Beta Blockers
A dangerous drug
Let me start by saying, Beta blockers are horrible. Out of all blood pressure lowering drugs they just may be the worst. Plain and simple. People who took them for a number of years had a very hard time getting off of them, both mentally and physically. They can make you feel like you are going insane. Most doctors will tell you they are very well tolerated, but that is far from the truth. In this article we are going to go over how beta blockers work, what the short term side effects are, why they are so difficult to get off of once your body becomes addicted to them, and why they are a poor choice for uncomplicated hypertension management.
Beta blockers have been around since 1964, with the first of the drugs being a non-selective variant. They work by inhibiting adrenaline, this in turn slows down your heart rate. The more the adrenaline is inhibited, the slower the heart beats. There is also another effect of adrenal gland inhibition, and that is the change of intensity in which the heart beats. Beta blockers can make the heart beat with less force, in turn causing less stress on it. This sounds well and good for someone with high blood pressure or heart problems, but we have not gotten to the side effects yet. This is a prime example of something that may look good on paper but does not quite live up to expectation in the real world.
Beta blockers do have the ability to lower the resting heart rate, however the effects they have on lowering blood pressure is minimal. It is thought that cardiospecific beta blockers work best for hypertension treatment. Studies done on beta blockers show far greater blood pressure drops than actually reported by patients taking them. Many patients report minimal effectiveness. Patients on a moderate dosage can expect to see their heart rate drop by an average of 11 bpm.
There is a study that showed patients who do respond well to beta blockers for hypertensive treatment might not be as well off as you would think. Clinical testing showed that although some patients may experience a decent drop in blood pressure from beta blockers, it was only lowered in certain parts of the body. So measuring the blood pressure at the arm did not show the whole picture. It was proven that patients actually still had high blood pressure within the heart chambers, so the reading on the arm cuff was irrelevant. Since these drugs can’t shrink all blood vessels, there is no guarantee it is shrinking the important ones that would pertain to the preservation of the cardiovascular system.
There is a huge issue regarding heart failure and beta blockers. Because beta blockers lower the resting heart rate they may help prolong the life of someone with severe heart failure. So doctors will often prescribe them to these patients without a second thought. However, some patients can experience worsened heart failure as a result of beta blockers. And it is not possible to tell who those patients may be. If a patient taking beta blockers for heart failure either cannot stand the side effects, or is experiencing worsening heart failure, they are then put in between a rock and a hard place. This is because beta blocker withdrawal is so brutal that it will put the heart under extra strain. Withdrawing from a beta blocker will cause the heart to beat faster and harder than it ever did before using the drug.
Long term use of any beta blocker may lead to heart problems. More research is needed on this, but a handful of patients taking beta blockers ended up having permanent damage to their heart as a result of using the drug. Although this is rare, you will not know if you are one of those unfortunate few who will experience this until it is too late.
Here is the FDA beta blocker warning for the drug Toprol (generic metoprolol), from their official government site: INITIAL US APPROVAL: 1992 WARNING: ISCHEMIC HEART DISEASE (See Full Prescribing Information for complete boxed warning) Following abrupt cessation of therapy with beta-blocking agents, exacerbations of angina pectoris and myocardial infarction have occurred. Warn patients against interruption or discontinuation of therapy without the physician’s advice.
I will write out a list of known side effects here. Anxiety disorder, panic attacks, extreme dizziness, feeling lightheaded, confusion, fatigue, weight gain, ringing in the ears, trouble sleeping (both insomnia and over sleeping), nightmares, chills, pain in the lower back or side of body, stomach issues, stomach pain, diarrhea, constipation, cold hands and feet, tingling in the hands and feet, nausea, general feeling of unwellness, getting out of breath quickly, breathing problems, poor circulation, worsening heart failure, sexual dysfunction, decreased sex drive, high blood sugar, feeling of warmth, weakness upon walking, halos around lights, impaired speech, feeling as if you do not want to move, sinus congestion, lung congestion, increased cholesterol, arrhythmia, and a dangerously low heart rate.
The mental side effects beta blockers can have on people can be very aggressive. Because of the fact that adrenaline can spike when you are excited or interested in something, patients often experience a complete lack of joy when on this drug. Many medical professionals who have studied this drug describe the side effect as “not able to find pleasure in activities or hobbies you once enjoyed”. Basically inhibiting adrenaline is taking away your ability to be interested in anything. Adrenaline is chemical that is needed for mental health stability. This side effect alone would be enough for me to not want to start a beta blocker regimen. Obviously different brands of the drug will effect everyone differently, so this lack of excitement/pleasure feeling may vary from individual to individual.
The onset of these mental side effects can make some patients feel as if they are trapped in their own skin. Patients may experience this once the drug reaches its peak effectiveness in the body. They can over think everything and start to feel as if there life didn’t turn out the way they wanted it to. It is important to note that the onset of this can happen gradually and slowly worsen after ingestion of the drug.
Depression occurs in a large amount of patients taking beta blockers. This is very common amongst patients taking these drugs, yet it is rarely talked about within the medical community. The lack of adrenaline can cause the mental state of a patient to decline in many different ways. Some of which medical professionals are unsure about. But we know for sure the lack of adrenaline causes depression. Patients also can experience a lack of self worth.
Panic attacks are common when taking beta blockers AND when getting off of them. They can range anywhere from 5 minutes all the way up to 8 hours. This happens because adrenaline is the body’s natural fight of flight response hormone. And when modifying this chemical level with drugs the body can not regulate it properly. This usually leads to the adrenal gland spiking hormone levels at times when it isn’t needed or warranted.
The physical side effects of beta blockers are also plentiful. Many patients taking beta blockers will experience a warming feeling coming over their whole body from time to time. Sometimes it is more focused in the head. It can happen regardless of the temperature in the room or outside. This happens because the chemical imbalances beta blockers cause make it hard for the body to modulate it’s own temperature properly.
Patients taking beta blockers often have a general feeling of unwellness. They may not know how to describe it but they do not feel like themselves.
Extreme fatigue is common when taking beta blockers. With the decreased adrenaline, you may feel sluggish and tired all the time. You can also experience fatigue from the lower heart rate. Exercise intolerance can also be experienced with beta blockers. You may end up discontinuing an exercise program you had started prior to taking beta blockers, and this can be for two reasons. The first one is of course the exhaustion and fatigue, and the second one is the mental fogginess and depression that can come along with beta blocker therapy. Many patients have reported an extreme lack of motivation for physical activities.
Some patients taking beta blockers have been hospitalized after first starting the drug. This can happen for a number of reasons. Patients can feel like they are going to have a heart attack because of the unsafe drop in the resting heart rate. Or just the opposite, a few patients have experienced a significant rise in their heart rate after ingesting the drug. It is not known why a beta blocker why increase anyones heart rate, but one theory is that the body becomes so confused that it tries to fight the effects of the beta blocker by over compensating for its potent heart rate lowering abilities.
It is important to note some brands of beta blockers may increase the heart rate after you initially ingest the drug, then within an hour give or take the heart rate decreases down to what it would normally be on the beta blocker. Many patients have reported this.
Involuntary arm movement and tremors can occur when taking beta blockers. Patients on beta blockers have reported there elbows involuntarily extending. This usually occurs when peak levels of the drug are in the system. Patients also experience trembling. This can happen when a person goes to open a jar or do any physical household task like take out the garbage. It is thought by some medical professionals that these physical side effects are more likely to occur when taking a third generation beta blocker.
Beta blockers have caused vision damage in a small number of patients. Although sometimes prescribed for glaucoma, patients do not always have a release of pressure behind the eye from beta blockers. More data is needed on this subject, but it is thought that this can happen from the blood vessels expanding to an unsafe size in or around the eye. This can potentially cause improper blood flow to the eye. It is important to note that this is more likely to happen from beta blockers that increase nitric oxide production. This is because these drugs have a more aggressive dilation effect on the smaller blood vessels in the body.
All these side effects of using beta blocker drugs are scary and horrible. However there is something much worse than the side effects of using beta blockers, and that is the withdrawal of beta blockers. The withdrawal of beta blockers can mimic the withdrawal of benzodiazepines, for those of you who are not aware of benzodiazepines, they have been proven to be one of the most addicting drugs ever created. Anxiety is greatly heightened, panic attacks can occur, resting heart rate will be heightened to a bpm far higher than before starting the drug, muscle aches are common, you can experience all kinds of mood disorders and mental health issues, and blood pressure can rise. The side effects of taking the drug can be experienced when withdrawing from the drug as well. In many patients that did not experience a lot of side effects on the drug, they will most likely experience them when they get off of it.
Withdrawing from beta blockers is a dangerous process and can lead to serious complications and even death. You should always do so under the care of a physician.