The People's Perspective on Medicine

The Beta Blocker Blahs Can Be Debilitating

Beta blockers like atenolol, metoprolol and propranolol used to be very popular BP drugs. But the beta blocker blahs can be problematic. What else works?

Beta blockers are blood pressure medications that have been around for many decades. They include drugs like atenolol (Tenormin), metoprolol (Toprol) and propranolol (Inderal). In some instances, such as hypertrophic cardiomyopathy, metoprolol can be essential. For a long time, though, such drugs were first-line approaches for treating hypertension. There is now some question about the wisdom of this approach. For one thing, people often complain of the beta blocker blahs or the beta blocker blues.

The Beta Blocker Blahs in Real Life:

Q. Thank you for writing about beta blockers making you feel like rubbish. I was diagnosed with high blood pressure eight years ago (140/80). My doctor prescribed atenolol.

It did NOTHING for my blood pressure, so after a couple of months my GP added perindopril. WOW! My blood pressure went to 120/70 in two days.

In the meantime, my heart rate that was formerly 80 or 90 BPM was now at 60 or less. Any task was so tiring! I have now passed 60 years of age and I could barely split wood.

When I realized this might be due to the atenolol, I halved the dose for two weeks, then halved it again for another two weeks. Now, a month later, my resting heart rate is back to 80. My blood pressure is 125/75 thanks to the perindopril. I can split wood, walk and even run again. For the past eight years on the beta blocker, I felt like I would pass out if I tried to run. Cheers from Australia.

The Beta Blocker Blahs Can Slow You Down:

A. You are not the first person to complain about the beta blocker blahs. One man reported that atenolol brought his blood pressure down to 130/63 but left him feeling “extremely fatigued.”

Another blamed metoprolol for his “fatigue, tiredness, blahs and depression.”

A woman in Texas complained about propranolol. She said it took away all motivation to work, cook or interact with others. After six months she was really depressed. She asked the nurse in her cardiologist’s office if the propranolol could be part of the problem. The answer: “unlikely.”

When Jasmine saw her cardiologist he said that depression is a common side effect of beta blockers. Not surprisingly, Jasmine was more than a little annoyed that no one bothered to mention that before prescribing a beta blocker.

Learn more about the beta blocker blahs at this link:

Is Your Blood Pressure Medicine Making You Sad and Depressed?

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Never Stop a Beta Blocker Suddenly!

We always worry that abrupt discontinuation of a beta blocker could lead to serious heart complications. If the prescriber agrees that a beta blocker should be discontinued, then it should be done gradually under medical supervision.

Find out why beta blockers are no longer considered first line treatments for hypertension at this link:

Back Pedaling on Beta Blockers (Atenolol, Metoprolol, Propranolol) for Hypertension

What About Perindopril (Aceon)?

Perindopril (Aceon) is an ACE inhibitor and is considered a first-line blood pressure treatment. Beta blockers, on the other hand, are no longer deemed the best choice for blood pressure control. They can cause fatigue and slow heart rate.

You can learn more about these medications and other approaches to manage hypertension in our Guide to Blood Pressure treatment. It is available in the health guide section.

Share your own story about blood pressure treatment in the comment section. Have you ever experienced the beta blocker blahs? What was that like?

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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I’ve been on Metoprolol for approximately 10 years following an NSTEMI. For the past 3 years I’ve felt dizzy, fatigued, and just plain crummy. EKG, Stress test, etc. normal. I really think it’s because I was switched to generic medications of Crestor and Metoprolol. MDs completely scoff at that but not sure what else it could be. New guidelines don’t even recommend continuing Metoprolol for MIs w/ nml EF for more than 3 years. I was treated under old guidelines.

Before my bypass surgery, I was on toprol. After surgery Dr took me off. I had Reynauds on my fingers. Since then, I haven’t had symptoms. This was 9 yrs ago.

Yes!!! I became depressed on Coreg and then started to get chest pain/discomfort. I was told ‘not to worry about the depression, and keep exercising,’ and I was given long acting nitro for my chest pains. Well, I had even more chest pains. My friend, a cardiac PA told me both meds could cause chest pain. I was only on the nitro stuff a few weeks so I weaned off that and then weaned off the Coreg. Both my chest pain and depression are gone. I control my BP via 400 mg of Indian Snakeroot and 2 caps twice a day of Hawthorn. My BP is 120/60. My cardiologist just shrugs and suggests that I try a calcium channel blocker. NOPE.

Weaning off nitro (only on it a few weeks) was 1.5 weeks. Weaning off Coreg (on it for 6 months) was 3 weeks. I had been on 3.25 x 2.

Currently on lisinopril 40 mg daily. As an RN, I know that there can be different side effects. What I hadn’t thought about is that you can be on a drug for years without problems and suddenly, without warning, have a problem with that drug.

I noticed last year that I was developing a distinct tremor in my arms/hands. Well, I’m not getting any younger, I thought. I did do a search for side effects on each prescription drug I take. Hmmm . . . turns out ACE inhibitors can cause tremors. I decided to see if that was my problem without stopping the drug. I was aware of the tremors and when they occurred. Waking up: no tremors. Wait several hours. Take my meds. Within 2 hrs I have tremors so bad that I can’t do anything on my computer since I can’t run the mouse. It scoots all over the screen. Sometimes I can do okay by holding the right hand with the left and push down. It gets so bad some days, I keep my hands away from my face. Don’t want to poke my eye out! Seeing MD in 10 days. I will be switching to a different class of drugs!

ACE inhibitors can cause renal failure.

They can, but renal failure as a result of ACE inhibitors is very uncommon. Still, patients should be warned of the possibility. Thanks for the reminder.

I’m 72 years old and I’ve been on Atenolol since 2000 and it’s done nothing but wonders for me! My heart rate was in the 120s before I started the drug. My b/p was 180/135. I was a nervous wreck. My hands shook. Atenolol slowed my heart to 63, come rain or shine, and I like that. My b/p came down within a couple of hours after taking the very first pill. My heart skipped beats all my life, even as a child. It does not skip beats on Atenolol–never! I’m calmer. (It also takes away shyness). I don’t tremble at the least little thing. I can breathe easier. No side effects. Atenolol is the best thing that ever came my way, and I have to stand up for it because it gets a bad rap these days. I’m sure it’s not for everyone, but it’s the one for me.

Beta blockers work on the fight or flight mechanism in our body. They decrease the fight response, specifically they are competitive antagonists that block the receptor sites for the endogenous catecholamines epinephrine (adrenaline) and norepinephrine (noradrenaline) on adrenergic beta receptors, of the sympathetic nervous system, which mediates the fight-or-flight response. (from wikipedia https://en.wikipedia.org/wiki/Beta_blocker)
So with less flight, fatigue is very possible, especially as you adjust to the med.
I am taking the beta blocker Prazosin for PTSD and it has helped the PTSD tremendously. This is because PTSD causes hypervigilance and nightmares almost all of the time (one is continually in fight mode).
It did take awhile for me to adjust to it – changing how your whole body nervous system works is very confusing to your body. I bounced around, up and down. But it was worth the ride. One interesting thing in that my digestion always seemed sluggish to me. That was because in fight mode all the time, energy was being sent to fight parts of the body (heart etc.) before lesser important functions like digestion. My digestion improved on Prazosin.

I took atenolol for some time years ago, and although I don’t remember getting depressed from it, I did fall asleep for an hour or more several hours after I took it in the morning, without fail. Good thing I wasn’t working at the time; the desire to sleep was just about irresistible. There was a change in staff at the group practice, and the doctor to whom I was switched thought atenolol wasn’t appropriate because of the diuretic properties and tried several different other kinds, always with unacceptable side effects such as headaches and dizziness, and finally settled on a calcium channel blocker, although not all of those have worked very well. (I just recently had a run-in with nifedipine [10 mg twice a day] upsetting my water balance and, in combination with aspirin, had me so dehydrated I got an unstoppable nose bleed and coughed up blood for the twelve or so hours it took to get the drug out of my system). Now I’m on amlodipine 2.5 mg once a day and doing fine on that, although I still have doubts about how much I need drugs with unmedicated readings from well below 120/80 to 138/70, although higher if I’m angry or otherwise upset in some way. I’m working on having several cups of hibiscus tea a day and getting more exercise, the latter of which had good results for a friend who was also in the borderline range. I also want to note that the drug I had been taking, isradipine, aka Dynacirc, is no longer being made, at least in the brand name, and is on indefinite back order otherwise, another orphaned drug that was effective without any side effects at all.

Thanks for writing about BBs. Was on Toprol for 6 months for arrhythmia. Low dose but still created many problems: fatigue, insomnia, listlessness, shortness of breath, low libido…every side effect you read about. Doctors seemed to underestimate effect but nurses understand as they see problems every day. Would never take again!!! Made palpitations, ectopics, heart rate much worse. Very powerful drug which controls adrenal system. To get off you must taper slowly!! Realize that you are going to have prolonged withdrawal period…months. Hard to believe that these prescribed so casually, not unlike benzos ( another horror story), and sleeping medicines- Ambien, lunesta, etc. Drug medicine can be very problematic!

A bit of propanolol does wonders for the ‘nerves’ when performing or speechgiving. All the focus is there, no shaking or wobbly knees.

I went to a doctor and he said my BP was high and need to be lowered. He prescribed me with bisoprolol. Few days later I was starting to feel nausea, Short breath, I can’t barely to much on the phone. After I quit all the BP drugs, I feel much better now, I lose weight, change my lifestyle.

I would love to get off of metoprolol. Unfortunately, when I inadvertently miss a dose I can tell after a few hours because my heart starts pounding so hard that if I’m sitting in a hard-backed chair it feels like every heartbeat thrusts my body away from the chair back. I take 10mg a day – half of the tablet in the morning and half at night. I don’t think I can go down to half a dose. But my resting heart rate is in the mid-40’s and I tire very easily. Any suggestions?

A resting heart rate in the 40s is very low. Please do discuss this with your doctor. She or he may want to adjust the dose or the medication.

I am on losartan, propranolol and nifidipene (sp) over the past six months. I have no energy despite trying to work out six days a week. I should have energy radiating from my finger tips. I am a male, in good shape, don’t drink or smoke. I now have no emotion towards my wife or anything just about. It’s causing huge marital problems and when I told the provider to take me off propranolol he disagreed and wanted to run more tests. Why is it so hard for them to accept that not every drug fits each person? I’m on the cusp of a divorce because I don’t care about anything and never had this problem before the meds. Maybe I should send my provider the attorney bill? I am going to wean myself off these meds because frankly my quality of life was better before them.

I was put on beta blockers in 2003 and until two months ago as the side effects were getting real bad and causing my knees to hurt real bad. I slowly went off and than went to CBD oil with 5 drops per day and my heart rate average is 80 with 123/64 and my knees are back doing great and no side effects.

When I was on Metropolol I felt really sluggish, barely able to get out of the car, not with it at all. It was given to me to slow down my heart rate and irregular beats. After 4 years on it I had a catheter ablation which took care of the tachycardia problem and then I stopped Metropolol. Now 20 years later my blood pressure is creeping up and all the blood pressure medications give me problems. Lisinopril did not do the job of reducing it yet my ankles swelled up anyway. Then I was given Losartan and after a week that whole family of drugs was withdrawn from the market. Are there any other options out there without side effects?

Some drugs used to decrease eye pressure for glaucoma patients are beta blockers. Timolol is one of the ingredients in the commonly-prescribed Cosopt. Have any studies been conducted specifically with these eye drugs?

I had a terrible experience with Metopolol. Within a month I was so tired I was close to disfunctional. Went to a number of doctors and not one said to get off the medication. I finally figured it out and asked to be taken off. Within a week I was almost back to normal. It is going on my allergic list so no doctor will prescribe it for me again.

Blood pressure elevation is idiopathic…doctors *don’t know* why the patient has this issue,but, alas, they have a solution. Prescribe a medication to chemically alter the body’s natural physiology. How’s that working for most Americans? We live in crazy world where too many people are walking around in a chemical straight jacket. This only guarantees repeat customers…never addressing the root of the problem. Our nervous system is the highway to every cell function in our body. Until you find that missing link, you’re only kicking the can down the road. Western medicine confirms everyone into one box. Everyone should have the same blood pressure. It’s insane. Side effects…that’s another topic…Do your own research..become your own advocate for your body..your health. Throwing medications at the problem is never going to work.

Does the beta blocker carvedilol also reduce energy and promote depression? I’ve been taking this beta blocker for 12 years. Currently my acupuncturist recommended I try to get the dosage reduced as it is affecting my Chi and thus my over all well-being.

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