Alpha Beta Blockers
Let me start by saying, these are strong drugs. They are essentially two strong hypertension drugs in one pill. Doctors often brush off the idea of these drugs having a substantial effect on the human body, and if your doctor tells you they are well tolerated and there is nothing to worry about, trust me they are wrong. Alpha blockers and beta blockers taken alone may cause significant side effects to the average patient. Alpha beta blockers work by blocking hormones in the body. These hormones which are inhibited in turn reduce the levels of epinephrine (adrenaline) and norepinephrine (a chemical similar to adrenaline). Both of these are produced by the adrenal gland. Epinephrine inhibition alone can reduce norepinephrine production, so alpha beta blockers have double norepinephrine blocking effects. They are usually not prescribed for uncomplicated hypertension because of there potency. Normally they are prescribed for heart failure and hypertension associated with another abnormality, such as left ventricular dysfunction or atrial fibrillation.
The first alpha beta blocker to enter the market was Labetalol. The timeline of it’s first FDA approval is a little fuzzy but it was believed to be first approved in 1977. The classifications of some of these drugs are a little bit fuzzy as well, because there are 2 third-generation beta blockers which are technically alpha beta blockers. These are Coreg, and Coreg CR (generic is Carvedilol); and also Trandate and Normodyne (generic is Labetalol). Make sure to do extensive research on which drug your doctor has prescribed for you before starting it.
Alpha beta blockers work very differently for everyone. Some patients have noticed a substantial drop in blood pressure which caused dizziness upon standing, and some patients experienced minimal blood pressure lowering effects. In rare instances a few patients experienced a raise in blood pressure. The average blood pressure lowering effects found in one study showed a 6 point drop in systolic and a 4 point drop in diastolic. However that is not an accurate way to depict the effects of the drug because age, race, condition of the heart, and dosage are all huge factors that play a role in it’s effectiveness.
Side effects of alpha beta blockers are similar to those of each drugs taken separately. I encourage you to read my articles on these drugs individually for a complete overview of both drugs separately. Many patients taking alpha beta blockers experience dizziness, balance issues, fatigue, anxiety, panic disorder, shakiness, tremors, low heart rate, hypotension, ringing in the ears, breathing issues (due to non selective beta blocker within alpha beta blocker drug), stomach aches, gas, bloating, weight gain, depression, cough, confusion, flu symptoms, headache, changes in hunger, swelling of the lower extremities, convulsions, hallucinations, nervousness, nightmares, general unwell feeling, and a pounding feeling in the chest.
A few side effects we will go over in greater detail, starting with the feeling of warmth. This feeling comes mostly from the beta blocker. Patients experience random bouts of hot feelings that happen through out the day when taking this drug. Sometimes the hot feelings can be just in the head, sometimes they can spread through out the whole body.
Weight gain is another very common side effect people experience with alpha beta blockers. This can happen with almost any blood pressure medication, but some are certainly worse than others when it comes to steady weight gain after taking the drug for a long period of time. The reason why weight gain is often worse with alpha beta blockers is because you are ingesting 2 drugs which can slow down the intestines. The intestines contract to move food along, however with the size of the blood vessels increased from these drugs, the intestines are no longer able to contract as efficiently. This will cause the intestines normal mechanism of action to be hindered. And as a result they will take longer to move food along through the digestive tract.
One of the worst side effects some patients experience from this drug are panic attacks. Because non selective beta blockers are for anxiety, they can effect peoples flight or fight response in different ways. Some patients might have a reduction in panic attacks if they had panic attacks before using this medicine. And if a patient never had a panic attack before, they may start to experience them once starting this drug.
There is an FDA warning about stopping this drug abruptly. It can lead to serious cardiovascular complications.
The withdrawls of alpha beta blockers can be brutal. Patients have experienced a high blood pressure rebound effect from the alpha blocker discontinuation, and a high heart rate and pounding in there chest from the beta blocker discontinuation. Anxiety may also be present. Many patients who have taken these drugs for an extended period of time have seen withdrawal symptoms last months. Your adrenal gland will need to re-learn the amount of epiniphrine and norepinphirne it needs to produce again. Because of this drugs effect to reduce both those hormones, the body tries to compensate by producing more of them. This goes unnoticed usually until the drugs discontinuation. There have been patients who discontinued these drugs after tapering down to the minimum dosage and saw minimal side effects and felt better right away with the drug being out of their system, however this is rare. As with any medication that blocks beta receptors, tapering down the dosage slowly over a period of time before discontinuation is absolutely necessary for safety of your cardiovascular system. Always speak with your doctor before stopping any medication.