Misc Propranolol

[Pissed_and_messed]

I have thought about starting to do propranolol regularly, with maybe some breaks if I smoke weed or drink alcohol. I have been doing it semi-regularly at doses 0-120 mg/day for few months now while withdrawing off of benzos. I have uncontrollable fits of sympathetic nervous system activation on daily basis which it helps. I am not expecting to get them under control before progressing with psychotherapy.

Now, what should I know and what side-effects to look for? So far I have observed none. Ultimately I am gonna discuss about this with my doctor also month from now. My life is a mess and observing these side effects is challenging. I also do mirabegron (beta-2-agonist) for bladder issues unrelated to propranolo use. One doctor I discussed with about it said it makes sense if I feel like this combination works. Also I do caffeine which is mostly just for addiction and dependence.

How easily rebounds come? I possibly have dependence already, but I have understood it is easy to recover to same baseline as before. But I don't want to do pills necessarily if it causes "ups and downs"+side-effects.

 

[plumbus-nine]

I am on propranolol for tachycardia, my resting BPM without it is around 105-120 and with down to 70-80. Take just 80mg/d, one 40mg in the morning and one in the night because in this country no retard formulae exists. There is a slight rebound if one dose is missed, more so when it's the one in the morning, but not too much. It will depend on the affinity of both agents whether mirabegron is blocked or not because propranolol is an unselective antagonist hitting all beta receptors.

Only side effect I sometimes get is sedation, actually pretty pleasant because it gives me some rest off my usual rumoring mind but it can interfere with everyday activities specially if you'd get it stronger than I do. Reduction of dosage helps or the switch on a non-CNS permeable beta blocker but that would also cut down on the beneficial effects for you I guess. I selected propranolol over newer gen beta blockers due to its efficacy for anxiety and drug withdrawals.

Seems like insomnia can be a paradoxical side effect but I don't seem to get it. Also the activity profile is non-linear, tried everything from 20 to 360mg and the higher doses don't necessarily perform better.

If you need something more effective for drug withdrawals I'd recommend clonidine, this one helps with sleep but also makes one lethargic and (it did for me) depressed yet can be a godsend during withdrawal.

 

[Jabberwocky]

I take 30mg per day. I've never noticed any side effects except if I take larger doses it can make me very uncomfortablely dizzy and lightheaded.

 

[Pissed_and_messed]

I seem to be lucky that I don't even get lightheaded ever. Also any benzo excluding legit alprazolam makes me more drowsy. So there are no perceived side-effects if we put sedation/excitement into context. I don't mind being little slower if that is more functional.

 

[CFC]

One thing to bear in mind with using beta-blockers is that when you've been on them for a while, you should not just stop taking them. You should taper down slowly to come off. This is because your body up-regulates the number of beta-receptors over time, and it can thus cause quite a harmful/dangerous rebound in heart rate and (sometimes) blood pressure if you suddenly stop using them.

 

[Pissed_and_messed]

One thing to bear in mind with using beta-blockers is that when you've been on them for a while, you should not just stop taking them. You should taper down slowly to come off. This is because your body up-regulates the number of beta-receptors over time, and it can thus cause quite a harmful/dangerous rebound in heart rate and (sometimes) blood pressure if you suddenly stop using them.

I could yet ask does tolerance rise comprehensively? My main issues are physical restlessness, excitement of breath and racing thoughts? In this order.
Preventative measures by regular use are tho better than reactivity so I am not sure if it matters.

 

[Eligiu]

I started taking propranolol when I was around 16 for severe anxiety, which has now been established to be cPTSD. It really is a great medication for physical anxiety effects. And my GP has no issue prescribing it due to the lack of addiction potential.

I take 40-80mg a day, depending on how I feel. No side effects I've noticed, but my cousin once took too many by accident and was like, totally spaced out, memory gone, slurring her words.

Stick to a low dose at first and taper up and you should be good.

 

[CFC]

I could yet ask does tolerance rise comprehensively? My main issues are physical restlessness, excitement of breath and racing thoughts? In this order.
Preventative measures by regular use are tho better than reactivity so I am not sure if it matters.

Tolerance varies from person to person quite a bit, but is not as strong or dangerous as the tolerance that comes from something like Clonidine or labetolol (which have alpha or mixed alpha/beta effects).

Also, with propranolol, because it kicks in fast, it's comparatively easy to give yourself a quick small catch-up dose if your first attempt(s) at cutting dose result in too many rebound effects (physical and/or mental).

It's still wise to make sure you keep a regular eye on things like BP and HR though (ie measure every few hours), as sudden changes could invoke a more risky rhythm disturbance like atrial fibrillation.

Again, it depends on the person and how sensitive their AV/sinus node etc is to beta stimulation. But it is a potential risk that grows the more 'cold turkey' you take things.