Beta blockers with NA enhancers??

[JohnBoy2000]

I've started a part time course a few months back and, we're due to make a presentation next month.

I fold under the pressure of public presentations without fail.
All the typical signs of beta receptor overaction; tremor, sweating, crazy heart beat, throat closes over.

I don't know if CNS NA enhancers would exacerbate that but, in any case, my GP scripted my a box of propranalol.

The usual dose for this type of situation seems to be 20 to 40 mg.

drugs.com has rave reviews about its benefits in these type of situations.

Firstly - whilst there doesn't appear to be direction dynamic interactions, and I don't believe there are kinetic interactions - in actual practice, would there be any possible contraindication between their concurrent use?
As in say, reboxetine and propranalol?

And in regards to actual dosing - any insights there?

Side effects?
Any lethargy etc?

 

[Cotcha Yankinov]

If you've been taking NRIs for a while then I would certainly suggest a trial dose of propranolol before the presentation, I would start low as well and work up carefully to find if you can take your prescribed dose without issue. Hypotension is the notable concern.

 

[CFC]

I've seen some people practically fall asleep on 10mg of propranolol, whereas I could pop 20-40mg and would barely notice. If you're a novice to beta-blockers, I would say 10-20mg would be enough to take the edge off performance anxiety, but definitely trial a dose first.

 

[Cotcha Yankinov]

I've seen some people practically fall asleep on 10mg of propranolol, whereas I could pop 20-40mg and would barely notice. If you're a novice to beta-blockers, I would say 10-20mg would be enough to take the edge off performance anxiety, but definitely trial a dose first.

Kinda OT but I've somehow received zilch from propranolol (even at 40mg) aside from hypotension, oddly enough my mom had preterm labor for a few weeks and was given a b2 agonist (terbutaline) to prevent labor. Nowadays there are all sorts of warnings about using it for preventing pre-term labor for more than a few days, as it crosses into the fetus brain, at a developmental stage where b2 receptors actually can't really desensitize (instead they supersensitize in response to b2 agonism at a developmental stage)

And now I love the taste of the red crayons 8(

 

[Ozle]

What noradrenaline enhancers are you taking? AFAIK reboxetine has hardly ever been prescribed in years, atomoxetine is the closest thing I know of that's in common use. And have you considered taking a break from them on the day of your presentation?

 

[CFC]

Kinda OT but I've somehow received zilch from propranolol (even at 40mg) aside from hypotension, oddly enough my mom had preterm labor for a few weeks and was given a b2 agonist (terbutaline) to prevent labor. Nowadays there are all sorts of warnings about using it for preventing pre-term labor for more than a few days, as it crosses into the fetus brain, at a developmental stage where b2 receptors actually can't really desensitize (instead they supersensitize in response to b2 agonism at a developmental stage)

And now I love the taste of the red crayons 8(

Tbh I'd have expected more of a bradycardia effect than hypotension. Does it not feel calming at all? How do you feel when you take a B2 agonist?

 

[Cotcha Yankinov]

I do get the bradycardia as well, but I am prone to hypotension as is (chronic deconditioning). I personally didn't get any calming/somnolence promoting effects from propranolol, but haven't tried it under a stressful situation. I would take it and still have insomnia (even with melatonin - as it is apparently advised for people who take beta blockers to take melatonin as well because b2 antagonism can decrease melatonin, and therein is supposedly a cause of the uncommon beta blocker related insomnia), so I thought it was interesting that some people get somnolence from it

B2 agonists I have never taken but amphetamines give me a pretty strong sympathetic response, lots of vasoconstriction and residual stimulation. Same with caffeine.