Metoprolol for anxiety reviews: The request could not be satisfied

18.10.197625.10.2021 by alexxlab

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Can beta blockers help with anxiety?

In March of 2020, I had an appointment with my primary care physician. I explained to her that, even though I was on Lexapro, a selective serotonin reuptake inhibitor (SSRI), for anxiety and depression, I still felt overwhelmed sometimes. By 5 p.m. every day, when the kids were home, hungry, and wanting attention, I felt a rising panic in my chest. I’d sweat and sometimes feel dizzy. Sometimes I’d snap at my children, or I would need to take a break somewhere quiet, away from others. Last Thanksgiving, I’d been preparing and cooking for two days, only to spend most of the meal in my bedroom. I told my healthcare provider I wanted to be able to handle the inevitable stressors in my life without feeling like I was drowning.

My doctor told me I was having a flight response and my physical symptoms indicated anxiety attacks. She prescribed me propranolol, a beta blocker, for anxiety. This type of medication is typically used for blood pressure control and heart conditions. I didn’t have a history of high blood pressure or cardiac problems, but she told me taking a small dose of this Rx is a good way to deal with “sometimes” anxiety. As someone who is generally pretty sensitive to medication, I didn’t want to take something stronger or possibly addicting. I decided to give it a try.

I’m so happy I did! The pandemic shut down schools (and everything else) a week after my appointment. I found myself home 24/7 with my kids, and it felt like the end of the world was right around the corner. I was very thankful for propranolol for anxiety in those early pandemic months and now, still safe at home almost a year later.

RELATED: Anxiety attack vs. panic attack

Are beta blockers effective for anxiety?

Beta blockers were not created for the purpose of anxiety reduction. “Beta blockers are often prescribed off-label for anxiety,” explains Spencer Kroll, MD, Ph.D. in pharmacology, the director of the Northeast Lipid Association. “[Off-label use] means they are not approved by the U.S. FDA for anxiety treatment.”

Even though they are not made specifically as an anti-anxiety medication, beta blockers can help to create a sense of calm when you take them. “Beta blockers can reduce heart rate,” Houston psychiatrist Jared Heathman, MD, explains. “When anxious, our heart rate elevates. This elevation gives the brain feedback that our body is appropriately panicking. This reinforces anxiety. If you inhibit the ability to raise your heart rate as quickly, your heart can give feedback to your brain that it isn’t panicking, especially not as much as would be otherwise expected. If our heart and body is calm, it provides calming feedback to the brain. This reduces anxiety.”

Sheldon Zablow, MD, board-certified psychiatrist, calls this process a “negative feedback loop.” He prescribes beta blockers for anxiety because they “break up this cycle by limiting the body’s ability to express the physical symptoms.” Tackling the body’s physical reaction to stress helps an anxious person’s brain feel more calm and in control.

That can make a huge difference in quality of life when anxiety affects you daily. Some anxiety symptoms feel so severe, and upsetting, that people experiencing them head to the closest hospital. “There are many symptoms that bring patients into a doctor or emergency room that turn out to be anxiety,” Dr. Kroll says. These physical symptoms of anxiety include:

Heart palpitations
Sweating
Itching
Skin breakouts
High blood pressure
Dry mouth
Difficulty swallowing
Gastrointestinal issues such as stomach upset or pain

As it turns out, anxiety reduction after taking a beta blocker is actually a side effect of the drug. So, even though my blood pressure is not in the range that requires medication when I’m not feeling anxious, my clever PCP did what Dr. Kroll says “is often beneficial as a clinician,” which is “to use those side effects as part of the treatment specific to each patient. ” I was worried that a benzodiazepine (like Xanax) for anxiety might make me feel too sedated to care for my kids. So, instead my PCP went with a beta blocker.

How long do beta blockers last for anxiety?

Officially, the half-life of propranolol is three to six hours, but in terms of how you feel, go ahead and plan for a couple of hours of relief. Beta blockers are usually prescribed in pill form to be taken orally. The medication works relatively quickly, reaching peak levels in as quickly as one hour. Once it’s in your system, the calming effects of a low dose of a beta blocker lasts for a few hours.

The standard dose of a beta blocker varies based on your symptoms, diagnosis, and other medical conditions. For anxiety, alone, healthcare providers usually start propranolol at a low dose, slowly increasing if necessary. There is also an extended-release version of propranolol, but for anxiety, usually the non-extended version is used.

How do beta blockers make you feel?

Beta blockers can help people who experience anxiety feel calmer and more in control of their emotions without making them feel under the influence. The goal of anxiety treatment is for you to be able to live your life without symptoms standing in your way. Beta blockers can lower the body’s adrenaline response to normal stressors, so you can focus on other things.

Unlike SSRIs—which manage anxiety and depression long-term and take several weeks to begin working—beta blockers are effective on the first use and can be used intermittently with no side effects. They alleviate short-term anxiety symptoms, but do not cure anxiety. If you are experiencing anxiety symptoms around the clock, you may need a different medication, or to use a beta blocker to supplement another prescription.

Beta blockers can be effective treatment for stage fright before events or public speaking engagements—and for sleep anxiety. “Historically, they have often been given to people for ‘performance anxiety’ before public speaking and acting,” Dr. Kroll says. Just be sure to try it at home first to see how the medication affects you before using it for a high-stress event. They may be effective for social anxiety if taken before parties or dates—a safe option for whenever anxiety emerges.

Dr. Zablow says a beta blocker “can be used in place of or with sleep aids to reduce pre-sleep anxiety. If worries about the past day or concerns about the next day increase heart rate, preventing a natural transition into sleep, this beta blocker prevents that interference.”

Side effects of beta blockers

“Beta blockers do not appear to have any problems or concerns in COVID-19 susceptible people,” says Dr. Kroll. If you are worried that a beta blocker might impact your coronavirus risk, ask your healthcare provider before starting the medication. There is potential for other adverse events from this type of medication.

Common side effects

As with all medications, there are potential side effects:

Dizziness
Lightheadedness
Tiredness
Decreased sex drive
Nausea
Stomach pain
Diarrhea
Constipation

Serious side effects

Less common, but sometimes serious side effects do occur:

Hallucinations
Cold hands or feet
Muscle weakness
Muscle cramps
Shortness of breath
Memory loss
Fluid retention
Blood sugar changes
Insomnia and nightmares
Allergic reaction
Vomiting
Shakiness
Weight gain
Skin rash
Mood Changes

Seek immediate medical attention if you show signs of an allergic reaction which include: trouble breathing, wheezing, swelling of the hands or face, and/or skin rash.

Unlike traditional anxiety medications, beta blockers are not addictive. Propranolol and the like do not cause drug dependency (or withdrawal symptoms when you stop taking them) and are safe to take occasionally over a long period of time.

“Propranolol is ideal in many ways because unlike benzodiazepines often used to treat anxiety, it can be taken without concern for driving, used with pain medications, or used with alcohol,” Dr. Zablow says. “I have successfully prescribed it to reduce the doses of required benzodiazepines, antidepressants, and antipsychotics.”

I was drawn to this positive effect of the drug as a parent who often has to be “on” even in the middle of the night. I can take propranolol and have no issues feeling sober enough to drive or interact with my kids, something I cannot say for other medications such as benzodiazepines, like Xanax.

Because a beta blocker is fairly fast acting but also does not impair users to a significant degree, Dr. Zablow says “it is helpful for someone with an anxiety disorder to just carry in their pocket for the possibility of an unexpected anxiety episode—just knowing it is there can reduce the occurrence of anxiety symptoms.”

I keep the medication in my bedroom for nights when I cannot slow my busy mind down. I also keep a bottle in the kitchen for when daytime worries keep me from being my best self. I don’t need them every day, but I’m glad they’re available for when I need them.

Which beta blocker is best for anxiety?

Healthcare providers generally prescribe either propranolol or atenolol for “off-label” treatment of anxiety. Ask your healthcare provider which medication might be a better fit for you and make sure you give a full health history. Here are the basic differences between the two:

Brand name	Inderal LA, Inderal XL, InnoPran XL	Tenormin
Generic name	Propranolol	Atenolol
Standard dosage for anxiety	Dosages vary based on the condition and can range from 10 mg to 80 mg. For anxiety alone, a lower dose is usually prescribed.	25-100 mg
Common side effects	Lightheadedness, dizziness, gastrointestinal issues	Cold hands and feet, tiredness, weakness
Learn more	Learn more	Learn more
SingleCare savings	Get coupon	Get coupon

When beta blockers aren’t right for you

If you have chronic, uncontrolled anxiety, you may need a more regular treatment than an occasional beta blocker—such as a daily medication. Some people, like me, use a beta blocker in addition to an SSRI. Dr. Kroll says, “In general, beta blockers are well tolerated, and symptomatic drug interactions are relatively infrequent.”

Beta blockers may not be the right choice for you if you have any of the following characteristics:

Asthma: “Beta blockers can interfere with asthma,” says Dr. Heathman. They can also cause issues if you have hyperreactive airways because the beta receptors might exacerbate breathing problems.
Underlying medical conditions that require medication: “Beta blockers may interact with a large number of commonly prescribed drugs,” says Dr. Kroll. These include certain antihypertensive and antianginal drugs, anti-arrhythmic drugs, anti-inflammatory drugs, psychotropic drugs, anti-ulcer medications, anesthetics, cholesterol lowering agents, warfarin, diabetes medications, and some tuberculosis medications. Tell your healthcare provider about all of the medications you take, so he or she can ensure there are no drug interactions.
Male or older age: “Beta blockers may be more effective in younger patients with hypertension than older patients and may be used to manage hypertension in females of reproductive age,” explains Dr. Kroll. Here, he is referring to it as a drug for hypertension with the added benefit of anxiety relief. Beta blockers should not be used in pregnancy unless benefit outweighs risk. So, talk to your doctor if you are pregnant or planning to become pregnant.

No drug is perfect and no person is the same. For me, as for many others like me, a beta blocker was an emotional life-saver during a very difficult time in history. The positive effects of being able to keep my cool while home with my kids, through an unprecedented time, and in the face of personal stressors, was priceless. I am very thankful my PCP thought to prescribe me a beta blocker. You cannot control life and sometimes it can be stressful—whether from a major world event, or just the everyday minutia of work and family. Beta blockers can help teach your body that, even when life is a bit too exciting, you can face it, deal with it, and even thrive.

Metoprolol: medicine to treat high blood pressure

Metoprolol comes as 2 different types of tablet: standard release and slow release.

Slow release is also called sustained release (SR):

standard release – releases metoprolol into your body quickly (you may need to take it several times a day depending on your dose)
slow release – dissolves slowly so you don’t have to take it as often (once a day is usually enough)

Your doctor may advise you to take your first dose before bedtime because it could make you feel dizzy.

If you do not feel dizzy after the first dose, take metoprolol in the morning.

If you have metoprolol more than once a day, try to space the doses evenly throughout the day.

Dosage

How much you take depends on why you need metoprolol and the type of tablet you’re taking:

high blood pressure: standard release – 50mg to 100mg, taken twice a day; slow release – 200mg, taken once a day
chest pain (angina): standard release – 50mg to 100mg, taken 2 to 3 times a day; slow release – 200mg to 400mg, taken once a day
an irregular heartbeat (arrhythmia) – standard release – 50mg, taken 2 to 3 times a day
preventing migraine: standard release – 50mg, taken 2 to 4 times a day, or 100mg , taken twice a day
too much thyroid hormone (thyrotoxicosis) – standard release – 50mg, taken 4 times a day

How to take it

You can take metoprolol with or without food, but it’s best to do the same each day.

Swallow the tablets whole with a drink of water.

Some brands have a score line to help you break the tablet in half and make it easier to swallow.

Check the information leaflet for your brand to see if you can do this.

What if I forget to take it?

If you miss a dose, take your metoprolol as soon as you remember, unless it’s nearly time for your next dose.

In this case, just leave out the missed dose and take your next dose as normal.

Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

If you often forget doses, it may help to set an alarm to remind you.

You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

What if I take too much?

Taking too much metoprolol can slow down your heart rate and make it difficult to breathe. It can also cause dizziness and trembling.

The amount of metoprolol that can lead to an overdose varies from person to person.

What is Metoprolol For Anxiety – Health Maintain

Metoprolol For Anxiety is the generic form of the brand-name drug Lopressor, prescribed to treat high blood pressure and prevent angina (chest pain). Anxiety of Metoprolol is a type of medication called a beta blocker. It works by relaxing blood vessels and slowing heart rate, which improves blood flow and lowers blood pressure.

Metoprolol can also improve the likelihood of survival after a heart attack. Doctors prescribe the long-acting form of the drug (Toprol XL) to treat heart failure. In some cases, a doctor may prescribe metoprolol for an irregular heartbeat.

Metoprolol Dosage For Anxiety

Both atenolol and propranolol come in pill form. The amount you should take depends on both the type of beta-blocker and your medical history. Never take more than what your doctor prescribes. You’ll likely notice results the first time you take beta-blockers for anxiety, but they can take an hour or two to reach their full effect. During this time, you’ll feel your heart rate decrease, which might make you feel more relaxed.

Depending on your symptoms, your doctor might suggest taking a beta-blocker regularly or just before stressful events. Usually, beta-blockers will be used in combination with other treatments such as therapy, lifestyle changes, and other medications.

Impact of Metoprolol Treatment

Metoprolol is a cardioselective beta-blocker. Beta-blockers prevent the heart from getting too excited or overworked. They do this by blocking off the beta receptors in the blood and heart. When the receptors are inaccessible, compounds that would usually excite the heart, such as epinephrine, cannot act on them and cause these effects. As a result, this may help keep the blood vessels relaxed.

When the blood vessels are relaxed, the heart does not have to work as hard to pump blood, which can help lower a person’s heart rate. Beta-blockers may also reduce how much oxygen the heart requires and lessen the need for it to pump faster. This combination of effects is what helps reduce the symptoms of heart problems, including high blood pressure and angina.

Precautions Metoprolol For Anxiety

Metoprolol may worsen the symptoms of heart failure in some patients, who may experience chest pain or discomfort, dilated neck veins, extreme fatigue, irregular breathing, an irregular heartbeat, shortness of breath, swelling of the face, fingers, feet, or lower legs, weight gain, or wheezing.

This medicine may cause changes in blood sugar levels or cover up signs of low blood sugar, such as a rapid pulse rate. It also may cause some people to become less alert than they are normally, making it dangerous for them to drive or use machines. Greater care is required with use in those with liver problems or asthma. Stopping this drug should be done slowly to decrease the risk of further health problems.

Metoprolol For Anxiety Side Effects

Metoprolol may cause side effects, the severity of which can vary between people. Common side effects include:

dizziness
fatigue
constipation
diarrhea
shortness of breath
coughing or wheezing
skin rashes
temporary mental confusion
blurry vision
short-term memory loss
reduced sex drive or loss of interest in sex

Many of these side effects will be temporary and may be relatively mild.

More severe side effects are also possible when using metoprolol, although they are generally less common. They include:

an allergic reaction, which may cause itching of the throat and swelling of the face, throat, or hands
cold hands or feet that may feel numb
extremely low or slow heart rate or weak pulse
extreme fatigue that may get worse over time
trouble concentrating
symptoms of depression, such as continuous or recurring feelings of sadness

Metoprolol Succinate Er For Anxiety

Metoprolol Succinate ER For Anxiety is a beta-blocker that affects the heart and circulation (blood flow through arteries and veins).

Succinate is used to treat angina (chest pain) and hypertension (high blood pressure). It is also used to lower your risk of death or needing to be hospitalized for heart failure. Metoprolol Succinate ER may also be used for other purposes not listed in this medication guide.

Metoprolol Succinate ER side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

very slow heartbeats;
a light-headed feeling, like you might pass out;
shortness of breath (even with mild exertion), swelling, rapid weight gain; or
cold feeling in your hands and feet.

Common side effects may include:

dizziness, tired feeling;
depression, confusion, memory problems;
nightmares, trouble sleeping;
diarrhea; or
mild itching or rash.

Metoprolol Reviews For Anxiety

A total of 154 patients (median age: 66. 39 years; males: n=101) were divided into eight groups on the basis of their mental status. HR decreased significantly from baseline values in all the groups to <70 bpm in the 12th month, P≤0.0001. The HADS depression and CBI scores significantly increased from baseline throughout the study frame (P≤0.0001 for all groups), but a significant decrease in the HADS anxiety score was observed in patients with anxiety (P≤0.0001 for all groups). Regression analysis revealed no significant correlation in any of the groups between the HR reduction and the change in the HADS/CBI scores, except for a change in the CBI scores of CHF patients with depression (P=0.01), which was HR dependent.

Side Effects of Lopressor (Metoprolol Tartrate), Warnings, Uses

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Side Effects of Toprol XL (Metoprolol Succinate), Warnings, Uses

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Anxious about a speech? A startup wants you to pop a minty cardiac drug

The pill works like magic, people who’ve used it say, to quell their anxiety around public speaking.

For decades, doctors have written off-label prescriptions for the heart drug propranolol to help anxious musicians, poker players, and tech executives calm their racing hearts and still their trembling hands before a big performance. Now, a San Francisco startup called Kick is planning to bring the beta blocker to a mass market — a plan that’s giving some psychiatrists and psychologists anxiety of a different kind.

Kick wants to become a telemedicine platform that makes it easy for nearly anyone who needs a confidence boost — before a first date, perhaps, or a big work presentation — to get a prescription for propranolol. They just need to pass a screening by filling out an online form and interacting in some way with a physician — the current idea is a video call.

As for the medication itself, Kick has reformulated the traditional pill into a minty lozenge, like an Altoid, that dissolves in your mouth, releasing 10 milligrams of the cardiac drug. The company wants to make it available in different colors and flavors, like watermelon.

“Our hope is to try to de-clinify the whole experience,” said Dr. Alex Dimitriu, a psychiatrist in private practice in Silicon Valley who has a stake in Kick and expects to prescribe propranolol through its platform.

The concept does not sit well with some mental health professionals.

“That’s a horrible idea. It’s a horrible idea!” said Stefan Hofmann, a psychologist who directs the social anxiety program at Boston University.

“No, you shouldn’t do that,” Hofmann said. “You want to do a very thorough assessment with a patient before you prescribe a psychoactive drug of any kind. You can’t do this via the internet.” (Hofmann, it should be noted, has ties to a competing business model of sorts: He advises a startup called SilverCloud that markets online cognitive behavioral therapy programs for anxiety and other conditions.)

Even physicians who sometimes prescribe propranolol for performance anxiety were critical of Kick’s pitch. Dr. Franklin Schneier, a psychiatrist who co-directs Columbia’s clinic for anxiety disorders, warned that Kick’s plan to repackage propranolol like Altoids “trivializes both the condition of social anxiety and the treatment of propranolol.”

Or as Stanford psychiatrist Dr. Anna Lembke put it: “To suggest that propranonol is entirely benign and equal to an Altoid, I think, is a really dangerous notion.”

“That’s a horrible idea. It’s a horrible idea!”

Stefan Hofmann, Boston University psychologist

That’s because although propranolol is an old drug with a strong safety profile, it still carries a small but real risk of side effects, ranging from lightheadedness all the way up to reports of congestive heart failure and the serious allergic reaction known as anaphylaxis.

Justin Ip, Kick’s founder and CEO, called these “legitimate concerns.” But he also characterized the fields of psychology and psychiatry as “relatively reticent to change” and “against anything that’s new” — even though there’s an acute need for innovation, given the severe shortage of mental health providers, particularly in rural areas.

Ip declined to compare his minty pills to candy, saying that “feels too fun.” But he said it was important to repackage the drug to reach a wider market of people who might not seek traditional psychiatric treatment but could benefit from propranolol if they saw it in a new light. (He also plans to offer a normal pill as an alternative to the lozenges.)

He pointed to other ways this is being done in more powerful drugs, such as an ADHD medication repackaged as a fruity chew — a move that also drew sharp criticism from some in the medical community.

Ip hopes to launch in the next few months in California, home to a vibrant culture of self-experimentation with pharmaceuticals, and then expand to other states. He expects a prescription to cost about $50 out of pocket.

A treatment for anxiety that’s fallen out of favor

Many people are afraid of public speaking. But when it gets severe and persistent enough, it’s codified in the DSM-5 as a type of social anxiety disorder specific to performance. About 15 million adults in the U.S. are believed to have social anxiety disorder, often undiagnosed and untreated.

Those who do seek treatment have a few options: Cognitive behavioral therapy, which involves talking to a therapist or completing online exercises. The class of antidepressants known as selective serotonin reuptake inhibitors, such as Paxil and Zoloft, which block the reabsorption of a neurotransmitter that regulates anxiety. Benzodiazapines like Xanax, which relieve anxiety by enhancing the effects of a neurotransmitter called GABA in the brain.

Then there are beta blockers like propranolol, which take a different tack. They suppress the autonomic arousal associated with fear — meaning no more racing heart. No more shaking hands.

Many psychiatrists embraced beta blockers for social anxiety and performance anxiety in the 1970s. But they’ve since fallen out of favor and are not considered a first-line treatment, in part because they aren’t as effective for people whose anxiety doesn’t manifest in mainly physiological ways.

“Bringing up propranolol is resurrecting a dead body,” said Hofmann, the Boston University psychologist.

Ip said he chose propranolol because it’s a cheap generic drug with few side effects and a long history of off-label use. He also pointed to a 2015 study that found that people who are afraid of spiders had a significant reduction in their anxiety after taking propranolol and being exposed to tarantulas, compared to people who were only exposed to the tarantulas or only took propranolol.

Still, anxiety experts caution that propranolol is a powerful drug. (It’s usually taken at a higher dosage than Kick is planning on.) It’s not recommended, for example, in people with asthma, and doctors take caution before prescribing it in people who have a history of arrhythmia, low blood pressure, or an elevated risk of fainting. Lembke, the Stanford psychiatrist, said she’s had patients who experienced withdrawal symptoms when they stopped taking propranolol after months or years.

“It’s a serious cardiac medication. I don’t think it’s something that should be prescribed lightly,” she said.

“It’s a serious cardiac medication. I don’t think it’s something that should be prescribed lightly.”

Dr. Anna Lembke, Stanford psychiatrist

Propranolol isn’t approved by the Food and Drug Administration to treat social anxiety or performance anxiety. But because Kick won’t be manufacturing the drug, it won’t be subject to FDA rules restricting off-label marketing by manufacturers. (The company worked with a compounding pharmacy to develop a proof of concept for the mint-style pill and is now talking to manufacturers.) Still, Ip’s being careful to comply with regulations.

“The way I think we’re going to message this is: Fear gets in the way of living your best self and achieving what you want to achieve and reaching your full potential, especially around the things that you value the most,” Ip said. “So what if there was a cure for that that involved an app and potentially a prescription drug?”

Kick, a San Francisco startup, plans to soon launch a telemedicine platform where people can get off-label prescriptions for a heart drug meant to be taken an hour before an anxiety-producing event. Alissa Ambrose/STAT

He envisions reaching not just people nervous about public speaking, but those who are shy. Or who fear going to the dentist. Or flying on a plane. Kick’s website also pitches the drug as a good bet for professionals experiencing “imposter syndrome” — meaning they worry they don’t deserve their seat at the table. It’s meant to be taken about an hour before the anxiety-producing event.

Kick is Ip’s first health-related business venture. His background is in consumer tech products; he previously worked on an app for finding hiking trails.

He developed an interest in mental health after he ruptured his Achilles tendon and found himself unable to walk and in an emotional rut.

“Fear gets in the way of living your best self. … So what if there was a cure for that that involved an app and potentially a prescription drug?”

Justin Ip, founder of Kick

Ip, who’s raised an undisclosed amount of venture funding, launched the first iteration of Kick in June. It’s an app that sends users a “kick of the day” to help them tackle their fears. Monday’s advice: “Eat a dinner item in the morning” — and then reflect on how breaking the rules made you feel. Ip worked with psychologists to design the content, which he said combines tenets of exposure therapy, mindfulness, and cognitive behavioral therapy.

Ip hasn’t yet figured out, he said, whether the telemedicine platform will be part of this app, a different app, or part of the company’s website. But he suspects that however he launches, he’ll tap into an eager market.

After all, Dimitriu, the psychiatrist working with Kick, already prescribes the drug several times a week to clients in Silicon Valley. He’s even taken the drug himself before big presentations. But he says he’s mindful that it’s not appropriate for everyone and will take care in screening online clients.

A ‘magic pill’ jump-starts a career

Before he became a high-powered tech CEO, Jim Safka was a high school kid so nervous about speaking in front of the classroom that he’d stay home from school.

Later, as a young assistant brand manager promoting Molly McButter butter-flavored sprinkles, he was so terrified about speaking during an advertising meeting that he could only get out a few words.

Safka tried everything he could think of: Taking an SSRI. Popping Xanax. Downing a few beers before big meetings. None of them worked.

Then, when he was about 30, a doctor prescribed him propranolol. He tried it at a regular meeting, and felt so confident, he even volunteered to speak.

“It was literally like a magic pill to me from that point on,” Safka said. And it marked “the beginning of the acceleration of my career.”

Safka rose through the corporate ranks, becoming CEO of Match.com and Ask.com in the 2000s. For about a decade, he took a 20 milligram dose of propranolol three or four times a week, an hour before he made a TV appearance, gave a speech, or ran a big meeting. He never experienced any side effects.

Eventually, Safka found, he rarely needed propranolol. Now 49, he’s working in nonprofit fundraising, as the founder of a new project to aid the victims of the recent Mexico City earthquake.

He’s also a fan of Kick’s vision of offering propranolol to the masses.

“I honestly believe it changed my life,” Safka said. “I hope that other people can realize that it’s available.”

Though he rarely uses it, he still keeps propranolol pills in his briefcase. Just in case.

Nebivolol Versus Metoprolol: Comparative Effects on Fatigue and Quality of Life – Full Text View

Hypothesis: the beta-blocker nebivolol is associated with less fatigue than metoprolol, the most widely-prescribed beta-blocker

Methods: a double-blinded crossover trial comparing nebivolol with metoprolol. Experimental procedures: Subjects will undergo electrocardiogram and routine blood testing, unless such tests have been performed within 6 months and are available for review. Subjects entered into the study will receive each of the two study drugs for 8 weeks. Metoprolol succinate will be given at a dose of 50 mg daily for 4 weeks, then 100 mg daily for 4 weeks. For nebivolol, dosage will be 5 mg daily for 4 weeks and 10mg daily for 4 weeks. Identical-appearing pills will be given, and the drugs will be given in randomized order without a placebo run-in period.

At the end of each 4-week treatment period on each drug, subjects will undergo a treadmill stress test (using the standard Cornell protocol), complete Quality of Life and fatigue questionnaires, and have blood drawn and frozen for later analysis for drug levels.

At the end of 8 weeks of treatment on each drug, subjects will undergo echocardiography and applanation tonometry (non-invasive measurement of aortic blood pressure) to assess heart function.

At the end of the study, the blinded subjects will be asked which of the two study drugs they preferred, and the extent to which their energy differed between the two drugs.

-Rationale: Millions of hypertensive patients are on life-long beta-blocker therapy. In many, it reduces cardiac output and increases peripheral resistance to blood flow (1). It is well-established that beta-blockers cause fatigue in many patients and reduce exertion tolerance. Every physician knows this, and tacitly accepts that many patients are living with this unwelcome side effect.

A new beta-blocker, nebivolol, has the standard beta-blocking effects, but also produces blood vessel relaxation (vasodilation), probably through increased secretion of the vasodilator nitric oxide. Studies indicate that nebivolol, unlike most beta-blockers, does not cause constriction of peripheral blood vessels, and is associated with improved heart function (2). Studies suggest that it is also less likely to cause fatigue (3).

Personal experience is consistent with this, as I have observed marked improvement in energy in patients in whom I have prescribed nebivolol in place of a different beta-blocker. The possibility of placebo effect of course cannot be excluded. Nevertheless, the known hemodynamic differences between nebivolol and other beta-blockers, and the positive clinical experience, warrant formal study to determine whether nebivolol is kinder than other beta-blockers in terms of the important side effect of fatigue.

Egilok instructions for use: indications, contraindications, side effects – description of Egilok tab. 25 mg: 60 pcs. (1246)

When used simultaneously with antihypertensive drugs, diuretics, antiarrhythmic drugs, nitrates, there is a risk of severe arterial hypotension, bradycardia, AV blockade.

When used simultaneously with barbiturates, the metabolism of metoprolol is accelerated, which leads to a decrease in its effectiveness.

With simultaneous use with hypoglycemic agents, it is possible to enhance the effect of hypoglycemic agents.

With simultaneous use with NSAIDs, it is possible to reduce the hypotensive effect of metoprolol.

With simultaneous use with opioid analgesics, the cardiodepressant effect is mutually enhanced.

With simultaneous use with peripheral muscle relaxants, neuromuscular blockade may increase.

With simultaneous use with agents for inhalation anesthesia, the risk of inhibition of myocardial function and the development of arterial hypotension increases.

With simultaneous use with oral contraceptives, hydralazine, ranitidine, cimetidine, the concentration of metoprolol in blood plasma increases.

With simultaneous use with amiodarone, arterial hypotension, bradycardia, ventricular fibrillation, asystole are possible.

With simultaneous use with verapamil, C _max in blood plasma and AUC of metoprolol increase. The minute and stroke volume of the heart, pulse rate, arterial hypotension decrease.Perhaps the development of heart failure, dyspnea and sinus blockade.

With intravenous administration of verapamil while taking metoprolol, there is a threat of cardiac arrest.

With simultaneous use, it is possible to increase the bradycardia caused by digitalis glycosides.

When used simultaneously with dextropropoxyphene, the bioavailability of metoprolol increases.

With simultaneous use with diazepam, a decrease in clearance and an increase in AUC of diazepam is possible, which can lead to an increase in its effects and a decrease in the speed of psychomotor reactions.

With simultaneous use with diltiazem, the concentration of metoprolol in the blood plasma increases due to the inhibition of its metabolism under the influence of diltiazem. The effect on the activity of the heart is additively inhibited due to the slowing down of the impulse conduction through the AV node caused by diltiazem. There is a risk of developing severe bradycardia, a significant decrease in stroke and minute volume.

With simultaneous use with lidocaine, a violation of the excretion of lidocaine is possible.

With simultaneous use with mibefradil in patients with low activity of the isoenzyme CYP2D6, it is possible to increase the concentration of metoprolol in the blood plasma and increase the risk of toxic effects.

With simultaneous use with norepinephrine, epinephrine, other adreno- and sympathomimetics (including in the form of eye drops or as part of antitussives), a slight increase in blood pressure is possible.

With simultaneous use with propafenone, the concentration of metoprolol in the blood plasma increases and a toxic effect develops.It is believed that propafenone inhibits the metabolism of metoprolol in the liver, decreasing its clearance and increasing serum concentrations.

With simultaneous use with reserpine, guanfacine, methyldopa, clonidine, severe bradycardia may develop.

With simultaneous use with rifampicin, the concentration of metoprolol in blood plasma decreases.

Metoprolol may cause a slight decrease in theophylline clearance in smokers.

Fluoxetine inhibits the isoenzyme CYP2D6, this leads to inhibition of the metabolism of metoprolol and its cumulation, which can enhance the cardiodepressant effect and cause bradycardia.A case of lethargy development is described.

Fluoxetine and mainly its metabolites are characterized by a prolonged T _1/2, so the likelihood of drug interactions persists even several days after discontinuation of fluoxetine.

There are reports of a decrease in the clearance of metoprolol from the body when used simultaneously with ciprofloxacin.

Simultaneous use with ergotamine may increase peripheral circulatory disorders.

With simultaneous use with estrogens, the antihypertensive effect of metoprolol decreases.

With the simultaneous use of metoprolol increases the concentration of ethanol in the blood and lengthens its excretion.

Prevention of migraine – effective against migraine, preventive treatment of migraine

Prevention of migraine really exists. The bottom line is that a person with this type of headache takes a drug every day for a certain period of time. His choice is made by a neurologist after examination. This medicine is effective for migraine, because it acts not on the symptoms, but on the very mechanisms of the development of attacks.Thanks to this, the number and severity of migraine attacks is reduced, and the burden from consumed painkillers is reduced.

But such preventive treatment for migraine is not prescribed for all patients with migraine.

It is justified if:

headache attacks become more frequent up to eight times a month or two a week;
Even special anti-migraine pain relievers – triptans: amygrenin, relaxax, zomig – are of little help to a person;
the patient cannot take analgesics and triptans due to contraindications – in the presence of uncontrolled hypertension, coronary heart disease and brain disease, after a heart attack; 90,072 90,071 people do not tolerate migraine medication well.So, for example, in some people, after taking such drugs, blood pressure rises or falls, and the pulse quickens. Hot flashes and a feeling of a lump in the throat occur. Abdominal pain and dry mouth appear. And although these side effects are temporary, not all patients can come to terms with them;
a person has a rare hereditary form of headache – the so-called hemiplegic migraine. With its development, the risk of stroke increases.

The choice of a drug for the prevention of migraine

For the prevention of migraine, seven groups of drugs are currently used as treatment – from drugs to lower blood pressure to drugs to lower female sex hormones.Almost all drugs used for the prevention of migraine were discovered by chance, during their practical use, and not specially created for this purpose. Therefore, at first glance, it may seem strange why a person with migraine is given a medication for epilepsy or depression. And so that he does not have a desire to cancel it, the doctor explains what its benefits are.

To find such a preventive drug for migraine is a whole art. The doctor must take into account the mechanism of its action, effectiveness, spectrum of undesirable reactions.Looks at concomitant human diseases. First of all, on the existing mental disorders. In the selection of a drug for the prevention of migraine, it is important that the prescribed drug does not exacerbate these problems, but helps to treat them. It also takes into account previous experience with the drugs and their compatibility. For example, concomitant use of vasodilator drugs can negate all prophylactic treatment for migraine.

In addition, it should be borne in mind that there may not be a quick effect of such treatment.You have to wait, be patient. Migraine prophylaxis drugs show their properties within three months. In this case, treatment is considered effective if the number of attacks is halved. For example, if you used to have a migraine headache eight times a month, but now it only hit you four times, this is already good. In the future, there will be even fewer attacks. And those that arise can be eliminated with lower doses of analgesics and triptans.

Prevention of migraine with Botox

In addition to drugs, Botox and its analogues are used for the prophylactic treatment of migraine.Prevention of migraine with Botox is the gold standard of treatment today. It is a scientifically proven, well tested and proven technique.

The drug is injected into the places of greatest tension and soreness on the head. It relaxes stiff muscles. Nerve endings that transmit pain are blocked. And thus the frequency and severity of migraine attacks is reduced.

One injection session usually lasts 4-6 months. Then the drug is completely excreted from the body.And its introduction can be repeated. And if you don’t like something – refuse or reduce the dose of the medicine. Moreover, if the injected Botox causes discomfort, there are approaches that can neutralize its effect ahead of schedule.

Prophylactic treatment of migraine must be repeated

However, no matter how successful the prevention of migraine is, it will not be possible to get rid of migraine forever. After all, migraine is a chronic disease, most often inherent in the genes. This means that under the influence of different provocateurs (causes of migraines) and at different periods of life, migraines can return.Therefore, it is necessary to carry out prevention of migraine from time to time. It is possible to change the drugs, their dosages, and the mode of administration.

But the person’s own attitude to the disease is also important. Every patient with migraine should understand that the frequency of migraine directly depends on his lifestyle.

It is necessary to identify all your personal risks – those factors that provoke a migraine attack specifically for you. They can be stress or any strong emotions, lack of sleep, overworking at the computer, eating certain foods or drinks, inhaling odors.

And as soon as the effect of one of these factors is expected, the preventive treatment of migraine is applied the day before. For example, if you know that in two days you will take an exam, sleep a little and strain your eyes a lot, you need to take, for example, some nootropic. This is the name given to medicines to improve blood flow in the brain.

Another, purely female case of episodic prophylaxis of migraine is menstrual migraine. It appears at the end of the cycle due to a drop in hormone levels.In this situation, 3-4 days before the start of menstruation, a woman is recommended to take NSAIDs – non-steroidal anti-inflammatory drugs. This will help prevent the development of severe attacks and serve as a good prevention of migraines.

Drugs for the prevention of migraine

Group of drugs	Examples of drugs	Concomitant diseases for which they are not prescribed	Concomitant diseases for which
Drugs against hypertension are prescribed: 1.Beta-blockers	Propranolol, Metoprolol, Atenolol, Bisoprolol	Depression, asthma, diabetes, heart failure, hemiplegic migraine is a hereditary form of the disease with an aura and an increased risk of stroke. With caution – with low blood pressure	Hypertension, coronary heart disease, panic attacks
2.Calcium channel blockers	Verapamil	Low blood pressure, rare pulse, constipation, depression	Migraine disease , asthma, ischemic heart disease
Drugs against epilepsy (anticonvulsants)	Topiramate, Valproate	Bronchial asthma, hemiplegic migraine, underweight, liver disease.With caution – for depression, anxiety, panic attacks	Obesity, increased convulsive readiness, epilepsy, manic syndrome
Antidepressants	Aminotriptyllin, Venlafaxine, Duloxetine	Decreased obesity, epileptic syndrome aura, urinary retention, heart block	Depression, anxiety, panic attacks, chronic pain, sleep disorders
Female sex hormone preparations	Monophasic combined oral contraceptives in prolonged mode – for example, for three months without a break for bleeding	Increased blood clotting and a tendency to form blood clots, severe varicose veins, past or threatened stroke	Hormone-dependent types of migraine, primarily menstrual migraine
Non-steroidal anti-inflammatory drugs	Ibu Profen, Naproxen, Aspirin	Peptic ulcer, gastritis	Menstrual migraine, arthritis and other pain syndromes
Botulinum toxin type A	Botox, Xeomin, Lantox	Severe diseases of the liver and kidneys, high tendency to bleeding, hemophilia, cancer	Chronic migraine, ineffectiveness of drug prevention or drug intolerance

For effective prevention of migraine, contact a specialist:

Naprienko Margarita Valentinovna
Chief Physician, Doctor of Medical Sciences, Professor, neurologist of higher
Filatova Elena Glebovna
Neurologist, Professor, Doctor of Medical Sciences
Oknin Vladislav Yurievich
Neurologist, Doctor of Medical Sciences
Yekusheva Evgeniya Viktorovna
Neurologist, Doctor of Medical Sciences, Professor
90 072
Latysheva Nina Vladimirovna
Neurologist, Doctor of Medical Sciences
Oranskiy Alexander Vladimirovich
Chiropractor, reflexologist, Candidate of Medical Sciences
Mikhailova Svetlana Anatolyevna
Neurologist, Candidate of Medical Sciences
1 Ivanovna
Neurologist3, Candidate of Medical Sciences
1 , Candidate of Medical Sciences
Gubareva Yulia Aleksandrovna
Neurologist, cephalgologist
Bayushkina Lyudmila Igorevna
Neurologist

How effective is metoprolol for anxiety?

Prescribing metoprolol for anxiety will be considered a misuse of the drug, meaning that it is not specifically developed or marketed to treat this type of problem.Metoprolol is a beta blocker that is intended to treat heart problems, including angina and congestive heart failure, and may also be prescribed to prevent heart attacks in people who have had it or are at risk for any other reason. This drug has been shown to effectively reduce anxiety symptoms in some patients, and it is believed to work by blocking certain receptors in the body that respond to stress hormones such as adrenaline.It can also be effective in reducing some of the negative physical effects of stress, such as increased heart rate and increased blood pressure.

Chronic anxiety disorder is characterized by persistent anxiety that can affect a person’s ability to function normally in daily life. People with this type of condition may develop persistent fears of injury or death for themselves or family members. They may also be hypochondriacs, have excessive health concerns, or may experience symptoms of obsessive-compulsive disorder, which is characterized by repetitive behaviors that are difficult for a person to control.In addition to these mental problems, chronic anxiety disorder can also cause physical effects, and metoprolol for anxiety can sometimes be used to relieve these symptoms. These include shortness of breath, increased heart rate or arrhythmias, and high blood pressure.

Metoprolol is thought to prevent adrenaline from absorbing nerve receptors in the brain, a hormone that the body releases in response to stress, when anxiety is triggered. The process of producing adrenaline in response to stress is called the fight-or-flight instinct.During a stressful or life-threatening situation, ancient people experienced a surge of energy and heightened feelings that could have made them more alert and able to deal with danger. While this gut response may have been helpful in such circumstances, it has caused physical problems in today’s people who experience chronic anxiety.

Although the use of metoprolol for anxiety may be effective in some people, it can also have harmful drug interactions with some of the other drugs commonly used to treat these disorders.A person who is already taking other medications should consult a doctor to make sure he or she can safely take metoprolol for anxiety. It is also important to report any negative side effects to a healthcare professional so that they can be addressed appropriately.

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90,000 19 reviews, instructions for use

When used simultaneously with antihypertensive drugs, diuretics, antiarrhythmics, nitrates, there is a risk of severe arterial hypotension, bradycardia, AV blockade.