Mental Health Metoprolol vs Propranolol for severe anxiety and GAD

cbtodacb

Bluelighter
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Aug 28, 2012
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Hello,

I was wondering what opinions were out their on the efficacy of these 2 drugs for severe SAD/GAD i.e. which one is more effective and better to have in the arsenal.

I would prefer whichever one lasts longer.

Cheers
 
If you want the one who last longer than ask for the metoprolol...Some people say its less effective for anxiety related symptoms since its a selective beta blocker for the B1 receptor...

I use both of them, not at the same time of course.

I like more the metoprolol because it reduce a lot more my fast heart rate...and blood pressure...stop also the clammy hands...25 mg x 2 a day is enough... But keep in mind that its not stoping the anxiety and negatives thoughts inside your head... I had panic attacks on both of them...

The Propranolol worked well when I start using it but stop working after some months... I used 40 mg to 60 mg a day divided in 10 mg dose or 20 mg dose x 4 times a day... Sadly the effect on the fast heart rate, clammy hands, tremor, they all dissepear after a while... But the propranolol last 4 h max and have less side effect... It tend to trigger some breathing problem at higher dose...the metoprolol don't do that on me...

Insomnia is far worse with the metoprolol...also some digestive problems as well...more tiredness at daytime also and both drugs decrease the exercise tolerance...

I hope it can help you... Start at lower dose and see what happen... The goal is to reduce the physical symptoms of anxiety...keep in mind that it don't stop the mentally anxiety...

In my case, I have severe anxiety (panic disorder with agoraphobia, SAD, GAD, OCD, somatisation disorder)... When I first start the propranolol the frequency of panic attack decrease since I had less physical symptoms but now even with higher dose of beta blocker I have more panic and I'm totally housebound and even at home I don't feel good...

So overall metoprolol right now do a better job for me...keep my heart rate low but my heart still pound in my chest and feel it all the time who trigger panic... I think it's because I fear that now that I take beta blocker, my heart is used to them and if one day I have a very bad panic attack, I fear that my heart will not handle it... And die from a heart attack...that's my main fear...
 
They both come in controlled release formulations, so duration is somewhat a moot point. I've never taken metoprolol so I can't say for sure what the difference between them is, but propanolol is considered to be the first-line drug for this particular indication.
 
The main problem is that controlled release come into higher dose... It's always better to start at the lowest effective dose! If someone start the propranolol long acting form at a dose of 60 mg or 80 mg, it will affect the blood pressure and give more side effects... I think that for SAD and GAD, it's better to start low since too many side effects from high dose can increase anxiety.

Also it depend where you live...here in the canada, the metoprolol controlled release in the lowest dose is 100 mg... That's too much...

Also, the older beta blockers like the propranolol lead to an upregulation of the beta adrenergic receptors in long term... So that's mean that you need higher dose to have the same effect. Only the newer ones like bystolic or the Coreg don't cause upregulation of the beta adrenergic receptors...

The propranolol is the gold standard RX beta blocker for anxiety, but that's not mean that the others don't work...

And don't believe that the fact that the propranolol is entering in the brain in high concentration will help more with the anxiety... The effect on the brain is not related to a reduction of anxiety but more central side effects like insomnia, vivid dreams, visual disturbances, depression, lethargy and extreme fatigue, just to name a few... Same apply for the metoprolol who also cross the brain barrier...

I did tried the atenolol, nadolol, they are hydrophilic so don't enter in the brain but both lead to extreme fatigue and didn't had less side effects...

Keep in mind that beta blockers are heart meds and not approve to treat anxiety...an antidepressant can do a better job to keep anxiety at bay, if you can tolerate them...sadly I can't...also benzo meds are good for gad and sad... But addiction occur most of the time and you get stuck on high dose of clonazepam like me, 8 mg day, with no effect on anxiety... After many years of daily use...
 
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Try both. I have been on each for extended periods of times; and they both have their up a down sides.
Met made me especially sluggish since it would lower my blood pressure so much. Say good ye to sex (maybe), less you have stims.
 
I take atenolol for high blood pressure and anxiety. 50mg 2x a day seems to keep my heart and guts persay working smoothly enough to tolerate life with Gad and Sad. I do still have my bad days in which i take a mg or two of kpin. Be careful with the bp meds man! They can and will kill you faster then kpin. or alp. alone from overdose and if you take them daily taper if you must come off. But all in all i have never taken either of the two your asking about however the atenolol is very similar. You may consider asking to try. Good luck !
 
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