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Thread: Want To Reduce Propranolol But Worried About Heart?

  1. #1
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    Want To Reduce Propranolol But Worried About Heart?

    So, I've been on 10mg of Propranolol for the past two years I think, or thereabouts. Before that, I had weened from 80mg slow release Propranolol, down to 40, then 30, then 20 ans then just stayed on 10mg once per day since.

    I take for my severe anxiety, as its not for heart or blood pressure. I'm 32 yr old female, I have Hypothyroidism and am on 50mcg for that. Anyway, I was thinking about reducing my dose down to 5mg a day, but my tablet comes in those awkward quarters, so will have to ask for the tablet that can be cut in half. Beside that, I am worried about side effects with the Beta Blocker, obviously would not stop without talking to my doctor but worried about being on this medication for, well, permanently?

    What would it do to my heart? Long term? Does 10mg have a large effect when reduced to 5mg or stopped? I guess I worry because I don't have heart or blood pressure issues (that I know of right now), and is purely taken once per day for my anxiety, will it cause lasting issues?

    What effect would it have on pregnancy?

    Sorry, just have these questions on my mind. Just thought about eventually reducing to maybe 5mg, or weening down to 5mg.

  2. #2
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    Re: Want To Reduce Propranolol But Worried About Heart?

    Hi

    This is just a courtesy reply to let you know that your post was moved from its original place to a sub-forum that is more relevant to your issue.

    This is nothing personal - it just enables us to keep posts about the same problems in the relevant forums so other members with any experience with the issues can find them more easily.

    Please also read this post:

    http://www.nomorepanic.co.uk/showthread.php?t=213239
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  3. #3
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    Re: Want To Reduce Propranolol But Worried About Heart?

    Quote Originally Posted by mischamoonlight View Post
    So, I've been on 10mg of Propranolol for the past two years

    I take for my severe anxiety, as its not for heart or blood pressure.
    Do you still have severe anxiety? If so, how are you planning to control it after you stop taking propranolol?

    Beside that, I am worried about side effects with the Beta Blocker, obviously would not stop without talking to my doctor but worried about being on this medication for, well, permanently?
    You should definitely get your GP's okay before changing the dose and also discuss how the anxiety can be managed without propranolol. If the plan is to switch to another med then the better option may be to stay on the current dose until the new med becomes effective.

    What would it do to my heart? Long term? Does 10mg have a large effect when reduced to 5mg or stopped? I guess I worry because I don't have heart or blood pressure issues (that I know of right now), and is purely taken once per day for my anxiety, will it cause lasting issues?
    Possibly. In the past beta-blockers where often prescribed for decades to reduce blood pressure, but they are no longer considered first line treatments for this in part because of their long-term side-effects. They are also not first-line treatments for anxiety, but can be useful in the short-term. Beta-blockers reduce the ability of adrenaline, aka epinephrine, to bind with adrenaline receptors which blocks the adrenaline surge of the flight-or-fight response, however, they have no direct effect on anxiety generation in the brain in the way antidepressants and therapy do. They are better long-term treatments.

    What effect would it have on pregnancy?
    There is limited and sometimes contradictory data. The UK Teratology Information Service's webpage on the use of propranolol in pregnancy explores the issues in some depth. However, one cautionary note, maternal anxiety (also depression) may also carry risks for the baby which aren't covered by the information on that site.
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  4. #4
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    Re: Want To Reduce Propranolol But Worried About Heart?

    I'm not going to just stop them without consulting my doctor, and I won't be stopping them permanently yet, I just wanted to try reduce them down to 5mg from 10mg, and work slowly over time see how that works on 5mg, and then ween off it from there, and try start working to look after my anxiety myself. I'll always have some form of anxiety, but don't want to be on a beta-blocker for the rest of my life that isn't for blood pressure or heart condition, and look after myself for other reasons too.

  5. #5
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    Re: Want To Reduce Propranolol But Worried About Heart?

    I will be contacting my doctor as well about reducing to 5mg. I've been on 10mg one dose a day for the last year or so, and I had a 24hr BP monitor a month or so ago, and my BP was fine, so want to reduce to just a slightly smaller amount from what I've been on for a while now. I just get anxious about side effects, or whatever you read, you read that heart attacks or sudden death, which is kinda....scary!

    Anyone experience with 10mg once a day dose for a long amount of time? Any side effects? I know here in Ireland, the smallest dose available comes in 10mg dose, which has a line through it that looks like it can be cut in half. I am given the 40mg, that I'm told to cut into quarters and just take 10mg a day (Which I do), but theirs no way of cutting that piece into 2x 5mg, because it would just fall apart.

    I'm not sure if that other tablet is available here in Ireland anymore, but I'm going to check with my doctor or pharmacist, as its the same medicine just in a different format. But would make it easier to reduce to 5mg.
    Last edited by mischamoonlight; 06-10-20 at 21:37.

  6. #6
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    Re: Want To Reduce Propranolol But Worried About Heart?

    Quote Originally Posted by mischamoonlight View Post
    I just wanted to try reduce them down to 5mg from 10mg, and work slowly over time see how that works on 5mg, and then ween off it from there
    I suspect that 10mg isn't doing a lot and then for only a few hours so 5mg is likely to be a waste of time. Immediate release propranolol has a very short half-life of about 4 hours so a 10mg dose taken in the morning will be down to 5mg in 4 hours and 2.5mg by mid afternoon and 1.75mg by nightfall. If you're taking it at night then you're starting the day with almost none still in your system.

    and try start working to look after my anxiety myself.
    Anxiety disorders (also depression) are the emotional expressions of atrophy of parts of the hippocampal regions of the brain caused by high brain stress hormone levels killing brain cells and preventing the growth of replacements. They are arguably a type of auto-immune disease. Both antidepressants and the cognitive/behavioural/mindfulness therapies work by stimulating the growth of new cells. These cells and the connections they forge produce the therapeutic response, not the treatments directly. (see also: Depression and the Birth and Death of Brain Cells (PDF)

    I just get anxious about side effects, or whatever you read, you read that heart attacks or sudden death
    These are very unlikely. Beta-blockers are still routinely prescribed to heart attack and stroke survivors in the immediate aftermath. Imo, the problem with beta-blockers isn't that they might kill you, but that there are much more effective long-term alternatives. If a med is needed then take the most effective ones which actually target the cause. The cost will be much the same.

    the smallest dose available comes in 10mg dose, which has a line through it that looks like it can be cut in half
    Scored tablets can usually be cut, but ask your pharmacist to confirm this.
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    The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.

  7. #7
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    Re: Want To Reduce Propranolol But Worried About Heart?

    Thank you for so much information, the auto-immune stuff is very interesting, and will look into that more. At the moment, I'm not making any rash decisions or cutting down anytime soon, but will be talking to my doctor about this for future plans in coming off and handling the anxiety some other way. At the moment, I'm not coming off them until I am in a better mind set and with my doctor's advice and support.

    I just worry about so many things that I tend to ramble it all out in a post, but glad you could break it down lol!

    THank you again though, its really informative post.

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