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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by Franz on February 18, 2012, at 15:31:17
Hello. I am taking .25 mg alprazolam at night and now in the morning too although it causes me sedation. yesterday I suffered one of those episodes when I get paralysed (not extreme anxiety, but worry, depresive thoughts and the body feels heavy and anergic). Later I took atenolol and it helped. I read this article (rats):
http://www.mendeley.com/research/the-effect-of-sympathetic-antagonists-on-the-antidepressant-action-of-alprazolam/
"Atenolol alone produced an antidepressant effect and potentiated the antidepressant action of alprazolam...our results reveal that alprazolam may produce antidepressant effects through the release of noradrenaline, which stimulates β2 receptors to produce an antidepressant action."Do you think it is a good combination to take long term?.
Posted by ed_uk2010 on February 18, 2012, at 15:48:00
In reply to Alprazolam + atenolol, posted by Franz on February 18, 2012, at 15:31:17
Interesting. At usual therapeutic doses in humans, atenolol is claimed not to pass the blood-brain barrier very readily because of it high water solubility and low fat solubility.
Do you think your anxiety/depression might have improved even if you hadn't taken atenolol? Symptoms can fluctuate such a lot.
Still, the concept of a beneficial interaction with alprazolam is appealing. One of the main problems with alprazolam is the risk of dependence.
Posted by ed_uk2010 on February 18, 2012, at 15:49:53
In reply to Alprazolam + atenolol, posted by Franz on February 18, 2012, at 15:31:17
I thought you might be interested in this part of the article posted by Franz...
In mice......'Prazosin treatment alone produced depression, but it significantly potentiated the antidepressant actions of imipramine and alprazolam.'
Posted by ed_uk2010 on February 18, 2012, at 15:58:40
In reply to Alprazolam + atenolol, posted by Franz on February 18, 2012, at 15:31:17
I'm interested in the idea that prazosin (an alpha-1 blocker) could increase the antidepressant effect of noradrenergic antidepressants.
If blocking alpha-1 receptors (eg. with prazosin) improves the action of NRIs, perhaps this is part of the reason why the noradrenergic TCAs such as nortriptyline appear to be more reliable in depression than reboxetine. Most TCAs block alpha-1 receptors to some extent, although perhaps not the same subtypes as prazosin, which is also more potent.
Posted by Franz on February 18, 2012, at 17:16:45
In reply to Re: Alprazolam + atenolol, posted by ed_uk2010 on February 18, 2012, at 15:48:00
> Interesting. At usual therapeutic doses in humans, atenolol is claimed not to pass the blood-brain barrier very readily because of it high water solubility and low fat solubility.
>
> Do you think your anxiety/depression might have improved even if you hadn't taken atenolol? Symptoms can fluctuate such a lot.
>
> Still, the concept of a beneficial interaction with alprazolam is appealing. One of the main problems with alprazolam is the risk of dependence.
>
>No, it was the atenolol which helped, it is not the first time.
Yes, alprazolam has a risk of dependence, like almost everything that works.
In the full article there are some speculations about partial BBB crossing of atenolol or other peripheral mechanism.
Posted by Phillipa on February 18, 2012, at 18:02:38
In reply to Re: Alprazolam + atenolol, posted by ed_uk2010 on February 18, 2012, at 15:58:40
Isn't prazosin what Scott is now taking? Phillipa
Posted by SLS on February 18, 2012, at 19:01:04
In reply to For SLS, posted by ed_uk2010 on February 18, 2012, at 15:49:53
> I thought you might be interested in this part of the article posted by Franz...
>
> In mice......'Prazosin treatment alone produced depression, but it significantly potentiated the antidepressant actions of imipramine and alprazolam.'Thanks for alerting me to this. Interesting.
- Scott
Posted by ed_uk2010 on February 19, 2012, at 5:45:29
In reply to Re: Alprazolam + atenolol » ed_uk2010, posted by Franz on February 18, 2012, at 17:16:45
>No, it was the atenolol which helped, it is not the first time.
OK, that's good. Thanks for posting the link.
Posted by Franz on April 21, 2014, at 10:10:59
In reply to Alprazolam + atenolol, posted by Franz on February 18, 2012, at 15:31:17
http://www.ncbi.nlm.nih.gov/pubmed/24361783
Pharmacol Biochem Behav. 2014 Feb;117:79-84. doi: 10.1016/j.pbb.2013.12.015. Epub 2013 Dec 18.
Interactions of atenolol with alprazolam/escitalopram on anxiety, depression and oxidative stress.
Shahzad N1, Ahmad J2, Khan W3, Al-Ghamdi SS4, Ain MR5, Ibrahim IA4, Akhtar M5, Khanam R6.
Author information
AbstractAnxiety and depression are highly comorbid disorders possibly sharing a common neurobiological mechanism. The dysfunction of serotoninergic, noradrenergic and dopaminergic neurotransmission, abnormal regulation in the hypothalamic-pituitary-adrenal axis (HPA), disturbance of cellular plasticity including reduced neurogenesis, or chronic inflammation connected with high oxidative damage play a crucial role in the development of anxiety and depression. The present study was aimed to investigate the effects of atenolol alone and in combination with alprazolam/escitalopram on anxiety, depression and oxidative stress. Wistar albino rats were subjected to 21 day treatment of drugs then exposed to elevated-plus maze (EPM) and modified forced swim test (MFST), and oxidative stress markers were estimated in isolated brain tissue of all groups. The results indicated that atenolol in combination with alprazolam/escitalopram exhibited antidepressant effects by significantly decreasing the immobility and increasing the swimming behavior in the MFST and anti-anxiety effects by increasing the percentage preference and number of open arm entries as well as time spent in open arm in EPM. Pretreatment with atenolol alone and combination with alprazolam/escitalopram also ameliorated tissue glutathione (GSH) and decreased malondialdehyde (MDA) level significantly which explore antioxidant properties of drugs, and combination augments the therapeutic response of monotherapy in depression. In conclusion behavioral and biological findings indicate that the combination of atenolol with alprazolam/escitalopram has the potential of being highly efficacious in treating anxiety and depressive disorders as well as oxidative stress.
Posted by P2thaJ on June 30, 2014, at 14:31:01
In reply to New study Re: Alprazolam + atenolol, posted by Franz on April 21, 2014, at 10:10:59
Franz, this is a very interesting post and one that I have specific experience with.
I have long told my p doc that atenolol is an antidepressant for me, especially when mixed with an SSRI or SNRI. Do you take atenolol and have you noticed the same effects?
Posted by Franz on September 14, 2014, at 15:56:46
In reply to Re: New study Re: Alprazolam + atenolol » Franz, posted by P2thaJ on June 30, 2014, at 14:31:01
> Franz, this is a very interesting post and one that I have specific experience with.
>
> I have long told my p doc that atenolol is an antidepressant for me, especially when mixed with an SSRI or SNRI. Do you take atenolol and have you noticed the same effects?Sorry P2thaJ, I did not see your post.
I took atenolol a while ago because I felt anxious, chest tightness. Many times propranolol or atenolol work better for me than alprazolam (I take low dose of all). I feel much better now. That made me search the forum to look for similar experiences or updates on better beta blocker options.I am not sure about atenolol' s antidepressant effect. I did not use it with SSRI s, which do not work well for me.
I will like to know about your experience.
Thanks.
Posted by P2thaJ on October 2, 2014, at 16:43:39
In reply to Re: New study Re: Alprazolam + atenolol » P2thaJ, posted by Franz on September 14, 2014, at 15:56:46
> I am not sure about atenolol' s antidepressant effect. I did not use it with SSRI s, which do not work well for me.
>
> I will like to know about your experience.
>No problem on the delay Franz.
Yes, I have begun taking Atenolol again and it has a significant mood enhancing effect for me. While it improves mood it does not seem to work for this by itself. I have had the best success when combining it with a strong noradrenergic agent, at this time Strattera, and a low dose serotonergic agent (escitalopram).
The effect of atenolol on mood for me is unlike any other agent I have tried.
Posted by oceansun on October 5, 2014, at 22:09:17
In reply to Re: New study Re: Alprazolam + atenolol, posted by P2thaJ on October 2, 2014, at 16:43:39
That's really interesting about atenolol. I take alprazolam for sleep, and propranolol (another beta blocker, one that crosses the blood-brain barrier) during the day for anxiety, and propranolol helps so much for anxiety and social phobia. I'm less depressed when I'm less anxious -- could that be part of the connection?
Posted by Franz on October 7, 2014, at 9:10:44
In reply to Re: New study Re: Alprazolam + atenolol, posted by oceansun on October 5, 2014, at 22:09:17
> That's really interesting about atenolol. I take alprazolam for sleep, and propranolol (another beta blocker, one that crosses the blood-brain barrier) during the day for anxiety, and propranolol helps so much for anxiety and social phobia. I'm less depressed when I'm less anxious -- could that be part of the connection?
I think yes. Many times propranolol cuts anxiety better than alprazolam for me. What is your dose?
According to the study I posted atenolol cross bbb a little or there is some other mechanism. It feels different. Less potent maybe. It is supossed to have less side effects.
Some people report good results with angiotensine inhibitors but I did not try any.
Posted by oceansun on October 9, 2014, at 22:40:14
In reply to Re: New study Re: Alprazolam + atenolol » oceansun, posted by Franz on October 7, 2014, at 9:10:44
I take 10 mg in the morning and 10 mg in the late afternoon. Any more than that I get tired. It seems like very little, but I think my other drugs (Wellbutrin & Abilify) increase the blood level of propranolol (I could be wrong). When I took the 60 mg SR once a day I felt dulled and very tired, it was an effort to move.
> > That's really interesting about atenolol. I take alprazolam for sleep, and propranolol (another beta blocker, one that crosses the blood-brain barrier) during the day for anxiety, and propranolol helps so much for anxiety and social phobia. I'm less depressed when I'm less anxious -- could that be part of the connection?
>
> I think yes. Many times propranolol cuts anxiety better than alprazolam for me. What is your dose?
>
> According to the study I posted atenolol cross bbb a little or there is some other mechanism. It feels different. Less potent maybe. It is supossed to have less side effects.
>
> Some people report good results with angiotensine inhibitors but I did not try any.
Posted by Franz on October 10, 2014, at 11:15:12
In reply to Re: New study Re: Alprazolam + atenolol » Franz, posted by oceansun on October 9, 2014, at 22:40:14
Thanks. Yes, I also take 10 mg when I take propranolol.
> I take 10 mg in the morning and 10 mg in the late afternoon. Any more than that I get tired. It seems like very little, but I think my other drugs (Wellbutrin & Abilify) increase the blood level of propranolol (I could be wrong). When I took the 60 mg SR once a day I felt dulled and very tired, it was an effort to move.
>
> > > That's really interesting about atenolol. I take alprazolam for sleep, and propranolol (another beta blocker, one that crosses the blood-brain barrier) during the day for anxiety, and propranolol helps so much for anxiety and social phobia. I'm less depressed when I'm less anxious -- could that be part of the connection?
> >
> > I think yes. Many times propranolol cuts anxiety better than alprazolam for me. What is your dose?
> >
> > According to the study I posted atenolol cross bbb a little or there is some other mechanism. It feels different. Less potent maybe. It is supossed to have less side effects.
> >
> > Some people report good results with angiotensine inhibitors but I did not try any.
>
>
Posted by P2thaJ on October 11, 2014, at 9:59:04
In reply to Re: New study Re: Alprazolam + atenolol, posted by oceansun on October 5, 2014, at 22:09:17
Sorry for the delay Oceansun as I just saw your post. Yes, I believe you are correct, the Atenolol is likely decreasing my anxiety which ultimately leads to a mood improvement.
Posted by Franz on October 12, 2014, at 13:19:28
In reply to Re: New study Re: Alprazolam + atenolol, posted by P2thaJ on October 2, 2014, at 16:43:39
Role of beta-adrenergic receptors in the ventromedial prefrontal cortex during contextual fear extinction in rats.
http://www.ncbi.nlm.nih.gov/pubmed/20667477Our results reinforce the role of the vmPFC in fear extinction mechanisms, suggesting that vmPFC-beta-1-adrenergic receptor activation underlies part of the facilitation of the fear extinction processes.
---
Systemic propranolol acts centrally to reduce conditioned fear in rats without impairing extinction
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2695810/
Propranolol reduced the expression of conditioned fear, without interfering with extinction learning.
Isn't there a contradiction? Does propranolol help or interfere with fear extinction? Any specialist here can clarify please? Thanks!
Posted by Rayray on October 16, 2014, at 20:36:52
In reply to Re: New study Re: Alprazolam + atenolol, posted by P2thaJ on October 11, 2014, at 9:59:04
Funny, I came onto this site for something else and saw this! I have been on this combination for years along with an SSRI, and do very for the most part.
Here's a better picture. I'm 64 y/o male who had suffered with long time depression, anxiety, and alcoholism. Sober 21 years, I almost never experience anxiety anymore, but some depressive symptoms appear from time to time.
My meds include: Atenolol 75mg. qd, Alprazolam .75mg qhs, Lexapro 20 mg. qd, and Wellbutrin 150mg. 2xd. (There are other meds for other conditions.).
I have been on this combination with minor tweaks or different SSRIs for about 20 years. I tolerate it well and essentially feel normal most of the time with occasional listlessness and disinterest in things. Rightly or wrongly, I believe this combo provided a floor under me when I was on high doses of prednisone (80mg qd !!) for about 6 months last year, followed by 200mg. qd of cyclosporine. I could easily have gone into a really deep hole.
Other observations: Atenolol will definitely slow your heart rate down, and keep a lid on palpitations. Lexapro is the best SSRI I've ever had, and Cymbalta makes me take people's heads off verbally.
Hope this helps!
Ray
Posted by Phillipa on October 16, 2014, at 20:49:27
In reply to Re: New study Re: Alprazolam + atenolol, posted by Rayray on October 16, 2014, at 20:36:52
Glad to hear you are doing well. Being almost the same age. What other meds do you take if you don't mind me asking. Thanks Phillipa
Posted by Rayray on October 16, 2014, at 21:28:18
In reply to Re: New study Re: Alprazolam + atenolol » Rayray, posted by Phillipa on October 16, 2014, at 20:49:27
> Glad to hear you are doing well. Being almost the same age. What other meds do you take if you don't mind me asking. Thanks Phillipa.
Certainly. I have an autoimmune condition of the kidneys called FSGS so there are a lot of BP meds going on, like: Lisinopril 30mg 2xd; Hydralazine 100mg. 3xd; Furosemide 40mg. qd. and also Lipitor 20mg. Yes, it's a lot, but it keeps me off dialysis! Best Regards, Ray
Posted by Phillipa on October 16, 2014, at 22:52:29
In reply to Re: New study Re: Alprazolam + atenolol, posted by Rayray on October 16, 2014, at 21:28:18
Thanks, not sure what the autoimmune of kidneys is but sounds like quite a few diuretics are needed. I am sorry you have so much stuff going on. My best to you. Phillipa oh and ps welcome to babble!!!!
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