727 replies to this topic

[frog]

Awesome about the final push - truly well done, but are you sure you want to go too far in with the next? Not even give yourself a small break? It is far from the ideal time at the moment and stresses will be high. Obviously you know best - and maybe the fact that you are still on the prop is stress in itself. We're all here for you regardless.

 

Hi IUN! I still popped in about once a day to read the posts but now that I'm spending less time on the bus I guess I was less active 

 

I definitely hear your concerns about doing a taper during this crazy time, but I think my adrenaline days are pretty much behind me so I don't think the prop is really providing any benefits anymore. On the other hand it's always possible that it's contributing to some of the lingering side effects: messing with my sleep or my stomach or my breathing, so I've been looking forward to ditching it to see if any of that stuff improves. Plus since prop doesn't have any effects on the brain I think it should be a pretty unmemorable taper Today is day 4, so far nothing much to report. 

 

Glad to hear about the sleep and the continuing waves. Still trying to keep the optimism alive as much as I can!

 

Hope you're getting through this ok. I know this is a lot to deal with when you don't have your normal activities to keep you busy. I'm lucky to still have work to occupy me and I'm finding other small ways to stay busy. I'm making my very first sourdough starter! Unfortunately so far unable to locate any bread flour so the actual bread may have to wait.... damn people and their panic purchasing!

[frog]

It’s been interesting being on this journey at about the same pace.  To see where we were and where we are now about has tears in my eyes.  It seemed like it took forever and went really quick.  I still have a lot of issues, but I’m worlds better than I was and it sounds like you are too. We were both pretty scared, miserable and desperate.  I imagine soon we will really be doing well and I look forward to it.

 

I'm with you 100%. I feel like in the last weeks, even with last week being pretty terrible, I'm finally seeing how far I've come. I'm having a hard time fully remembering just how bad it was once, which is probably for the best anyway. But I remember hearing it could be 6-8 months and thinking there's NO WAY I will last that long, nope, never, I can't. And here I am 5 months later, still hanging on. I'm sad that I had to go through it, but proud of myself all the same (hope you are too!) and really grateful for my husband and my mom for seeing me through all those really dark times. 

 

There's definitely room for improvement still, and this whole pandemic lockdown is really testing me, but I feel like I'm at least... 80% of the way there. I'm so grateful for everyone on this forum for all the support, all the constant reassurance, and all the knowledge when no one else had any!!!

[Mxpro32]

I'm having a hard time remembering how bad it was too. At least how bad it felt. I remember the language I used to describe it and I have a vague idea how completely overwhelmed and lost o was, but it's difficult to truly remember how it felt. That's probably for the best. As of now, it's hard for me to sort out what are lingering cymbalta withdrawal symptoms, what are symptoms of still being on klonopin, what are symptoms of tapering from klonopin, and how much is normal mental health stressors from the coronavirus. I'm doing pretty well overall, so I guess that doesn't matter either.

[invalidusername]

Frog....

 

I can see your point for getting the withdrawal underway. My only concerns is that the withdrawal can brings its own complications - even if they do relieve some that it could be giving. Viscous circle, but as you say, done slowly, it will be OK. Just go steady.

 

MX....

 

I really feel for you being at that 80% and getting hit by the virus stuff. I would have said I was around 90%, and it is very much testing me - today in particular. I hope I will get used to it and my anxiety will learn the new routine as it looks to be with us for a few weeks yet. 

 

We are all going to be in for a bit of a test with it I guess. I hope we all come out stronger as a result. Difficult for me to say that as I must admit I am on the fence as to whether I will get to the eye of this storm, or whether I will be left battling it for the duration. But I won't go down without a fight I can tell you!

[frog]

FH, or anyone else who has experience being on beta blockers, I have some questions/concerns/comments? 

 

I'm currently taking 10mg propranolol in the AM, and 10 in PM (down from 20 am/pm as of a few weeks ago and was on that dose for about 4 months or so). My psych NP prescribed them 'as needed' back in December, but at the time 'as needed' was literally all the time so I settled on an am/pm routine. I was also obviously feeling all sorts of terrible physically back so there would have been no way to figure out if the addition of beta blockers caused any new physical side effects or not. Now that things have improved quite a lot, I definitely don't see any need to taking the BBs on a strict schedule so my plan is to taper down to 0 just to be safe and from there to just potentially take them if the anxiety feels particularly bad (probably unlikely to happen, as I'm definitely a 'power through it' kind of person. I'll rarely even take Advil if I have a headache lol. I think it's just how I was raised)

 

After talking to my psych NP a few days ago, he pretty much dismissed my concerns over any possibility of side effects from propranolol or any potential problems getting off it easily. His reasoning was that the dose I'm on is very low compared to those who truly take it for hypertension, etc. and would be at risk of developing issues.  

 

I don't really like using Google as a way to diagnose side effects because I feel like it's often an 'ask and you shall receive' outcome. And often online it's not mentioned what dosages are being discussed when talking about any of it. But I do feel like some of the problems I'm still experiencing seem to be somewhat consistent with potential beta blocker usage, so I'm hoping someone can shed some light. 

 

1. I've read that propranolol is known to decrease melatonin production leading to insomnia, etc. I started having trouble falling asleep in late November before I started taking the propranolol but at the time it made sense since my adrenaline and anxiety were crazy. Now in April both of those have calmed down a ton and yet I still can't fall asleep without taking Seroquel every night (I tried to lower the Seroquel dose last night per doc's suggestion, and it was a total failure. Couldn't fall asleep all night)

 

2. I've read that propranolol can mess with your body's blood sugar regulation. I've had several strange episodes over the past few weeks: going on a long walk only to suddenly feel a bit woozy and my legs feel like jelly. Or standing in the kitchen for a while peeling a bunch of vegetables and suddenly feeling lightheaded like I need to steady myself immediately. I ate some fruit that time and the dizzines completely went away, so definitely blood sugar related. 

 

3. Some strange sensations with my heart where I'll be sitting doing nothing, and suddenly I feel something like a small adrenaline type surge and my heart feels like it's being squeezed. Thi was new last week where it was happening most days. Not something I had experienced in prior weeks. 

 

 

Sorry for the extremely long post, but does any of this sound familiar to anyone who's been on beta blockers? Is it possible that the propranolol could be causing some of this even at such a low dose and not being taken for heart/blood pressure problems in the first place? Or does this seem like lingering effects from Cymbalta, or maybe something else entirely? It's definitely causing me grief because I still don't really feel like myself. 

[fishinghat]

I agree with your dr. A taper over a 3 or 4 week period should cause little issues. You might see a slight increase in bp and/or physical anxiety symptoms during that period but they would be very mild.


1. Tapering Seroquel while coming off a beta blocker is a bad idea in general as the lose of the Seroquel will increase your anxiety and decrease your ability to sleep. Propranolol does decrease the production of melatonin. Once you have been off the propranolol a week or so your sleep should improce some.


2. Actually research shows that propranolol actually raises blood sugar levels. People on beta blockers do often notice this effect when exercising. Ity does seem like a glycemic effect but I can find no data to support that.


3. I would suspect that this is an effect in the drop of propranolol. Episodes of surges in adrenaline do occur during beta-blocker withdrawal but they should only last a couple of days after a change in dose. They are usually much milder than this though.Does it feel like you skipped a beat and then the next beat is very forceful?


I was on atenolol, also a beta-blocker, and when I came off I noted swings in my blood pressure and pulse that would ebb and flow during the day. Due to the rise in blood pressure I did not exercise during my weaning of atenolol. All my symptoms dissappeared about 1 to 2 weeks after coming off it. I hope this helps ease your mind.

[frog]

Thanks FH.

Were you on a low dose of the atenolol as well? Also what kind of symptoms did you experience and were they only while you were tapering or did you have them when you were just on it in general? 

 

1. I only take the Seroquel at night right before bed so I was hoping to not have issue with withdrawal coming off of it. Just the obvious loss of having an aid to put me to sleep potentially leading to sleep issues. 

 

2. Is there anything else that could be causing issues with blood sugar if not propranolol? It's definitely an unsettling experience. 

 

3. It lasted about a week after I dropped by half a pill. it seems to be better today I think. I don't really feel like I skipped a beat only that I felt like when a panic attack is starting up and then I would feel my heart squeezing and then it would all go away. 

[fishinghat]

I was on 25 mg 3 times a day. I had nothing but positive effects while taking it. My weaning took about 2 to 3 weeks and included some heart pounding, faster pulse and some PVCs. all of that cleared up within 10 days of finishing my last dose.


1. Unluckily it is likely that you will have some withdrawal effects. Most do but if taken slow it can be managed over a 2 or 3 month period. As you well know, the slower the better.


2. The only thing I can think of is the Zyprexa. Research indicats that hyperglycemia (high blood sugar) is fairly common serious health effect for Zyprexa. Sorry, no help there.


3. With these panic attacks are the symptoms just physical (heart pounding, fast pulse and physically restless or is there also anxiety, irritability etc?

[frog]

Ugh anyone else having trouble getting something to post? 

[frog]

(trying to post this in two parts, because for some reason the forum isn't letting me post in full)

 

Hi FH,

 

I just checked online and it said that Atenolol is a selective beta blocker so by design it is much better at targeting the beta 1 receptors in the heart only and much less likely to hit the beta 2 receptors that are all over the place so seemingly much less likely to have any of the other effects that the non-selective ones do (like propranolol). From what I understand the nonselective ones bind to receptors all over the place so are more frequently used to manage anxiety since they don't just work on the heart. But I think that also makes them more likely to cause unwanted side effects if I had to guess? I still think my slightly labored breathing and the dizzy spells are connected to propranolol. I guess I'll find out when I'm completely off it, but I just wanted to see if anyone has had any similar experience with this particular drug.

[frog]

1. I'm temporarily pausing the propranolol taper this week to do just one drop on the Seroquel. I just want to see if I can lower the dosage slightly and still be able to get decent sleep. If I can then great and I will stay on this new dose and go back to tapering down the propranolol maybe next week or so. If I can't sleep then I will go back up to the dose that was working and still go back to tapering the propranolol next week. 

 

I reduced the seroquel by a half of a pill so from 50mg a night to 37.5mg. Night 1 I didn't sleep at all. Night 2 I took a little melatonin before bed as well. I still couldn't fall asleep for hours but I think at some point I did finally drift off. I'm tired as heck today but I think I will try again tonight with the melatonin. Hopefully it's just that my body needs a few days to adjust to the new dose. 

 

2. I don't take Zyprexa. I think that's another member. I just take propranolol, and small doses of seroquel and gabapentin at night

 

3.The panic attacks started only while going through Cymbalta withdrawal. Never had them before. At first I think they were lasting practically all day, then slowly the length decreased and they became more sporadic and shorter lasting. I haven't had them at all for a number of weeks but last week they came back a bit. It was at least a few days that they came on, just for a few minutes or so and only if I laid down on the couch and wasn't doing anything at the moment. Suddenly I would get that feeling like my body was out of my control with my heart going fast and like I couldn't hear anything anymore, but it would pass pretty quickly. There wasn't any irritability but I can't say for sure if there was anxiety with it or not. 

 

Sorry for another super long post. 

[fishinghat]

My apologies about the Zyprexa. Too many posts for too many years.  lol

 

I do agree that it is likely to be the propranolol causing the labored breathing and dizziness. Also, you are right about the difference with selective and non-selective beta-blockers.

[frog]

Lol it's ok. You are just one person and there are many of us. That's why I always try to include a recap of all my meds in my posts

 

I'm glad you agree about the prop I'm very hopeful that those two things will clear up soon. Neither are super oppressive but they still create some anxiety and would still be a huge relief to not have to worry about them anymore. 

 

Do you have any advice on the optimal timing to taking melatonin for sleep? I'm going to try again tonight with the lowered Seroquel dose and some melatonin and hope it takes less than 4 hours to fall asleep...

[fishinghat]

For tablets about 1 hour before sleep and for sublingual about 15 minutes befiore sleep.

[frog]

Noted. I have liquid right now. Supposedly a dropperful is 1ml which it says is 10mg melatonin. So I've just been doing a few drops. Maybe I should try a little more

[invalidusername]

If that is what is said on the bottle for 1ml containing 10mg, but the dropper should be marked. My liquid melatonin has markers down the side, although a "drop" is a standardised measure so it can be calculated, but there should be directions somewhere on it...

 

I agree with Hat on about 15 minutes for the liquid to start kicking in. Better to take it and then read a book or meditate to get off to the land of nod...

[frog]

the only measurements on the dropper are for 1ml and .5ml so 10mg and 5mg

I did read a bit last night and put away my book when I felt like my eyes were getting very tired, only to close them and start having all sorts of anxious thoughts. So fun! I was still awake hwen my husband came to bed after 2am, but sometime after that I must have FINALLY drifted off, maybe just from pure exhaustion at that point because I woke up next around 8am. I feel a bit stuck between a rock and a hard place because I don't want to continue taking Seroquel since it is a pretty serious sedative and mood stabilizer but it does pretty reliably put me to sleep pretty fast. If I had a crystal ball and could see that if I just give it a few nights on this lowered dose, my body will adjust, then no problemo. But of course it's hard to have several nights of no sleep in a row as I'm sure everyone on this forum has had experience with

[fishinghat]

Research shows that doses of greater than 1 mg melatonin can actually interfere with sleep. The recommended diose is 0.3 mg. I actually use 0.17 mg and it does great. In case you need to calculate it is 20 drops per ml so 1 drop would be 0.5 mg of melatonin.

 

10 mg per ml is a high dose for sublingual melatonin. Mine is 3 mg/ml.

[frog]

This is the kind I have https://www.amazon.c...86968568&sr=8-9

[fishinghat]

I see no problem with that product.

[invalidusername]

Ditto - no harm in trying that little bit more as each will be different, but it is right what Hat says. the Mrs found that out the hard way, despite me telling her, more is not better in this case from a given threshold.

[frog]

Are there potential negative side effects from taking too much? When I took the few drops of the one I have the other night I didn't notice anything bad it just.. didn't put me to sleep. 

 

Unfortunately last night I gave up on the seroquel reduction as the not sleeping was wreaking havoc on my anxiety and I felt terrible, so went back to regular dose. 

 

I did a little more reading today about seroquel and seems like rebound insomnia is pretty common even on the very low dose I'm on. I reached out to my doc for advice or something else I can maybe take to help bridge the gap to get off this stuff. Alternatively I'm thinking of trying tapering in even smaller increments (hard to do because the dang pills are TINY!) and taking off a quarter of a pill instead of a half and see if that doesn't affect my sleep as much. 

 

I felt much better today so I think tomorrow I will resume reducing the propranolol so I can at least knock one thing off the list!

 

I've also made a virtual appt with a new primary care doc (I need to rebuild my entire team of docs now that we live in CA) and am going to ask her for a referral to a gastro doc. Apologize for the TMI but I'm still really struggling with constant diarrhea. It's much better than when withdrawal first started but it's still plaguing me and it's playing a very big role in my remaining anxiety. It's hard to feel happy and good and carefree when you're constantly worrying about if your stomach is going to betray you... Best guess is it's just "IBS" but at least maybe there's some medication I can be prescribed to take care of this?

[fishinghat]

Frequent dosing of melatonin will lead to tolerance and it will no longer have an effect. Lay off it for a few days and it weill work again, Constant dosing can also generate some depression.

"Alternatively I'm thinking of trying tapering in even smaller increments"
Absolutely.

Imodium works well for the diarrhea (over-the-counter). Also one of the common prescriptions for IBS is dicylcomine which is moderately helpful.

[frog]

Update: Today is my last day on a consistent dose of propranolol. I've been taking it at 20mg morning and evening for about 4 months now. It was prescribed to be taken "as needed" but well at that point I needed it all the time because I was getting panic attacks every day several times a day out of nowhere. Now that the panic attacks are gone I don't really feel any need for these anymore and I actually think they've been contributing to some negative side effects. I've had shortness of breath pretty much the entire time, a decrease in energy, and many instances of lightheadedness/woozyness (this was particularly alarming, and I'm seeing this go away as I've gotten close to being done. My armchair theory is that when I was doing something physical that demanded a faster heart rate, the beta blocker was preventing my heart from reaching the beats I needed and effectively depriving my body of the oxygen needed for the activity). 

 

Anyway just wanted to share my experience with beta blockers as a means of coping with Cymbalta withdrawal! Definitely a mixed bag for me, but I wouldn't change it. They were a huuuuge help when things were really bad but I'm really glad to be done with them now! I would say the only thing that bummed me out, which really shouldn't be surprising me at this point, was my psych NP essentially dismissing my concerns that the propranolol was causing some of these side effects and just continuing to say that I was on a much lower dose than someone taking them for heart/BP issues, so it was unlikely it would be causing any issues. Well I believe he is mistaken!

[frog]

Well it's been a week and a half off beta blockers. The occasional shortness of breath still hasn't cleared up unfortunately, so I think it's just related to anxiety/adrenaline at this point. It just feels like there's still some tightness in my chest and at some points in the day I have to take a deeper breath than feels normal. On the plus side I feel like the BBs were really preventing me from doing any kind of physical exertion because they wouldn't allow my heart to beat fast enough to keep up with the demand. I also feel like my overall energy level is slightly higher, I feel a little less lethargic and slightly more energized. Happy about that. 

 

FH and IUN, Speaking of adrenaline, does it seem normal that I would still have more than a normal amount? It's not crazy like it once was with all the constant panic attacks, but it still feels like it's there kind of bubbling underneath. It's easy to ignore when I keep myself busy but if I'm being still I can still feel it. I'm telling myself that it's still slowly going lower and lower, but wanted to know if that's a fair assumption?

 

Lastly I'm still not sure if I feel ready to tackle Seroquel, so I was thinking of nixing the Gabapentin first. I'm on 300mg just once at nighttime, it's 3 capsules of 100mg each. Do you have any weaning schedule advice on this one? I don't really feel like it does anything but of course I thought that with Cymbalta too...

[fishinghat]

Definitely still adrenaline from Cymbalta withdrawal. It still may take 2 or 3 months. I would wait until about 2 months after the anxiety/adrenaline issues resolve before tackling the gabapentin.

[invalidusername]

Well as you have come off the BB, the effects will be similar to that of the Cymbalta, the difference being that the bb's blocked the effect of epinephrine rather than norepinephrine - the former being very similar for heart function, whereas the latter is what is carried through the veins, so in effect, either could cause the imbalance at the moment. 

 

I am not too sure how one would identify when the body is trying to reestablish the homeostasis for epinephrine vs that for norepinephrine. But there is for sure nothing strange with how you are feeling at this juncture...

[frog]

IUN I've had this kind of low-ish level but noticeable adrenaline even before I started coming off the BBs, otherwise I would agree I would just chalk it up to the taper. I definitely saw increases of anxiety The average level of intensity does seem to be very slowly lessening tiny bit, by tiny bit, of course as it is with this whole process it's only weeks later that you finally look back and say huh, I'm feeling better than I was then. So it's helpful to have someone to instill some confidence about the present/future!!

 

I think it's been SO long at this point that I've felt... completely still, that I've forgotten that that's even possible. I guess there's just this constant worry that even though these 6 months the adrenaline system has been healing and healing and healing and healing but maybe now it might suddenly decide that it's good where it's at and it's not going to keep getting better. 

[invalidusername]

Well with the cocktail of drugs that you have been on, it is logical to see why this has occurred. And I had adrenal issue for a very long time after I switched from Cymbalta. I stopped early in the November and I was still having issues the following March, and that was only after 12 weeks on the damn things! 

 

But neural plasticity will tell you that your brain must work itself out. All the time you are doing your best to tell your brain what it should be doing, it will correct itself, but as Hat is always saying, these things can take up to 2 years unfortunately. And trying to see the smallest amounts of improvement during that time is like trying to find a fart in a jacuzzi....

 

This is also where Hat would come out with his catchphrase...

 

Time and bloody patience

[Mxpro32]

like trying to find a fart in a jacuzzi....

 

 

lol.  I've never heard that one before.