I know this is an old thread, but I just went through similar with Carvedilol after transitioning to it after a heart attack. I was first put on Metroprolol and then Lisinopril for high blood pressure after my incident, and then was switched to Carvedilol about a year later. Within 3-6 months of taking Carvedilol, I started experiencing insomnia, nightmares, panic attacks, and mood swings. I also had similar "hard" heartbeats like OP, along with excess weight gain and throbbing tinnitus that was unexplained. All of that combined turned out to be potentially contributing to my nervous system feeling like it was on high alert/survival mode; causing other issues. I was fortunate to learn about the adverse effects Carvedilol can have on some people due to the crossing of the blood-brain barrier. Some of it also boils down to regulating your nervous system through proper nutrition, weight loss, and adequate sleep. After losing 45lbs, I eventually was able to get off the medication completely with my cardiologist's recommendation, and have been feeling like my old self before the heart attack. Within two weeks of stopping, I was no longer anxious and the other symptoms stopped in kind. I'm now two months off and feeling better than ever. It has been a horrible, horrible, experience and in my case, the trade-off has not been worth the side effects and whatever decreased heart rate and blood pressure regulation was gained. Since exercising more, my system also feels more stable. Despite the increased intensity of workouts, my heart rate and blood pressure haven't spiked like it was doing while on the medication. It's been improving steadily. Of course, if you suffer from heart failure or other conditions, this may not apply to you - so make sure to get the right team in place to answer any questions.