Q. My father takes atenolol to control his blood pressure. He has had terrible difficulties with respiration in addition to low-grade depression and lack of energy. Is there an alternative class of drugs that he could try? He is by nature a very active, energetic man and feels virtually immobilized by this drug, so he’s very anxious to seek out better options.

A. Although beta blockers like atenolol, metoprolol or propranolol are frequently prescribed, such drugs are rarely appropriate as first-line blood pressure medications (Cochrane Database of Systematic Reviews, Aug. 15, 2012).

They may not reduce the likelihood of heart attacks or strokes (Archives of Internal Medicine, Oct. 8, 2012).

Beta blockers can make breathing more difficult, especially for people susceptible to asthma (Journal of Asthma, Nov., 2012). Fatigue and depression are also potential side effects.

We discuss the pros and cons of beta blockers plus various other blood pressure medicines and non-drug approaches in our book, Best Choices From The People’s Pharmacy (online at PeoplesPharmacy.com). Your father must not discontinue atenolol without medical supervision.

Other readers have also had some problems with atenolol. Here is one story: “I had been feeling tired and had no energy for years. My feet and ankles would swell to twice the size. I started to have shortness of breath. My cardiologist ran every test and everything showed normal. She was ready to give up and then decided to try one last thing.

She cut my atenolol to half the amount I was taking. In two days I had all kinds of energy, no shortness of breath or swelling. I feel at least ten years younger than my 73 years. Atenolol slows the heart rate down. I have lost 15 pounds because I am so much more active now.”

Another person, like your father, found that the drug precipitate breathing difficulty: “I was on a low dose of atenolol for about a year. It left me with chronic asthma/low-grade bronchitis.”

Finally, though we worry most about cardiac reactions to stopping atenolol suddenly, here is another reader’s experience suggesting that abrupt discontinuation may be quite uncomfortable as well as risky: “My brother’s doctor added atenolol 50 mg to his Lisinopril-HCTZ (40-25 mg) medications after 3 months to get his blood pressure down to below 120/80. It worked (bp about 100/70) but his heart rate had been in the 60s and ended up at times in the 40s with the atenolol 50 mg. While on the atenolol for 4 months, he was able to sleep but not great. While the doctor prescribed taking the atenolol all at once, we found he seemed to feel a little better with the dose split 50-50 morning-night.

At his last doctor visit, the doctor lowered the atenolol dose to 25mg to be taken at night due to a pulse in the 40s and my statement that my brother seemed a little slower moving. After 10 days on the reduced dose, my brother developed complete insomnia (no sleep at all for 6 nights straight). We called the doctor and the nurse added trazodone 50 mg. He took that for 3 nights and it did nothing. When we called the nurse, she said trazodone takes time to work.

After reading about atenolol withdrawal and the risks of trazodone, we decided that he should go back to his prior atenolol dose of 50mg split morning and night and not take the trazodone. He did get a decent night’s sleep the 2nd night of going back on 50 mg atenolol but it didn’t seem to help the first and third night. We are hoping it works tonight.”

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  1. Beth

    Has anyone had problems with interactions between Atenolol and Trazodone? I have taken 100 MG of Atenolol daily for several years to regulate my heart rhythms with good results and no significant side affects. Then about four months ago I went to my doctor with insomnia problems, and she put me on Trazodone. Started at 100 mg a night but felt hung over next morning, so she cut me back to 50. Slept like a baby at first. But as time has passed I have had increased episodes of irregular heartbeats and slight pressure in my chest, and now the Trazodone has stopped helping me sleep. Any thoughts?

  2. Margaret

    Hi, I have read with interest problems with Atenolol,I have a sliding hiatus hernia and was prescribed Lansoprazole 20mg x 1 daily some months ago. Also Atenolol 25mg for slightly raised blood pressure.
    Because of severe bloating and wind I took myself off Lansoprazole because I thought this was causing the bloating and wind……I continued with Atenolol and I am still very bloated/wind so after reading about Atenolol I think that this is the cause of my bloating problems. I have had blood tests, endoscopy and stool test for colon cancer…all appear to be okay. Can I safely stop Atenolol????or do I have to wean myself off them. My doctor does not seem concerned but I am, I feel and look about 4 months pregnant, have put on weight that I cannot get rid of even when I try, have continuous wind that is very embarrassing !! Anyone else with same problems?
    Margaret, UK

  3. Val

    I am taking Atenolol for arrhythmia. In 2007 was prescribed metoprolol and had total body aches and pains like I had worked out. One day forgot to take the pill and had no aches or pains. Doctor then put me on Diltiazem. Was on that for a few years then the doctor increased the dose. Within months had gum overgrowth in my mouth and horrible acid reflux which I have never had in my life. Went of that drug in 2011 and was put on generic Atenolol.
    My only issue with this drug is the manufacturers!
    In 2014 my mail order company sent me my next 90 day supply and within 2 1/2 weeks I was in ER with the most horrible arrhythmia episode. I was having them that whole year on and off and made 5 trips to ER. Then in 2015 the manufacturer changed to Zydus and within days I felt like a new person! In October, 2016 manufacturer changed to TEVA. Within 21/2 weeks was in the ER with arrhythmia episode. Told the doctor I am not taking these and had some left over Zydus pills. Trying to get more from that Manufacturer. All manufacturers have different ingredients in their products…..be aware.

  4. Rachel B
    Corpus Christi, Tx

    I have been on Atenolol 12:0.5 milligrams twice a day and I have noticed that my stomach is bloated and I have put on weight. I can’t seem to lose weight even though I barely eat throughout the day. My joints are hurting and I have no energy at all. I have gone to a gastrologist to see what is wrong with my stomach and they can’t seem to find anything.

    I finally started doing research on atenolol and Ibesartan that I am on right now twice a day and the symptoms have persisted since I have been on these medications for the past 7 months. I will go see my physician and discuss these two drugs . Thank you for all these comments that people have made because it has made me aware of the side effects of this drug.

  5. John

    I’m on 150mg Atenolol and suffer slow heart rate and breathlessness on exertion, or shortness of breath when I sleep. I also have fluid retention which I consider is caused by Atenolol not to mention Haemoglobin depletion which caused Atrial fibrillation, I now have heart flutter and irregular heart beat and was put on Pradaxa 150mg. I am a very tall and heavily built, 6′ 8″ weighing in at 26 stones, lifelong non-smoker or drinker, I never had these problems until I was put on meds, so I hope to start weaning myself off Atenolol, at least reduce the dose with doctor approval.

  6. geraldine

    just coming off atenolol as numbness in feet tired all the time wheezing breathless insomnia tightness in chest worse when walking bloated tummy. I feel so much better after 3 days off feel more alive and alert than I have been in last 2 and a half years on this med thanking every 1 for comments.

  7. walsh

    I would like to add a thought. I was about 41 years old. I was on Hydrochlorothiazide . And 25 MG of Atenolol. I noticed that I was having issues standing and pain. I continued to work on a daily basis. It seemed that I started having a tingling sensation in my hands. I would wake up in the night where it was like my hands were frozen. I would wake up because of the pain. I would shake my hand and get the blood flowing and then go back to sleep. I then would start the whole process over again.

    I started to have lots of problems with walking. My ankles legs and knees would hurt on a daily basis. I was a very active person. I would work in the yard in the Texas sun all day. I would pick up things like stepping stones. I noticed I was losing a lot of my strength and also brain power. It was like I was on cloud 9. I would not be able to remember easy things like a word as simple as Christmas. I told several doctors about the situation. They told me I needed to lose weight. By the way I was weighting about 260 big boned and very strong. It seems I gained about 40 pounds after starting the Atenolol.

    I was given MRIs and such. They finally told me that I had carpal tunnel. Some days my hand would hurt and some days it doesn’t. I tried metoprolol and same issue. I went back to Atenolol. At this point I resigned from my job of 15 years because I could not stand. It hurts too much. I go to sleep at night and my whole body Hurst when I lay down. I went to a doctor in another state and he kept me on Atenolol and Losartan. I feel like I am being tortured. And yes I must say that I have shortness of breath. So I take all of my meds and vitamins religiously.

    Last week, for some reason I did not put the Atenolol in my little pill thingy for the week. I started having high blood pressure type feeling. Pain behind my eyes and such. I took a Hydrochlorothiazide (which totally gave me horrible gout years before is why I stopped. The gout went away immediately.) and a Tylenol. I went to the eye doctor and they checked my eye pressure. It was not good. I started thinking hey maybe I did not add the Atenolol to the meds for the week. Sure enough I didn’t, all explained. It controls the pressure but I know Atenolol is killing me. I barely can hold my cell phone as I type this. While I was not taking the Atenolol two weeks ago I was fine. My hands were not numb. I was able to sleep with no hurting legs or hands it was awesome. The doctor told me to lose weight. He kept me in these meds. I hope this helps someone.

  8. Jackie

    I was put on Atenolol , Only on it for two weeks now, and I feel like a zombie! Cannot stay awake. Pain in my hips. I plan on going to see the Doctor tomorrow, so tell them to put me on something else besides Atenolol. I take Lisinopril 40mg so far so good, but I take two meds, altogether. I went to work today everything was slow mode. But I believe its the first drug, Atenolol 25mg.

  9. Maria

    Informative site thank you.

  10. Lee
    United States

    I just started taking atenolol because I was having hair loss with metoprolol. Each time I take it, I get nauseated – with or without food. Third day on it, I also got sl dizzy and lightheaded. I think I’d rather go back to the metoprolol.

  11. Luke
    Riverside, CA

    I have been taking Atenolol for 7 or 8 months now, along with Diltiazem. These have been prescribed for AFIB. I cannot say that they have helped with the arrhythmia but they are adding to other problems. I have put on at least 15 lbs; have a bloated abdomen; my asthma has gone from acute to chronic; and my cholesterol has shot up. Interestingly, my general practitioner wants me to take statins, without a thought to how they might interact with these other meds. I have fired him.

  12. TS

    Don’t take Atenolol! This is an old drug and, as the article above states, it is not even effective for preventing heart attacks and strokes. My 97 year old mom was put on Atenolol along with a blood pressure-lowering drug, Lisinopril about four years ago. She became almost zombie-like. I was told, well, she’s old. That’s normal for her. No matter how I protested that it was not, the damn doctors kept insisting she take it.
    Finally, I determined that if she was going to die, so be it, but her quality of life was so miserable, it was hardly worth living. She stopped taking the Atenolol and the Lisinopril. We began drastic improvements in her diet, cut out sugar entirely, began introducing one tablespoon of vinegar a day. Her blood pressure now is normal and she has much more interest in life.
    Unfortunately, after taking Atenolol for 2-3 years, and Statins for up to 10 years, I think she has irreversible dementia.
    I wish, with all of my heart, I had not listened to any of these doctors who insisted she need these drugs! Maybe they prolonged her life by a year or two, but they sure as hell took all the joy out of it!
    Don’t forget the unholy alliance between pharmaceuticals and the health industry. Some doctors receive a commission for putting their patients on drugs.

  13. Lisa

    I was taking 25 mg Atenolol for moderate blood pressure problems. I had side effects that came on so slowly that I never related these symptoms to the medicine. My feet began to ache and my ankles and hands swelled. My joints starting aching as if they had lactic acid building up. My ips got so bad that I had to stop exercising.
    The aches and pains escalated in the inability to walk normally and stairs were nearly impossible. I had wheezing and shortness of breath. I became almost debilitated. Doctors sent me for all kinds of tests, nuero, neuro-muscular, gout and arthritis. All tests came back within normal limits, but I was not functioning well with daily activities. I could not take a shower more than once a week, as the shortness of breath was so bad, I was afraid I was going to fall in the shower. I purchased a medical chair for the shower. It was hard just to cut my toenails, as I could no longer cross my legs.
    I recently was taken off the atenolol as my blood pressure was stable. In only 3 days, my symptoms were starting to subside. It has been 3 weeks now and I am making such progress with movement it is unreal. I am not 100% yet, but each day I gain more strength. My wheezing is almost gone, and I can actually wear shoes, not just slip-on sneakers which have been the only shoes I could wear between the foot swelling and pain.
    I gained 70 pounds while on this drug! I have started losing weight (I have come down 1 pant size, but will not get on a scale) and all my cravings were sweets are gone.
    I will NEVER go back on this drug again! I am trying weight reduction, moderate walking, flaxseed and every other antioxidant and omega 3 food I can obtain. This medicine brought me close to complete disability and not ONE doctor suspected the atenolol!

  14. jf

    I have been on atenelol 50mg for nearly 4 weeks now, I have absolutely no energy, to the point that its an uphill struggle to get up and go to work, I can hardly keep my eyes open at times, I have also started bursting into tears over the last week or so. My leg pains also seem worse than normal. I really don’t like taking medication!

  15. JLB

    I take 100mg atenolol and 5mg norsvac once a day in the morning for blood pressure control. I also have copd that I take spiriva once a day. I do have shortness of breath and some fatigue plus sometimes slight dizziness.
    Is it likely that the combination of the drugs I take could contribute to my condition? What are the options to atenolol?

  16. cpmt

    HIS DOCTOR should check for vitamin (like vitamin B12),& mineral deficiencies… and ask if he can take Co. Q10 for energy and help with circulation.

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