Posted by KaraS on January 30, 2005, at 14:00:09
In reply to Re: atenolol is cardioselective » KaraS, posted by emme on January 29, 2005, at 9:53:13
> > > > I just read that in one of Ed's posts above. Does that mean that it isn't contraindicated for asthma?
> > >
> > > All the drug info I've ever seen for it says it is contraindicated for asthma; there will be some cross-over between receptors with all the beta-blockers.
> > >
> > > > Does it also have a tendency to cause or worsen depression?
> > >
> > > All the beta blockers have the potential to cause depression. I believe my doctor tried atenolol because it crosses the BB barrier less readily than, say, propranolol. I think it was a good choice to try to avoid potential worsening of depression. If you want to find out more about how much actually makes it across the BB barrier, do a search on "atenolol" and "blood brain barrier". I think I saw one or two on Pubmed where they measured how much crossed the barrier.
> > >
> > > But what it all boils down to is that you wouldn't know if it made you more depressed unless you tried it. But you've said the doctors wouldn't prescribe it. What were their reasons? Are you asthmatic? Do you have really low blood pressure? Beta blockers could be contraindicated for a number of reasons.
> >
> > NO, I had no signs of asthma and they hadn't even taken my blood pressure when they said no. They both gave me the impression that it just wasn't done. I think the truth is that they were uncomfortable prescribing a medication they think is outside of their specialty or expertise.
>
> Okay, so if there's no obvious physical reason for you to not be able to try a beta blocker, then then you can try going in armed with information in order to open a discussion. A search on "anxiety beta blockers" will bring up a number of references to beta blockers as a treatment for anxiety, especially for social phobia. Not that social phobia is your issue, but it might show them that there's precedent for their use in psychiatry. I think I was my pdoc's guinea pig. She suggested atenolol after she'd seen something in the literature about propranolol being used to expedite response to ADs.
>
> I took a quick look on Pubmed and NIMH for starters.
>
> Giving you a general sense that it's not done isn't a very satisfying explanation for deciding a medication isn't appropriate. If they have a valid objection, then they should state explicitly what that is.
>
> http://www.nimh.nih.gov/publicat/adfacts.cfm?styleN=two
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9622045
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15014622
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12408422
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10832377
>
Actually I did a little more research and there is still a chance of it causing depression - just not as much chance as if you took a nonselective beta blocker. Did you notice any increased depression when you took it?
poster:KaraS
thread:448161
URL: http://www.dr-bob.org/babble/20050128/msgs/450171.html