The People's Perspective on Medicine

Bad Dreams from Beta Blockers

Q. I’ve been sleepwalking and having really bad dreams for two years. It finally hit me that this all started soon after I started taking Toprol. Have others had such problems?

A. Toprol (metoprolol) and other beta blockers (atenolol, propranolol) can cause nightmares and disturbed sleep for some people.

Other side effects from these drugs include:

• Fatigue, tiredness, depression
• Dizziness, lightheadedness
• Itchy skin rash
• Difficulty breathing, asthma
• Slow heart rate
• Cold hands or feet
• Sensitivity to sunlight, sunburn
Heart block (a problem with the rhythm)
• Blood disorders

Other people have also faced this problem. JP says: “Metoprolol for high blood pressure caused such nightmares, such vivid dreams and finally, sleepwalking! I talked to the doctor and I now take this same medication in the morning instead of at bedtime. That might help some people.”

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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I have been having the most vivid and creepy dreams. Before I doze off and wake up, I’m being touched in my bed and shaken. My conditions are chronic migraines, depression, and severe anxiety. I’m getting hallucinations on this med and frightening dreams that make me dread sleep. I was so worried I went to the 24-hour doctors, only be treated like a nut job and told to see my psychologist earlier and be handed the psych service number. It’s not my other meds its not a mental health issues its the beta blocker , Only change in my life was the new medication ,

I brought all the info on the side affects, and they didn’t want to even look at it. I barely got a sentence in. They acted like such a medication simply does not have such side effects yet the very same symptoms are listed in the medication’s pamphlet.

I felt pretty helpless before now after the visit even more helpless. I couldn’t believe i was treated like a loony toon , And what upset me more was they said dont take it if you feel like it go cold turkey , Only for me to go home and do THEIR JOB and find out simply stopping a beta blocker is very unwise and unsafe. I just cant believe they couldn’t be bothered to tell me to ween of and how to instead never told me a thing about that.

If i were to stop the meds the symptoms would go away if i were to start it up again they would be back , Even then i know i would be sent to my psychologist who cant do a thing for me regarding medication once again and treated like a nut job.

I wouldn’t wish my experience on anybody but my worst enemies.

I started taking metoprolol 25mg six days ago, and the crazy, vivid dreams/nightmares started the same night. The dreams are usually negative, and once or twice I woke up in the middle of the night with anxiety and heart pounding. Last night was the worst to date: in my dream I was being suffocated by my husband, and I was pushing, clawing and biting him in attempts to get him off me. I woke up to the sound of my scream and with shortness of breath, and I had really scratched my husband several times across his chest. I feel terrible about that. I’m not even a week on the meds! I’ll stick it out until my next doctor visit and hope they cease as my body becomes adjusted.

Wow im exactly the same. If i miss a dose i get palpitations

I haven’t been having dreams that I remember when waking until recently. I have long term high blood pressure that is still not been corrected and because of this I take a lot of such drugs. In the last 6 months I’ve begun to have weird dreams, not too scary really but two of them led to sleepwalking, one of which led me to call for the fire department to stop a fire. I described this to my primary provider who has asked me to meet with their social worker associated with the center. I talked about it to my cardialogist the next day saying that I thought it was metoprolol that caused it but there were several drugs so I couldn’t be sure. He kind of blew me off kindly. I’m still being worked on sleep apnea study on an appropriate machine too.

I strangely enjoy my metropol dreams. Like ores lots of dead relatives and friends from the past mixed with problems of the day. Last night I was at my childhood sailing club, while writing code for them…my job…saw some old friends and of course couldn’t find my car from the 80s….can’t wait what tonight will bring :)

I started this medication about a month ago (25MG at bedtime) for heart palpitations. I too have very vivid dreams, never a nightmare yet but fond memories of childhood, daily activities, vacations and all positive stuff. Sometimes Im interacting with loved ones that have passed away. It is almost scary how real they seem and how I remember them as well. I always go to bed wondering what my dreams will be of next :)

I started this medication about a month ago (25MG at bedtime) for heart palpitations. I too have very vivid dreams, never a nightmare yet but fond memories of childhood, daily activities, vacations and all positive stuff. Sometimes Im interacting with loved ones that have passed away. It is almost scary how real they seem and how I remember them as well. I always go to bed wondering what my dreams will be of next :)

What a shame that doctors don’t listen well. They have heard these stories enough times to realize it’s the drug but they act like it’s the patient, not the drug. I recently got off metoprolol ER because of too many side effects. Now I’m on Nadalol (at my request). I sleep much better and can exercise better. Metoprolol affects areas of the brain, Nadalol functions differently. Not all beta blockers do the same thing but they all do slow the heart down. I sympathize with those on metoprolol.. please research these drugs…

I was on metoprolol tartrate for at least a year, with no problems. I took it to relieve stress and lower my blood pressure, per medical prescription from my cardiologist. Unfortunately, after the first year or so, I slowly began to have vivid, vivid, terrifying hallucinations in my sleep — night terrors — where I saw snakes and wild animals and intruders in my bedroom. I would occasionally bolt out of bed in terror, screaming. I even did this in a vacation cottage full of friends one night. They all thought I was mildy crazy.

Finally, one night I bolted out of bed and injured my knee very badly, and had to go to the ER. My partner told me I had to get help of some sort; that these three-times-a-week screamfests were becoming hard to take…

One night, I woke up with this weird idea that it somehow had to be the metoprolol. I cannot explain why I reached this conclusion in my sleep. I ran to my computer in the middle of the night and Googled “metoprolol tartrate night terrors.” Up came various web sites discussing this side effect. I soon went to a sleep lab and saw a sleep disorder physician. Working with my cardiologist, he switched blood pressure meds to Atenolol on a low dosage instead of metoprolol tartrate. Sleep apnea was also diagnosed. I am on BIPAP (a type of breathing device when I sleep) and I am off metoprolol tartrate entirely. Rarely, I will wake up and talk loudly. But the thrice-a-week night terrors, with vivid and horrible hallucinations, are gone. Thank God.

If you have this issue, direct your doctor to this site. My doctors searched the net just like you did, and concluded that maybe it was metoprolol tartrate (with some apnea) that was causing my nightmares. There is hope for you! Don’t give up.

I went prepared with all of this printed out, and they didn’t even want to take the time to look at it. They concluded I was nuts and gave me the number to the suicide hotline : ( I see a psychologist for my anxiety but these side effects are not mental health side effects. I got nowhere, and I’m so upset. They acted like such side affects cant be real, and you’re are nuts or making this up. THE SIDE EFFECTS ARE IN THE PAMPHLET THAT COMES WITH IT IN THE UK. I MEAN, COME ON!


i’ve had hallucinations too with a betablocker, propanolol then seloken
the only way to stop these hallucinations is to stop the betablocker (way of acting present in all the pharmacovigilances too)

i never believed to supernatural things, but during these hallucinations i was sure to hear spirits talking together
that’s quite the same things to all others patients who experienced hallucinations under beta -> the patient is in relation with dead peoples (spirits)

so if someone passing by this page have the feeling he’s in relation with spirits under beta, it’s not spirits, but just hallucinations and these hallucinations will disappear by the halt of the beta (assuming that if someone is reading this page, this person is for sure either having bad dreams with beta or hallucinations)

these hallucinations occured during 32weeks of beta, 22h/24h, 7days/7days
they were so vivid and coherent that even 3years later i still have a bit of doubts about spirits (even if i never believed to supernatural things before these 32 weeks)

i’ve changed the first page of my website to talk only of what happened to me under beta, so if someone wants to know what to not do when hallucinations occurs with a beta you just have to read this page :

I was prescribed Metaprolol a year ago. I too have extremely vivid dreams and at first they were nightmares. Now they are just vivid and extremely complex dreams. Sometimes I don’t sleep that well, but most nights I do. The payoff for this medication is that it lowered my blood pressure from 200/120 to 130/75. I’m just glad to have a few years left. I see how it can cause some problems with sleep. But for some of us it’s a proper trade off.

I was recently prescribed Toprol for irregular heart rhythm and I’m so relieved to find this site. I have been having continuous nightmares along with depression since taking this medication. I am calling my cardiologist today to go back on my Bisoprolol Fumerate. This medication did not give me these horribly vivid dreams and keep me up at night. Last night I dreamt that my 3 yr old granddaughter died a terrible death. This medication is scary and should be researched further.

I was prescribed a beta blocker for glaucoma. Only two drops a day in one eye. Immediately I had such vivid, horrible nightmares. I dreaded going to sleep, and felt I’d rather lose my sight than live with the nightmares every night. As soon as I stopped the beta blocker the nightmares stopped.
My ophthalmologist did not believe me but my optometrist did (he had experienced the same reaction to beta blockers). Find a doctor who believes you,and find another treatment!

I have been on Ramipril for two years and on thyroid meds since my early 20s. After triple bypass surgery Metoprolol tartrate and Prevastatin were added to my regimen. For the last year my sleep patterns have worsened, waking every two hours and unable to get back to sleep easily. I find I now have shortness of breath (or panic attacks), not sure which. I am also experiencing serious and sudden (not gradual) hair loss, which I find totally devastating. And new stress in my life seems to be multiplying these symptoms.

In the middle of all this I have attempted to change to a doctor closer to home but they are too busy to see me unless I’m willing to wait a month for appointments. Just 2 yrs ago I noticed none of these symptoms and only experienced shortness of breath which I thought exercise might fix. I almost wish I had not seen a doctor. I honestly don’t know which way to turn.

My partner is taking propranolol and he don’t take it like as directed. But I am asking is yelling sweating sluring of words dizziness confusion paranoia extreme tiredness pains easy bruising psychotic episodes are all these possible?

Hello everyone,
I, too, take Metopropolol and have terrible sleep problems. I dream constantly about family members who have been dead for years, violent situations where I’m enraged and scream and yell and no one pays attention, and then I resort to physical violence, and then actually slap the bed with my hand , hit my husband, and talk in my sleep. Last night I actually dreamed about my sleep problems, and my husband woke me up because I was chanting. He’s getting really fed up and I hate going to bed. I take 100 mg. in the morning. I see my doctor in a week or so, but I’m afraid he’ll blow me off.

I’m so, so sick of this.

I just discovered what my problem is, I happened to just run across some case files on incidents about Metoprolol induced hallucinations. When I read the stories, I was flabbergasted! I had been trying to describe this to my primary care doctor for several years, until they got so bad, I had to request that she and my cardiologist find out about this. I emailed both and heard back from primary and now am waiting to hear from cardiologist. It fit what I was experiencing to a T. They had gotten so bad it was effecting my daily life. I thought I’d seen enough “dead” people to fill a stadium. I talked constantly,had conversations. I would wake everyone up screaming for these “horrible dead people” to get out of my room! when I would try to explain this to my primary, I really felt like she thought I was crazy. I also take amiitryptilene so I always thought that somehow thats what was causing these incidents. While I’m waiting to hear from my cardiologist, I took it upon myself to drop the evening dose and only take the evening one,so far”, Knock on wood”, I haven’t experienced one incident for a week now. Just like that it stopped, I sleep through the whole night,I feel rested in the morning, I hope I don’t jinx myself by saying this, but I believe that’s all it was. all this time of suffering through the nights, and it’s been that teeny tiny little pill all along.

Did you have to drop the amitriptyline or the metaprolol? You said you had to drop the evening dose and only take the evening one so I’m confused. Thanks!

I have been taking metoprolol tartrate for about 10 years, for about a year now I wake up after going to sleep with vivid dreams, heart racing, numbness in my arms and sometimes pains in my jaws, has anyone had these same side effects?

After starting Metoprolol Jan.9th, I have daily vivid, & at times bad dreams with the expected aftereffects. I may try to use it in the morning instead of 930PM, but remember that Atenelol does not cross the blood/brain barrier & impact the central nervous system, unlike Metoprolol.

I was prescribed Propranolol as a preventative medicine for my severe migraines. Within 3 months, the migraines had all but stopped. However, I was having such bad night terrors that I became frightened to go to sleep. Even my husband feared going to bed as I woke him night after night with blood curdling screams and even pushed him out of bed on one occasion. I cannot tell you how horrendous the nightmares were and would never go back on beta blockers even if my life depended on it. I didn’t realise it was the propranolol doing this until discussing it with my doctor as it was preventing me sleeping and I was near to being divorced by my husband. The GP explained that beta blockers are one of the only drugs that can breach the blood/brain barrier and that this side effect will only affect some people. She took me straight off of them and said I should not ever take them again. I’m afraid I never found anything as good a prophylactic for my migraines :(

I have been on Metoprolol for about 9 years. Three years ago, my Heart Specialist (Lipid Medicine) increased the dosage and that’s when I noticed the nightmares I had been having increased significantly. I told my doctor so, some 6 months later. Without hesitation or further discussion, dosage was immediately reduced to original prescription. Now, the bad, recurring nightmares are back and worse than ever. I speak with dead people – who have passed on decades ago and who talk as if they belong in the actual world – I kill strange people in a rage as if they were all out to kill me – I shoot them in the face, I kick them off high rise buildings.. etc. And those happened 6 nights out of 7…! My GP immediately fingered Metoprolol as the culprit and replaced it with another blocker. That was only 3 weeks ago, and nightmares have already stopped. I do have dreams – but they are mild. My advice is DO NOT HESITATE to discuss it with your doctor and insist he or she listen to you carefully. DO NOT LET the doctor ignore you on this issue. It is absolutely horrible to live that way and spend time killing people in the night or having conversations with the dead. Stop waking up in a jitter and all sweaty, as I did. Some even get physically violent against sleeping partner. It’s just horrible.

I’m 35 and have been on Nadalol (generic Corgard, a beta blocker) for migraine prevention for almost 4 years. Every dream I have is a nightmare. Every night. Granted, it could be the combination of the drug with my previously-diagnosed depression & anxiety (which there is no longer anyone in my small town to treat it competently). However, they didn’t get really bad or happen every night until after starting the beta blocker. It’s hardly a choice though – excruciating migraines or terrifying nightmares? Hopefully the tendency to migraines will go away as I get older?

I have similar symptoms as documented by others ranging from vivid dreams to sleeping walking. The patient info given with the beta blocker I take (Topolol) had indicated this when I first started taking it but its no longer contain this info. I plan to discuss with my provider during my next visit because the vivid dreams or sleepwalking continues unabated and appears more intense if I drink a glass of wine at bedtime. Thanks for having this forum and this info was very helpful for me.

I have been on Metoprolol for years and before that it was Toprol. I have searched from Dr. to Dr. for reasons for all my problems. I’ve had coughing, palpitations, fatigue, depression, dizziness, difficult breathing, cold feet and hands, light headedness, poor coordination, and many other problems and have asked a number of Dr.s to change my HP Med. but they all seem to just laugh it off. Am I wrong in wanting to change?

NO.. YOU ARE NOT WRONG…. The first time I told my doctor (a specialist in lipid research), my meds were immediately reduced. The nightmares diminished… that was 3 years ago. Now, they are just as bad. My GP agreed the Metoprolol was most likely the problem. He replaced it about 2 weeks ago with SDZ-BISOPROLOL, FUMARATE. The nightmares have ended already. I have mild dreams – no nightmares. I do not sleepwalk. Sit down with your GP and spill your guts with a lot of conviction… MAKE him listen. There is no reason for a medic pro to think you’re joking or crazy.

I was given Metoprolol to regulate my pulse rate, not my blood pressure. I was given the highest dose and told to take it at night. I struggled for almost a year with fatigue, tiredness, and depression. I complained to the cardiologist about these symptoms and was ignored. I happened to read a heart newsletter that outlined the side effects of fatigue, tiredness, and depression as major issues for Metoprolol. It also listed insomnia.
I had not understood that insomnia also could mean having trouble going to sleep… I thought it just meant staying asleep. I had lots of trouble going to sleep. It seemed to take more than an hour and a half to fall asleep.
I changed cardiologists. The new one put me on Bystolic, which I take in the AM. I have not had any difficulties with it. I have not had any trouble falling asleep quickly.

Yep, I too had vivid, bad dreams on Toprol XL.

Wouldn’t it be amazing if this drug is what is causing my weird sleep. I never thought for a moment that this could be the problem I thought I had a reaction to 5 mgs of Ambien when I occasionally took it. But wouldn’t it be amazing if this were the problem. I hallucinate in my sleep. I sleepwalk. I talk. I have horrendous dreams. Will definitely talk to the doctor about this drug since Metoprolol is one of the Beta blockers being talked about as being ineffective and not the correct drug to be taking. Thanks for the alerts.

I have the same problem with melatonin and valium. Anyone else notice that?

When I was diagnosed with high blood pressure and LBBB, the first medicine prescribed for me was metoprolol. Boy, did it ever give me nightmares! As cartoon scamp Dennis the Menace once said, “I dreamed in wide-scream and technicolor.” I was very glad when my Rx was changed to a different type of BP regulator a few weeks later.

I switched my beta blocker to night to avoid fatigue in the day time. The vivid dreams seem to occur either way. After my mother had a stroke I discovered she hadn’t been taking her beta blocker because of the fatigue and dizziness. That helped make me determined to put up with the side effects.

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