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Propranolol?

Discussion in 'Problems Standing: Orthostatic Intolerance; POTS' started by Prefect, Dec 4, 2017.

  1. Prefect

    Prefect Senior Member

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    My symptoms are mostly from the neck up. Dizziness, sensory problems, eye focusing problems, cognitive issues, anxiety, disassociation, and the occasional bout of IBS. And non-allergic rhinitis, which I'm convinced is due to constant low grade hyperventilation, something I've done unconsciously for 20 years.

    I've had mild POTS (my standing pulse is high, which I'm sure is the cause of my hyperventilation) for about 20 years which started with an infection. But its impact on my ability to do things using my body is close to none. My body does not feel fatigue. I can exercise. In fact brisk moving around helps my head symptoms, which I think is because the muscle pump gets blood up to my head.

    My doctor sees a lot of patients with POTS and CFS (which I don't have), and the moment I told her my opthamologist told me my eyeballs have tremor (yes...my eyeballs - not eyelids, EYEBALLS! - have constant tremor!) and also the fact that alcohol helps a lot of my symptoms, she suggested I have autonomic activation (said she sees the eyeball tremor in some of her patients) and prescribed me Propranolol.

    If I only have head symptoms and hardly any body symptoms, can a beta blocker help my head symptoms? Can my POTS be causing the head symptoms without much impact on my muscle strength and body stamina? Hey I'll take the Propranolol if it will help my head stuff, I just find it hard to believe. Does it help with anxiety?
     
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  2. Murph

    Murph :)

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    I take propranolol daily.

    I was wary at first but I looked into a lot of the research on it and it seems to have a real positive effect. People who take it are less likely to die.

    It reduces heart rate spikes and adrenaline, so it is good for anxiety. In me a little goes a long way. I was prescribed 20mg a day, which is a low dose. I take 5mg at the moment. I see it as a cheap, low dose drug with low risk and possibly some health benefits!

    However, the risk is it can lower blood pressure. So if you're already dizzy, that's one to watch out for. i've seen some doctors say beta blockers are no good for POTS because the problem is already that the heart can't keep the blood where it needs to be and slowing down the heart doesn't help. My doc says reducing the HR spikes is beneficial in and of itself, but that's more for the CFS I think.

    It's hard to say from the symptoms you've outlined if the good effects will outweigh the bad but trying it to see is probably a good plan!
     
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  3. Forbin

    Forbin Senior Member

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    Propranolol is given for anxiety, among other things. I know that it is sometimes taken by professional musicians to combat "stage fright" that would otherwise effect the fine motor control they need to perform.

    My understanding is that propranolol works in this fashion by interrupting the feedback loop between heart rate and anxiety. An increased heart rate can increase anxiety, and vice versa.

    I think it is also used in "panic attack syndrome," where heart rate and anxiety seem to spiral out of control for no reason.

    Propranolol was the first drug I was given following the sudden attack of dizziness which marked the onset of my ME/CFS. Being struck out of the blue by such a level of dizziness naturally made me very anxious. I had the distinct sense that the dizziness indicated I was about to lose consciousness.

    However, propranolol didn't help my dizziness or any of the other ME symptoms that quickly emerged. If the dizziness had truly been episodic, instead of constant, propranolol might have kept me from being spun up by sudden episodes of it. As the dizziness quickly became ever-present, the novelty and anxiety about it naturally diminished. My subsequent anxiety was related to wondering what the heck was causing these symptoms.

    The tremor in your eyes is called nystagmus and is very likely connected to your dizziness. As the body's main balance center is in the inner ear, I would see an otologist to get your dizziness evaluated and to rule out other possible causes of dizziness/vertigo.

    Dr. Melvin Ramsay, a pioneer of ME research, mentions a sudden unexplained attack of vertigo as one the principal types of ME onset:
    [bolding mine]
     
    Last edited: Dec 5, 2017 at 3:33 PM
  4. Sushi

    Sushi Senior Member Albuquerque

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    You can't always predict the effect of Beta Blockers. I take 5 mg of propranolol twice a day and it does slow my heart rate and seems to help prevent spikes when I am more active. If you doctor prescribes it, trying it will be the only way to see what its effect is on you. In higher doses, many report that in increases fatigue but response is somewhat individual. I have had genetic testing for pharmaceuticals and while I am fine with propranolol, according to the test, I would have a bad reaction to another common Beta Blocker, metoprolol.
     
  5. voner

    voner Senior Member

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    @Sushi,

    what is the genetic testing about pharmaceuticals you did?
     
  6. Sushi

    Sushi Senior Member Albuquerque

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    My cardiologist ordered a pharmacogenomics test from Asperio Laboratories. I don't see their website, but here is a YouTube:
     
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  7. Prefect

    Prefect Senior Member

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    Is it sedating, and if so do you take it at night? I have a 9-5 job and need to be reasonably alert, although the sensory issues I get wreck enough havoc on my concentration so maybe a bit of sedation might help...? I find after dinner alcohol consumption leads me to feel the most normal I feel all day. I can even think better at that point, it's ridiculous.

    I've had inner ear testing and all that done; it's normal. I don't get true vertigo, just jittery eyeballs and, as a result, inability to concentrate. I've even picked up smoking so I can have better focus while I drive to work. I've wondered if I should try Modafinil or some other dopamine agonist.
     
  8. Sushi

    Sushi Senior Member Albuquerque

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    I've never found it sedating and haven't heard that others have, but I'd guess that anything is possible.
     
  9. Murph

    Murph :)

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    @Prefect it is not at all sedating. calming maybe but it doesn't affect alertness. At a job it could be useful as it prevents HR rising with stress. You'll be cool under pressure!
     

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