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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by WhatToDoNext on July 27, 2008, at 20:51:14
I posted about severe anxiety from the Transfer of Xanax XR to fast acting in another post. This transition was done within the last week.
My symptoms were Severe Shortness of breath at times for no reason, and alot of fidgeting around, couldn't sit still. Was feeling the Anxiety real bad in the chest.
I went to 2mg bid on my Klonopin as directed by my MD, (was previously on 1mg bid). I stopped the Xanax XR 1mg bid completely and started on the fast acting Xanax 0.5-1mg x 4 day. For the past few days, my anxiety has been out of this world. I have been short of breath, dizzy, headache, very very anxious (much more than baseline). II've been eating Xanax 1mg at a time with no relief at all, just major sedation. The only other med I'm taking is Zoloft 50mg daily. I stopped drinking coffee about 4 days ago and thought maybe I was having Caffeine withdrawal, so I drank two cups this morning, got a little relief from the shortnes of breath, but it soon returned to a rate of about 40 breaths per minute. I have had this happen now about 4 times over the past few days. When it happens, rush to my med cabinet and start taking doses of meds I recently came off of. The only two meds I recently came off of were 1. Buspar 45mg, titrated down to nothing over about a two week span, but I was only on it for about 3 weeks total. The other med I had stopped was my Propanolol, which I had taken for years, but my Cardiologist said to switch over to Calan, a Calcium Channel blocker, as I the Propanolol didn't seem to help my anxiety anymore. I'm trying to eliminate meds, as I'm only 39 y.o. and feel like maybe the meds are makiing my anxiety condition worse.
S0, the past few days have been hellish, as the sympstoms persist all day. I sit by the phone and contemplate calling 911, but don't want to wind up in a psych ward as my mind is intact and I just have extreme anxiety which no other med has helped in the past.
So today, I started thinking hmmmmmmmmmmm. Maybe I should look up about the Propanolol, didn't think much of it as I've been off of it for about two weeks, but I decided to take it and see what would happen. 20 min. after ingesting 20mg of propanolol, my Shortness of breath subsided and so did the intense anxiety that was like a constant panic attack sensation.
I've googled all over the place and read about rebound tachycardia, and headaches, dizzyness, rebound hypertension, and I found a few sites that said possible anxiety, but I couldn't find anything about shortness of breath or labored breathing.
I think I have found the fix now out of process of elimination and hopefully saved myself a trip to the ER and the Psych unit, where this would have been overlooked, and I would have been pumped full of tranquilizers I'm sure. I've never been hospitalized, but I've read and I don't want to wind up there at all costs.
So my big question: How the hell could being off Propanolol cause shortness of breath and the severe anxiety I have had x the last 3-4 days ?
I have read that when starting a Beta blocker, people can develop this symptom, but nothing, and I mean nothing about this happening when coming off.
Thanks in advance for anyone who might have insight into this knowledge.......
Regards,
Steve
Posted by Phillipa on July 27, 2008, at 23:42:01
In reply to Question about Propanolol (Beta Blcoker) Anxiety, posted by WhatToDoNext on July 27, 2008, at 20:51:14
Oh the first post said inderol so it's calan is this listed as a side effect? Let me do a quick google search for you since you seem so upset. Phillipa
Posted by Phillipa on July 27, 2008, at 23:54:09
In reply to Question about Propanolol (Beta Blcoker) Anxiety, posted by WhatToDoNext on July 27, 2008, at 20:51:14
Okay may have something for you. The other name for calan is verapamal. It can cause shortness of breath used for hypertension, cardiac arrythmia do you have a heart condition? Please read below. Could be an allergic reaction. I think it warrants an immediate call to your cardiologist. And please let us know what the outcome is. Phillipa
Verapamil
(ver ap' a mil)
Contents of this page:
Why is this medication prescribed?
How should this medicine be used?
Other uses for this medicine
What special precautions should I follow?
What special dietary instructions should I follow?
What should I do if I forget a dose?
What side effects can this medication cause?
What storage conditions are needed for this medicine?
In case of emergency/overdose
What other information should I know?
Brand names
Why is this medication prescribed? Return to top
Verapamil is used to treat irregular heartbeats (arrhythmias) and high blood pressure. It relaxes your blood vessels so your heart does not have to pump as hard. It also increases the supply of blood and oxygen to the heart to control chest pain (angina). If taken regularly, verapamil controls chest pain, but it does not stop chest pain once it starts. Your doctor may give you a different medication to take when you have chest pain.This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
How should this medicine be used? Return to top
Verapamil comes as a regular tablet and as an extended-release (long-acting) tablet and capsule to take by mouth. The regular tablet is usually taken three times a day. The extended-release tablet and capsule are usually taken one or two times a day and should be swallowed whole. Do not chew, divide, or crush the extended-release tablet or capsule. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take verapamil exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.Verapamil controls arrhythmias, high blood pressure, and chest pain (angina) but does not cure them. Continue to take verapamil even if you feel well. Do not stop taking verapamil without talking to your doctor.
Other uses for this medicine Return to top
Verapamil is also used sometimes to treat migraine headaches and cardiomyopathy. Talk to your doctor about the possible risks of using this drug for your condition.What special precautions should I follow? Return to top
Before taking verapamil,tell your doctor and pharmacist if you are allergic to verapamil or any other drugs.
tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially aspirin, carbamazepine (Tegretol); cyclosporine (Neoral, Sandimmune); fentanyl (Duragesic); heart and blood pressure medications such as beta-blockers, digoxin (Lanoxin), disopyramide (Norpace), flecainide (Tambocor), quinidine (Quinaglute, Quinidex), diuretics ('water pills'), or any other blood pressure lowering medication; lithium (Eskalith, Lithobid); medications to treat depression; medications to treat glaucoma (increased pressure in the eye); phenobarbital; rifampin (Rifadin, Rimactane); theophylline (Theo-Dur); and vitamins.
tell your doctor if you have or have ever had heart, liver, or kidney disease, muscular dystrophy, or gastrointestinal obstruction (strictures).
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking verapamil, call your doctor.
if you are having surgery, including dental surgery, tell your doctor or dentist that you are taking verapamil.
you should know that verapamil may increase the effects of alcohol and make them last longer.
What special dietary instructions should I follow? Return to top
Verapamil may cause an upset stomach. Take verapamil with food or milk.Talk to your doctor before using salt substitutes containing potassium. If your doctor prescribes a low-salt or low-sodium diet, follow these directions carefully.
What should I do if I forget a dose? Return to top
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.What side effects can this medication cause? Return to top
Verapamil may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:constipation
dizziness or lightheadedness
headache
upset stomach
heartburn
excessive tiredness
flushing (feeling of warmth)
slow heartbeat
vivid, unusual dreamsIf you experience any of the following symptoms, call your doctor immediately:
swelling of the face, eyes, lips, tongue, arms, or legs
difficulty breathing or swallowing
fainting
rash
yellowing of the skin or eyes
fever
increase in frequency or severity of chest pain (angina)If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/index.html] or by phone [1-800-332-1088].
What storage conditions are needed for this medicine? Return to top
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.In case of emergency/overdose Return to top
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.What other information should I know? Return to top
Keep all appointments with your doctor and the laboratory. Your blood pressure should be checked regularly to determine your response to verapamil.Your doctor may ask you to check your pulse (heart rate) daily and will tell you how fast it should be. If your pulse is slower than it should be, call your doctor for directions on taking verapamil that day. Ask your doctor or pharmacist to teach you how to check your pulse.
The extended-release tablet (Covera) does not dissolve in the stomach after being swallowed. It slowly releases medicine as it passes through the small intestines. It is not unusual to see the tablet shell eliminated in the stool.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
Posted by WhatToDoNext on July 28, 2008, at 7:03:10
In reply to Re: Question about Propanolol (Beta Blcoker) Anxiety, posted by Phillipa on July 27, 2008, at 23:54:09
I'm new here, and when I made the first post It didn't show up, so I thought I did something wrong and typed it all over again only to find out that the original post showed up later.
Anyway, here is the story so you understand it.
I was on Propanolol for a few years and it controlled my HR so that I wouldn't go into panic mode as it was my first symptom of a panic attack. It worked great, but than my HR started going in the 140's at rest with free floating anxiety. I went back to the cardiologist and he told me maybe my body had gotten use to the med and he switched me to a Calcium Channel Blocker after a quick wean of the Propanolol. The first dose made me feel kind of sick, so I called him and he just said not to take either.
So, somewhere between 1 and 2 weeks after this, I developed this severe shortness of breath accompanied with severe anxiety and I mean severe. It has been at least 5 x worse if not more (the anxiety), since this began. I loaded up double on my Xanax and Klonopin to no avail. I only became very sedated, but the anxiety didn't budge. I tried eating benadryl, as this has helped my anxiety in the past, again to no avail. Then I realized I had stopped drinking coffee a few days prior due to the increase in anxiety and shortness of breath, so I made some coffee thinking it was caffeine withdrawl, again, to no avail.
Finally, I took 20mg of the Propanolol and poof, within 20 minl, the shortness of breath resolved as did the intense anxiety and other symptoms, dizzyness, mental fog, etc.
This is what is puzzling me. All the literature talks about start up shortness of breath, but this was shortness of breath due to not having the med on board and it's this that I can't find in the literature. Not only the breathing problem, but when I tell you the anxiety was intense, you have to understand that it was INTENSE, like I've never felt. Just to give you an idea, I've been out of work for several months due to the underlying anxiety that began, which would cause me to shake and make me unable to drive, barely leave the house, etc. So when I say this was 5 x worse or more, just imagine. I am a strong minded individual and can take alot of pain, both physical and emotional, but what I just went through was disatourous. I took 20mg of Propanolol last night before bed again and just woke up here at 8 am and I am pretty much anxiety free. Nothing else has changed in my med tx.
I take: Zoloft 50mg, Klonopin 1mg twice / day, and Xanax as needed now, Thats it..... And of course, restarted the Propanolol.
I will call the Cardiologist regardless, but the literature doesn't mention anything about Shortness of breath as a withdrawal symptom nor does it mention the severe anxiety that developed.
Remember, this went on for almost a week. It was so bad, I was so close to checking myself into the Psych ward. But the reinstation of the Propanolol got rid of everything. I am not a conditioned person by nature, so forget any type of placebo effect.
Thanks again for all of the great support I've received thus far on this Board.
Steve
Posted by Phillipa on July 28, 2008, at 12:27:58
In reply to Sorry for the double post, let me clear this up !, posted by WhatToDoNext on July 28, 2008, at 7:03:10
Steve first you deserve a great big welcome to babble. In your first thread you mention propanolol and inderol which are the same med inderol being the brandname and then the second thread I think you said calan being the other name for verapamil. So I did read the info on inderol or propanolol and it mentioned withdrawal effects that if the side effects went away with the reinstatement of propanolol for panic not heart conditions you did the right thing. I used to have incredible panic attacts and inderol or propanolol is not recommended with thyroid disease which I have so my pdoc used 25mg of lopressor. As my anxiety was so bad he wanted me on this before giving me l0mg of paxil. I also had to go to 2mg of xanax divided doses. I think I took this combo for about a year at which point the lopressor was making me so tired I stopped it I guess cold turkey and was fine. And continued with the l0mg paxil and xanax. But it seems for some strange reason I usually not always don't get withdrawal effects as we're all different. Anyway do you have a pdoc? Maybe the two could consult? And thanks for explaining takes a while to get the hang of posting and that's fine. Phillipa
This is the end of the thread.
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