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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by JohnX2 on February 24, 2002, at 17:25:37
wondering if anyone experienced severe
anxiety on pindolol (visken)?Pindolol is a partial beta agonist and
is supposed to block excessive noradrenergic
transmission, but the medicine made me extremely
anxious.This is compared to propranolol (Inderal) which
is a full beta blocker and made me calm.What I'm wondering is if this implies that
the pindolol is actually augmenting a hyponoradrenergic
state in the synaptic cleft. The medication actually
mades me hypomanic after 3 days, then petered out
in 1 hr. worked like this twiced. i suspect a catecholamine
depletion. My depression lifts are always accompanied by
caffeine or excersize which increases cortisol and
the nor(adrenergic) response. But alas I think some
malfunctioning feedback loop stops the ball game.
I've been reading how noradrenergic meds will poop out
if crappy feedback causes a post response monoamine depletion
(big surprise).Anyone else get edgy on Pindolol?
-John
Posted by janejj on February 24, 2002, at 20:57:15
In reply to anyone anxious on pindolol?, posted by JohnX2 on February 24, 2002, at 17:25:37
Hi John,
I am very impressed by your drug knowledge !! I have never heard of pinidlol, so I can't help you there but, I am interested in the different types of drugs you have taken ! I guess you have taken all the SSRI's etc ?
Regards Janejj
Posted by JohnX2 on February 24, 2002, at 23:15:39
In reply to Re: anyone anxious on pindolol? » JohnX2, posted by janejj on February 24, 2002, at 20:57:15
Hi JanejjI am both honored and depressed at the same time
to hear your comment. I'm so glad to share my
experience and knowledge, if only I haven't
taken so many bad paths to get to where I am.
Some day I'll get to home base.I haven't taken all the SSRIS, but I've taken over
25 medicines including about 1 from every class of medicines.
I've churned through 4 pdocs, 2 GPs, and 2 neurologists
in 3 years while taking those medicines. I get antsy when
things aren't working and like to experiment and learn on
the side. I was misdiagnosed with Major Depression with 3 pdocs
before the 4th one got me the right treatment for bipolar II.
Hence all the failed medicine trials typical of treating a bipolar
as a major depressive.Hope you are doing well.
Regards,
John> Hi John,
>
> I am very impressed by your drug knowledge !! I have never heard of pinidlol, so I can't help you there but, I am interested in the different types of drugs you have taken ! I guess you have taken all the SSRI's etc ?
>
> Regards Janejj
Posted by henryO on February 24, 2002, at 23:41:12
In reply to Re: anyone anxious on pindolol? » janejj, posted by JohnX2 on February 24, 2002, at 23:15:39
Not me- Pindolol is an effective augmention agent for me. I combine it with Prozac and Ritalin but it doesn't make me anxious. Actually I think it does the opposite in a small way.
Posted by JohnX2 on February 24, 2002, at 23:58:37
In reply to Re: anyone anxious on pindolol?, posted by henryO on February 24, 2002, at 23:41:12
Thanks for the feeback I appreciate it.So I wonder if this says something about
the steady state workings of my noradrenergic
neurons. Pindolol one would think would generally
relieve anxiety as it is a less potent agonist
of the beta receptor than noradrenaline. But if
there was little noradrenaline in the synapse, then
I suppose pindolol could be a net agonist, increasing
beta transmission. This is similar to Buspar
which is a partial serotonin receptor agonist (it
binds to serotonin receptors less potently than
serotonin). In a serotonin deficiency state, buspar increases
serotonin conductance. In a serotonin overload
state, buspar decreases conductance.Does this sound reasonsable?
-John
> Not me- Pindolol is an effective augmention agent for me. I combine it with Prozac and Ritalin but it doesn't make me anxious. Actually I think it does the opposite in a small way.
Posted by paulb on February 25, 2002, at 18:38:44
In reply to anyone anxious on pindolol?, posted by JohnX2 on February 24, 2002, at 17:25:37
Pinodol may have caused you to become
hypomanic after 3 days, and then petered out because it blocks the 5-HT1a auto-receptors that control the release of serotonin. If they are blocked then more serotonin is released via a negative feedback loop. OOnce your brain adjusted to the increase in 5-HT then that may be the reason it petered out. Just a theory. But the auto-receptor blockade is what makes pinodol special among the beta-blockers. Blockade of the 5-HT1a post-synaptic receptors could also cause further serotonin activity at other receptor causing hypomania but propranalol has the same property so I would assume it was the auto-receptor blockade, an antidepressant mechanism comparable with MAO inhibition and monoamine re-uptake. Just think of Mirtazapine.
paulb
Posted by JohnX2 on February 25, 2002, at 19:41:01
In reply to Re: anyone anxious on pindolol?, posted by paulb on February 25, 2002, at 18:38:44
paulb,I thought about the 5ht-1a blockade. I've always wondered
why propranolol doesn't share the same AD property as
pindolol. I guess this has stymied scientist. I wonder
if it does have something to do with the full beta blockade
getting in the way of an anti-depressant response.-John
> Pinodol may have caused you to become
> hypomanic after 3 days, and then petered out because it blocks the 5-HT1a auto-receptors that control the release of serotonin. If they are blocked then more serotonin is released via a negative feedback loop. OOnce your brain adjusted to the increase in 5-HT then that may be the reason it petered out. Just a theory. But the auto-receptor blockade is what makes pinodol special among the beta-blockers. Blockade of the 5-HT1a post-synaptic receptors could also cause further serotonin activity at other receptor causing hypomania but propranalol has the same property so I would assume it was the auto-receptor blockade, an antidepressant mechanism comparable with MAO inhibition and monoamine re-uptake. Just think of Mirtazapine.
> paulb
Posted by janejj on February 25, 2002, at 23:46:40
Opps sorry this was supposed to be a reply to the Piniolol Post!!
Hi John,I admire the way that you haven't given up ! It must have been tough having to go through all those pdocs and meds.I don't think I'd have the strength to do that, so I am taking strength from you.
Good Luck in your search for the right meds and take care.
Janejj
Posted by JohnX2 on February 26, 2002, at 0:34:17
In reply to JohnX2, posted by janejj on February 25, 2002, at 23:46:40
Janejj,Thanks for your kind words. I really appreciate
your support.I've had my ups and downs in life. I got this
crummy disease and also experienced a lot of pain as
my family went through rough times as a child.
. But I also got a lot of support and I have been
gifted with a good education. Most of all I
just plain hate losing at anything. I REALLY hate
giving in. I hate to be beat. Don't know where the
heck this comes from. Maybe it was a bred
survival skill from getting through rough times
as a child. So I continue to press on. I know
I will pull through as I always do.
I look forward to a new life when I get past this
all. Support along the way from kind people like
yourself will make it go all the more quicker and
easier.cheers.
john
> Opps sorry this was supposed to be a reply to the Piniolol Post!!
>
>
> Hi John,
>
> I admire the way that you haven't given up ! It must have been tough having to go through all those pdocs and meds.I don't think I'd have the strength to do that, so I am taking strength from you.
>
> Good Luck in your search for the right meds and take care.
>
> Janejj
Posted by paulb on February 26, 2002, at 5:07:21
In reply to Re: anyone anxious on pindolol? » paulb, posted by JohnX2 on February 25, 2002, at 19:41:01
Im glad you now understand Pinodol[not Pindolol]
pharmacology. On the contrary beta-adrenergic blockade may enhance the effects of a 5-HT antidepressant. Blockade of these receptors may stimulate the release of more 5-HT and that culd cause hypomania. I guess its the same rationale for augmentation with atypical antipsychotics plus they antagonise the 5-HT2 receptors, not the 5-HT1 post-synaptic receptors.
paulb
Posted by JohnX2 on February 26, 2002, at 16:44:00
In reply to Re: anyone anxious on pindolol?, posted by paulb on February 26, 2002, at 5:07:21
Ok, I call your bluff and say its Pindolol not Pinodol. ;)
My spelling is atrocious, but every reference
to pindolol that I have is "pindolol" including
the "American Psychiatric TextBook of Psychopharmacology",
"Essential Psychopharmacology" and many references
on medline.Is Pindolol referred to as Pinodol in some lands?
Thanks for your thoughts on the medicine, whatever
its spelled.-John
> Im glad you now understand Pinodol[not Pindolol]
> pharmacology. On the contrary beta-adrenergic blockade may enhance the effects of a 5-HT antidepressant. Blockade of these receptors may stimulate the release of more 5-HT and that culd cause hypomania. I guess its the same rationale for augmentation with atypical antipsychotics plus they antagonise the 5-HT2 receptors, not the 5-HT1 post-synaptic receptors.
> paulb
Posted by paulb on February 26, 2002, at 17:37:02
In reply to Ok, my spelling doesn't stink that bad. » paulb, posted by JohnX2 on February 26, 2002, at 16:44:00
No I apologise you were right. In some lands it may be Pinodol but not that Im aware of.
http://www.priory.com/pindolol
Hope it goes well with the beta-blocker if you are augmenting it.
Posted by Theresa on February 28, 2002, at 9:07:47
In reply to anyone anxious on pindolol?, posted by JohnX2 on February 24, 2002, at 17:25:37
Hi. My doctor put me on Pindolol a couple of months ago to offset the sexual dysfunction caused by Celexa. He said it would also help the AD effect. His prescription was to take 1 to 5 pills a day (5mg/each)depending on what amount helped the sexual problem. I have anxiety anyway and after I took one pill for a few days I did feel more anxious. I'm also taking Klonopin that helped but did notice more anxiety. I was concerned because I've had Serotonin Syndrome with other drug combos and was afraid that since Pindolol extends the time serotonin is in your brain that I might be getting the syndrome again. I've looked up drug interactions between Celexa and Pindolol and there weren't any. I am now taking two pills a day but am apprehensive to go up any further. I've noticed the anxiety being worse some days than others. The 2mg of Klonopin a day does take the edge off but sometimes I have to add a Xanax on those bad days. Hard to tell if it's just my anxiety disorder or the Pindolol. It does seem to help the sexual problem, though.
Theresa
Posted by SLS on March 1, 2002, at 9:59:20
In reply to Re: anyone anxious on pindolol?, posted by Theresa on February 28, 2002, at 9:07:47
> I was concerned because I've had Serotonin Syndrome with other drug combos and was afraid that since Pindolol extends the time serotonin is in your brain that I might be getting the syndrome again.
Hi Theresa.Where did you get the information regarding the ability of pindolol to "extend" the availability of serotonin? Is this localized to the synaptic cleft? I imagine this is a result of the ability of pindolol to block serotonin 5-HT1a autoreceptors.
I don't know how universal an indicator this is of serotonin syndrome, but you might want to check your body temperature to see if it is elevated. I guess there is an outside chance that this pindolol-induced "anxiety" is a mild form of akathisia. Has this ever been reported?
Thanks.
- Scott
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