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  • BDD Moderators: Keif’ Richards | negrogesic

A beta-blocker like propranolol to help with methylphenidate side-effects, withdrawal

G

Ghaenrynquau

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Aug 8, 2016
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Wouldn't taking propranolol make methylphenidate comedown easier? Or would that unopposed beta-blockade lead blood circulatory problems? People say methylphenidate is too peripherally stimulating which is not nice and propranolol is exactly used to combat the peripheral signs of agitation, anxiety. Has anyone tried?

Thank you!
 
Sure. The fears of runaway alpha-stimulation are generally overblown, and a low dose of propranolol, or especially labetalol, will usually make things easier if you suffer anxiety or agitation on the comedown.
 
I agree the whole alpha stimulation thing is overblown (and why labetolol is better) but still think a benzo is better for a stim comedown and surely safer.
 
I suppose it depends if they can get hold of one - many can't - though a beta-blocker is pretty safe. I personally prefer a full adrenergic blockade so I can get a quality sleep on comedown, rather than benzo unconsciousness, but I'm also pretty experienced with the protocol and the risks.
 
I only say benzos as it seems agitation and anxiety are the chief complaints here. Beta blockers have their role in treating certain types of such things but not sold on the way OP wants to use them.
 
You may be right. I guess it depends how he reacts or whether he has other medication options. FWIW beta-blockers on stims do kill any agitation or anxiety that I may have, but it may be different for others.
 
I've always been preferable of opioids and benzos for stim comedowns personally- though this is obviously unhealthy and not recommended. And availability/obtainability are obviously bigger concerns/factors than with beta blockers.

There have been times where I've been left with nearly no options though, and always a surplus of beta blockers....but I've never gutted up to trying them, mainly out of fear for the alpha simulation mentioned here....is this REALLY THAT overblown? I've used beta blockers for many different applications throughout my years but have always shy-ed away from them for this....anything to do with stims really.

In OP's interest of self preservation, would anyone know how "overblown" this danger might be with methylphenidate specifically? Because it seems most of the knowledge in respect to this phenomenon centers on amphetamines, not piperidines....which may be of greater concern..

-PA
 
You're right, the recent papers I've seen contradicting the former recommendation to avoid beta-blockers (eg) are almost exclusively regarding cocaine and/or amphetamines, which would be the biggest culprits in any emergency setting.

However, I can't see logically how the class should have much relevance since the beta-blocker isn't altering the pharmacodynamics of any drug directly. Rather, it's impeding its ability to interact with beta receptors, and it is this blocking that caused the former theorised concern (as blocking beta can stimulate alpha).

Receptor affinities may differ vis-a-vis a different drug or class to varying degrees, but the subsequent alpha-adrenergic response isn't going to suddenly or randomly become disproportionately excessive in response. If in doubt, start out with a very low dose and gradually titrate up.

With ritalin, I have used beta-blockers before (specifically propranolol, nebivolol, labetalol, bisoprolol), though admittedly not for the comedown, instead just to take the edge off the peripheral stimulation, which they all did quite nicely - particularly the nebivolol, surprisingly.
 
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