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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by jms600 on July 4, 2011, at 8:32:47
Has anyone ever had any success with beta blockers for fairly severe panic disorder?
I took propanolol for a short period of time years ago for general anxiety. It wasn't a huge success, however, I'm wondering if it may work with panic disorder which I've since developed. I also suffer from GAD, social phobia and unipolar depression.
I'm currently on 225mg of Effexor, 600mg of lithium, and 15mg of Valium on an 'as needed' basis when things get really bad. Been on countless other anti-depressants, anti-psychotics, and anxiolytics - my last being Klonopin which really exacerbated my depression. My doctor won't prescribe MAOIs due to their dietary restrictions and side effects.
I'm looking to take a beta blocker on a daily basis as a preventative, rather than just occasionally on an as needed basis.Any advice greatly appreciated.
Posted by Phillipa on July 4, 2011, at 11:07:05
In reply to Beta blockers for panic disorder anyone??, posted by jms600 on July 4, 2011, at 8:32:47
I don't think they work if you take them continuously. I do hear they are good before a speech public performance. Klonopin also depressed me why not switch to xanax as if put under tongue it works quickly for panic attacks. Phillipa
Posted by jms600 on July 4, 2011, at 12:02:38
In reply to Re: Beta blockers for panic disorder anyone?? » jms600, posted by Phillipa on July 4, 2011, at 11:07:05
> I don't think they work if you take them continuously. I do hear they are good before a speech public performance. Klonopin also depressed me why not switch to xanax as if put under tongue it works quickly for panic attacks. Phillipa
Hi Phillipa. I want to avoid taking benzos regularly due to tolerance. I keep Valium for when I'm at my very worst. If I were to take it on a daily basis, I'm worried tolerance will develop and so I'll have nothing to take when my anxiety/panic is very bad.
Posted by jono_in_adelaide on July 4, 2011, at 17:03:28
In reply to Beta blockers for panic disorder anyone??, posted by jms600 on July 4, 2011, at 8:32:47
Beta blockers (generaly non selective ones like propanolol) can help the racing heart and the tremor of a panic attack, but they dont help the mental symptoms, the fear, panic or agitation.
They wouod usualy be used as an adjunct to SSRI's, benzodiazepines etc, rater than as a stand alone treatment.
A major study conducted in the UK in the 70's on Transicor in anxiety found that the only benifit was realy that it let the doctor give a prescription (which the patients expected) without having to prescribe an addictive drug like Valium - ie, Transicor was realy just an active placebo.
I would say give propanolal a try for a month and see if it helps you - its cheap and safe, so you dont have much to lose, and it might turn ut to be just what you need. Probably best taken along with an SSRI though.
Posted by orbital on July 5, 2011, at 8:05:58
In reply to Beta blockers for panic disorder anyone??, posted by jms600 on July 4, 2011, at 8:32:47
They might be helpful if your general symptoms are mainly physical (irregular/racing heartbeat etc).
I'm not sure they would work for PD/ during a panic attack per se - any chance of finding a benzo (preferably sublingual) that's not depressogenic?
Personally, I find beta blockers extremely helpful for general anxiety, they've enabled me to take stuff that I couldn't normally tolerate; such as stimulants in general Provigil, caffeine etc. Also help with public speaking etc.
You mentioned propranolol. I found it too fatiguing and short-acting, there are plenty to choose from of course, my preference overall is atenolol which doesn't cross the blood-brain barrier, so it feels cleaner, less side effects. The dosage options are more limited, though.
The one drawback I can think of is having to taper off them after prolonged daily use, but then, that holds true for most meds.
hth
> Has anyone ever had any success with beta blockers for fairly severe panic disorder?
>
> I took propanolol for a short period of time years ago for general anxiety. It wasn't a huge success, however, I'm wondering if it may work with panic disorder which I've since developed. I also suffer from GAD, social phobia and unipolar depression.
>
> I'm currently on 225mg of Effexor, 600mg of lithium, and 15mg of Valium on an 'as needed' basis when things get really bad. Been on countless other anti-depressants, anti-psychotics, and anxiolytics - my last being Klonopin which really exacerbated my depression. My doctor won't prescribe MAOIs due to their dietary restrictions and side effects.
>
> I'm looking to take a beta blocker on a daily basis as a preventative, rather than just occasionally on an as needed basis.
>
> Any advice greatly appreciated.
>
Posted by chasethdevil on July 10, 2011, at 15:58:35
In reply to Beta blockers for panic disorder anyone??, posted by jms600 on July 4, 2011, at 8:32:47
As far as I know, beta blockers only help with the physiological symptoms of a panic attack. They cannot prevent a panic attack and they cannot help with the psychological feelings of panic.
However, for many people these physiological symptoms are sort of what keeps their panic disorder alive, and having a consistent way to treat your bodily responses may lessen your anxiety and I suppose help treat the panic disorder in the long run. Especially if you know the triggers for your panic attacks perhaps a beta blocker could be taken in advance. A lot of musicians take it specifically for performance anxiety because their physiological symptoms like shaking or sweaty palms can interfere with playing.
I also replied to you because it looks like we have dealt with the same problems. Doctors have given me a bunch of different anxiety related diagnoses, along with major depression.
Looking at what you are on- some heavy duty meds, and it sounds like you've worked your way through, I honestly doubt beta-blockers would help but I do not discourage you from trying them because (I believe, I'm not quite sure) that they are relatively harmless and would not likely interact with your other meds.
Have you considered maybe finding a new psychiatrist? The medications you are on seem dated, with bad reps for side effects and withdrawal symptoms. I was on 75 mg Effexor XR for a couple years and tapering off of it (SLOWLY) was my worst nightmare. Then the same with Pristiq, which my current pdoc at the time said was like Effexor but better. It was not for me. I had the same side effects and when they became too much, the same horrible withdrawals.
It's good to question the authority here- this is your life. I find that professionals in the same field have hugely varying opinions on the same medications and treatments. I feel like I've finally found an excellent psychiatrist. She keeps up with current advances in research and doesn't pander to pharma sales. She describes to me the method of action of the drug, experiences the drug has had with other patients, why she believes it my be a good try for me. She understand that everyone metabolized medications differently and that needs to be taken into account so you won't overmedicate. Her one downside, and it's a big one- she doesn't take insurance. Of course, right?
I hope you find the right combo for you.
Lindsay
> Has anyone ever had any success with beta blockers for fairly severe panic disorder?
>
> I took propanolol for a short period of time years ago for general anxiety. It wasn't a huge success, however, I'm wondering if it may work with panic disorder which I've since developed. I also suffer from GAD, social phobia and unipolar depression.
>
> I'm currently on 225mg of Effexor, 600mg of lithium, and 15mg of Valium on an 'as needed' basis when things get really bad. Been on countless other anti-depressants, anti-psychotics, and anxiolytics - my last being Klonopin which really exacerbated my depression. My doctor won't prescribe MAOIs due to their dietary restrictions and side effects.
>
> I'm looking to take a beta blocker on a daily basis as a preventative, rather than just occasionally on an as needed basis.
>
> Any advice greatly appreciated.
>
Posted by zatar on July 12, 2011, at 8:59:45
In reply to Re: Beta blockers for panic disorder anyone??, posted by chasethdevil on July 10, 2011, at 15:58:35
Propranolol 10mg augmented clonazepam 0.5mg nicely for my severe panic attacks. I am prone to mild serotonin syndrome symptoms, so I can't do SSRIs and increasing the dose on clonazepam is depressogenic. I felt very mellow on the propranolol/clonazepam combo without feeling drugged out. And everyone said I smiled more. ;-)
Trying propranolol alone for panic attacks that recurred didn't do anything. My new pdoc won't prescribe clonazepam, so diazepam 1-2mg has to do, though it's not as smooth as the above combo.
This is the end of the thread.
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