2 replies to this topic

[zivcha]

Hello everyone,

I have been on cymbalta for 6 years (60 mg for anxiety, social phobia, depression, OCD). a year ago i decided to withdraw. during this year i was between 30 to 60 mg. currently im on 30 mg. as part of my withdrawal journey (and for some time before it), i experience fast heart rate, with strong beats, feeling of no air, palpitations, sweating, hyperventilation. these occur mostly at nights and i also when i wake up (i wake up  very early even when im exhausted because i have fast and strong heart beats and hyperventilation). this occurs almost every night (regardless of how tired i am). for years, my quality of sleep is very poor.

 

from what i read here and from some reading i did, i think that my sympathetic system is too active during those intervals which causes the above symtoms.

i decided i want to try chlonidine as i know it moderates the sympathetic response. on a holter test i did a few years ago (continous overnight heart rate and blood pressure measurements) i had some intervals of bradycardia (slower then normal heart rate). back at the time, my doctor told me it can be a bit risky to use beta blockers since it can lower my heart rate even more. during the years i had a few more holter tests in which no bradycardia was seen. actuaqlly, one holter showed that my blood pressure was higher than normal at night time (non-dipping blood pressure).  I was tested for cathecholamines concentration twice and both times the values were normal (i dont understand why).

 

as previously mentioned, i want to start taking chlonidine as an attempt to restore my quality of life back. i am afraid though because of the bradycardia issue. therefore, i decided to purchase sensors for heart rate and blood pressure that i can use overnight and see how my body reacts to the medication.

 

does anyone here have experience with such devices and can reccommend on a brand or product? preferably it should be wearable or wireless for me to be able to sleep without any disturbances cause by the devices.

 

Thanks alot in advance!!!

 

[fishinghat]

Normal catecholamine tests are normal (no pun attended) even under stressed conditions. It is not the amount of circulating catecholamines that matters but the amount bound and stimulating the nerve ending. In general, these compounds are produced separately in the brain and body because permeation of the blood brain barrier is limited although somatic catecholamines doe restrict blood vessels going to the brain in turn decreases O2 to the brain and effects cognition.

 

I am in full agreement on the use of clonidine to help correct your sympathetic nervous system. The adrenal gland is one of the few glands that is not enervated with the parasympathetic nervous system. For those who are not familiar the sympathetic nerves send signals for a system to increase activity and the parasympathetic sends signals for a system to slow down. In the case of the adrenal gland it receives signals (from stress, threats, fear,....) from the brain to increase adrenaline, noradrenaline and other compounds. When the stress is over it does NOT send signals to the adrenal gland to slow down. Instead the brain detects extra circulating adrenaline in the brain and reduces the signal being sent to the adrenal gland to produce adrenaline, etc.

 

Clonidine is an alpha adrenergic agonist. This means it stimulates the nerve endings in the brain which detects adrenaline/noradrenaline. The brain is fooled into thinking there is too much adrenaline in the blood and decreases the sympathetic signal to the adrenal gland as well as areas which produce these compounds in the brain.

 

Use of a alpha agonist (eg clonidine) and a beta blocker (eg atenolol) at the same time is worrisome for most drs as both can lower blood pressure. Your concern is absolutely justified. I took both clonidine and atenolol at the same time for several years. Normally(since birth) I have been bradycardic (pulse around 52 ro 60) with periodic paroxysmal atrial tachycardia with pulse reaching 180 beats per minute. Originally when I developed anxiety I was put on the atenolol at a very, I mean very, slowly titrated rate. Then the clonidine was slowly introduce. Each has a period of time where the body adapts to the drug and the decrease in bp moderates. In time more medicine can be introduced. I wore a bp/pulse monitor for a while after each dose change. Unluckily they were supplied by the drs office and I really don't even remember the brand of the units. They were not wireless however. By the way these medicines worked wonders for me. I do not need the atenolol anymore but do still use the clonidine.

 

You are on the right tract Zivcha.

[zivcha]

thanks alot.

tomorrow im meeting mr doctor. i will ask chlonidine + perhaps another AD to be more stabilized.

 

i decided to purchase a continuous HR+BP monitoring system. no cheap - about 2000 dollars, but since we are talking about my health and this is a problem i carry for years - i decided that it is the right thing to do.

 

thank you.