me can see someone elses experience.

I had been taking half inderal (80mg extended release) for about 3 years following severe panic attacks making me housebound. These tablets slowly helped me build confidence to get out of the house and get back to work. Unfortunately these tablets were discontinued and this gave me a wake up call / kick up the backside that made me realise that I had been using these as a crutch and just taking them without getting to the bottom of what had caused these panics and I was just masking the symptoms. Unfortunately this caused even more panic as I knew I had to try a different slow release (I had been prescribed the half inderal branded type because the others disagreed with me). I was terrified of trying a new tablet - doesn't help that I have OCD, hate change and hate taking meds never mind trying new ones!

Anyway my lovely GP suggested I try the instant release type and said I could take up to 8 x 10mg a day. This seemed a huge amount even though I was taking this amount over 24 hours and the fact I am fearful of meds didn't help.

I was scared of how these would affect me with the other type still being in my blood and my normal tablet taking time was midday and the day I should hve takenn the tablet I put it off until about 6pm and took 2 x 10mg. About an hour later I felt the drug kick in. I feel drained, nervous but like a zombie. I didn't like it at all! I took myself off to bed and led watching tv willing it to wear off! I think a lot of this was my own anxiety. I am so good at making myself feel rubbish

The next day I took a 20mg dose in the morning and another around 5pm.

For the first few days I felt really zombied - I think whilst my body got used the different way the medication is released. I had my first CBT session a few days after taking them and I was dreading it as it was at the other side of town and driving is when my panics used to kick in. I did start to panic on the way there and spent most of the session freaking out but I got through it and I have been able to function - get to work, go shopping, drive etc on this dose without panic taking hold and taking over.

This is the dose I have been taking ever since and it works for me so far. My hope is that I can wean myself off this dose to just taking it as and when I need to (when the panic is too much and I need something to calm me down).

It has been so long since I started taking the tablets after my mini breakdown that I have just been continuing to take them thinking I need them to control the panic. I had assumed I would need 80mg to keep tabs on the panic attacks but so far so good. I hope that weaning myself off them slowly will work and I won't need them as much as I think I do. I feel better about myself and although my life anxiety is still with me I know I need to learn how to manage it so I don't get stressed out and then the anxiety gets out of control.

Does anyone else take the instant release tablets? How many do you take? Have you managed to wean off them successfully?

[Svojski85]

Hi, just a quick answer from my own experience. Tablets are not ideal because you constantly need to comply with a strict dosing regimen to perceive any positive effects at all. Taking it up to 8 times a day (or three or four times a day a couple) is a dreadful experience since a normal person just can't comply with such routine. You can try the whole day propranolol, knowing that they don't work great, so you may read my earlier posts from this week to get your way round it.

One thing to know with tablets (to contrast with whole-day capsules) is the instant release mechanism under which they work. In other words, they dissipate in your tummy instantly and they do not linger there for up to 10 hours as long-acting whole-day medications do. Therefore, you can get a rather debilitating surge of effect (that's called toxicity, when the medication is too strong and can even kill some because their bodies may not be able to cope with the suddenly rushing effect most noticeable over the first 2 hours in all immediate-release tablets). If you read into the "science" of drugs, you may find out that long-acting medications work for 10, sometimes up to 20 hours... So, if you took a 160mg long-acting Inderal, which worked for genuine 20 hours, you were actually getting 160mg/20hrs=genuine 8mg per hour on average as the drug was designed and produced in this way. With a tablet, which works immediately but for a much shorter duration, say 3-5hrs, you would get 10mg/5hrs=2mg per hour on mathematical average, however due to the instant-release profile (in other words, it does not take the drug the whole day to break apart in your tummy, but it dissipates almost immediately, usually within 30-45 min completely), you could get say a 5mg rush in the first hour, 3mg in the second hour, 1mg in the third hour, and 0.5mg in the one or two hours of its effect... Taking 8*10mg at once, make your own maths, and you will end up with a toxic effect, i.e. 80mg/5hrs=15mg per hour on mathematical average, but in reality you are supplying your body with some 40mg in the first hour, 24mg in the second, 8mg in the third, and 4mg in the last two hours because the drug dissolves completly and almost immediately since it is not a whole-day preparation with a sustained-release mechanism.... And then, you take another set of tablets later in the day, and the sudden toxic surge is back in force! Bingo!

Therefore.... When the indication by the doctor is for a long-term condition (not just for say stage fright, seeing a denting, going on a single journey somewhere), then long-acting drug formulations might be more appropriate.

[pollynewsome]

Hi i take one 40mg tablet first thing in the morning.. works fine until later in the afternoon and only if i have to do something different and then i get a bit panicky.. doc said i can take another to take panic away but i manage not too.. waiting for cbt.. Keep strong. x

[Carrera74]

I find that taking 2 x 10mg twice a day (at 9am and 5pm) works for me. I had taken the 80mg extended release ones previously but only the Half Inderal agreed with me so went on to the instant release ones. I had worried about the dosage not being right as my GP said I could take up to 80mg over 24 hours as I had been taking that dose already (over 24 hours) but I know that it's different maths for instant release.

I have picked up a new prescription today though and the pharmacist has given me a different brand again and these are making me feel a bit odd, well I am blaming the tablets, it could well just be me as I'm stressed to the max at the moment :(