Propranolol or metoprolol for stimulant induced tachycardia?

[JohnBoy2000]

I'd used propranolol as it is common.

But the wikipedia page on methamphetamine suggest metaprolol is superior for treating meth tachycardia due to, "lipophilic properties and CNS penetration".

Over a year ago I had dosed meth (mistakenly) to 200 mg whilst using Mianserin (mirtazapine analogue, but blocks both alpha receptors, 1 and 2).

And was totally fine.

Recently I did the same without Mianserin and went into wild psychosis and panic.

Perhaps Mianserin regulates potential psychotic effects of meth.

......

But in any case, would Metaprolol be considered superior to Propranolol for treated this concern?

 

[Jabberwocky]

I really don't think there is really going to be a big difference here.

Both propranolol and metoprolol are lipophilic (readily crosses BBB) and have CNS properties.

Propranolol has a slightly longer half life.

I would lean to propranolol having a larger safety profile which is why it's more common, but just my guess. Personally I've used it with meth many times and never had any issues.

 

[Eryximachus]

Metoprolol after labetalol are the drugs of choice, and possibly the only drugs, that directly stop the mechanism of action of amphetamine.

 

[Skorpio]

I would be cautious about using beta blockers to treat stimulant side effects due to causing unopposed agonism of alpha 1 receptors. This can cause dangerous rises in blood pressure.

Beta 2 adrenergic receptors regulate the effect of norepinephrine on heart rate, so blocking them will decrease heart rate. They also relax vascular smooth muscle, causing vasodilation.

This vasodilatory effect is opposed by a vasoconstrictive effect of alpha 1 agonism from norepinephrine. Normally when both systems are not blocked this maintains proper vascular tone and blood pressure control under high norepinephrine states.

Blocking beta 2 receptors preturbs this balance, and if you take these drugs you should monitor your blood pressure.