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How did you wean off Metoprolol?

Heart Rhythm Conditions | Last Active: Feb 21 1:08pm | Replies (543)

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@rezon8r

Anyone who wants to ween off beta blockers should read my story.
I had a heart attack July 2015 and was placed on beta blockers (metoprolol). I was on 25mg to start, half a pill in morning and evening. Over a few months my pulse was dropping to 43 bpm and my BP was very low. My doctor recommended cutting the dose to half to see how I did. It helped a bit. (12.5mg) once a day.

About 2 months later - out of the blue, my heart started racing 155 bpm and my blood pressure spiked to 180/100. I had chest pain, difficulty breathing, sweating, dizzy... was positive I was having another heart attack. Off to the ER. They did ecg and trope, X-ray... all was fine and my symptoms abated over a few hours.

The next attack happened about 3 weeks later. Same thing. They gave me a hotter monitor and nothing. This went on for a year. I had several stress tests that said all was good. They prescribed lorazepam and told me it was anxiety attacks.
Sometimes my heart rate was 170+ and bp 225/130.
I was in hell. Doing vagel exercises and holding my breath in a bowl of ice cold water. The attacks started to get worse and more frequent. Sometimes waking me up at 4am. The lorazepam did nothing to abate - but still 4 cardiologists, a heart specialist and maybe 25 different doctors wrote it off to anxiety attacks. Yet, after almost 3 years of this, I had strong suspicion it was a rebound effect from the beta blocker.

I tried to ween off it very slow for 2 years. Once I was off for 3 1/2 weeks and then BAM, massive attack that actually registered a tiny trope test. So I had to go back on.

Finally, my heart specialist said let’s switch beta blockers- that metoprolol is a twice a day drug and I was only taking a small amount once a day. So we switched to bisoprolol 2.5mg (half a pill) once a day. This was in August 2018.

The attacks stopped completely. What was happening, yet nobody will admit, was the metoprolol was wearing off every evening before I took my next dose, or shortly after... my body started to produce adrenaline again, and since I had developed billions more adrenal receptors (from being on beta blockers - bodies reaction to the drug), my body would flip out and I would have a hypertension/tachycardia attack.

2 weeks later on the bishoprolol and I felt like crap. Dizzy, no energy, insomnia... but no attacks. Bp and pulse were low so we cut dose to 1.25mg. Felt like crap for a month... then started to feel a little better.
This January, I had had enough of feeling dizzy and no energy. One night my pulse went down to 40bpm and my BP was 190/110. Off to emergency I went. They did all the tests and nothing. So we decided to cut my dose to ween off. I was told by several doctors to just go off cuz it was such a small amount. But having read so much, I thought I should ween. So .65mg tiny thing.

It has been 2 weeks now and I’ve been to ER with crazy high BP twice - but it always comes back down after a few hours on its own. I keep having these attacks again and I’m 100% sure it’s caused by the beta blocker.

This time I’m going to power through even if it kills me. This is a nightmare drug and after almost 4 years of pure hell - I have had enough.

My understanding is although I may be off the drug for months at some point- there is still the physical manifestations of the extra adrenal receptors that will eventually deteriorate as my chemistry normals.

Couldn’t imagine doing this without God. Good luck everyone who is fighting this battle.

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Replies to "Anyone who wants to ween off beta blockers should read my story. I had a heart..."

Thank you for sharing. Every body is different. Mine has always been different from others. Nothing for me is normal . My body reacts opposite to health situations away from the "norm". Sounds like yours does also. I have been taking Metoprolol 100 gm for about 6 years. In the beginning it helped along with Clonidine started at low doses so naturally when BP kept rising the doses were adjusted higher making the matter worse. I understand the feeling like crap...like a zombie. Mouth so dry you could spit cotton. Gas and walking farts falling asleep not being able to drive...Every heart test and ultrasound, test for blocked arteries all normal. No reason for high BP increase more drugs that will work. NOT I listened to my body. I slowly weaned down on Metoprolol from 100mg 3 times daily over 2 weeks keeping track of BP 3 to 5 times a day. Really need to watch salt intake like poison to me. Life is a journey and how right God is my pilot.

Hi, Sorry to hear of your problems. Doctors listening, or actually not listening to patients is a problem at times. I had an undiagnosed seizure disorder for 15 years and was thrown out of my neurologist office because he said nothing was wrong. I consulted another doctor, he did a 24 hour EEG, you can't believe the looks you get leaving the hospital with multi-color wires glued to your head. LOL. But it showed seizure activity from the moment it was connected and a 15 year nightmare went away almost over night while on the right medications.

I'm not contradicting you, we each have a somewhat personalized response to medications. Because I didn't experience it, doesn't mean someone else didn't. But I've taken higher doses of Beta Blockers (Now I'm on 350 mg Metoprolol taken as 200 mg in the morning and 150 mg at night), I've taken 240 mg Inderal LA as a migraine preventative in the past. And though I'm on Metoprolol for rate control of afib I'm actively experiencing, at the time the afib started I was taking 600 mg of Acebutolol as 200 mg three times a day. I haven't seen the issues you describe in myself.

I just wanted to convey that readers should not jump at the idea of taking Beta Blockers is unusually harmful, this is not often the case when drugs are prescribed by doctors that know the patient's overall condition, other illnesses the patient has, and prescribes with that knowledge in mind.

I readily agree that we all should be an active participant in our care, and that includes reading on the subject, listening to the experiences of others, conveying this to our doctor, and getting a second opinion if we're not confident in the actions proposed or taken by our doctor.

Hello @rezon8r, I thought I would follow up regarding your post. It was really helpful because this is really tough. I'm in the middle of a withdrawal and with God's grace with my slow taper, I should be off Metoprolol by the beginning of June. How are you doing?

Hi,
How's its been since you've weaned off? I'm currently going through the process.

Thank you!!! This is the first thing I’ve read that makes sense to me. I live in Canada where the medical system only lets you have one crack at a cardiologist or diagnosis. I was put on metoprolol 2years ago- for suspected atrial flutter- no symptoms other than a high heart rate that spun back down on its own but which I felt worried about when it showed up on a drug store monitor I used just by chance-I had no discernible symptoms otherwise- I had other cardiac tests-all normal but was put on metoprolol while on a wait list for a cardiologist. Immediately upon starting the medication I was so sick! Fatigue, general malaise, sleeplessness, chest pain, shortness of breath and low blood pressure. I knew it was the metoprolol- my dose was eventually reduced to half 12.5 mg twice a day so I wasn’t as sick- but I’ve never been the same. I wanted to go off it but was convinced by others that I needed it to protect my heart- since atrial flutter could cause stroke. I also continued to have the tachycardia even more often. Meanwhile the “triage” at the cardiologist I was waiting to see, decided I was low priority and I had to wait 11 months to be seen (while continuing metoprolol and feeling ever worse.) No one would even consider trying me on a different beta blocker when I asked- though a pharmacist suggested it. Doctors here so busy and burnt out- it’s impossible even to get a 10 minute phone appointment with a GP for which- if you can get it -you wait 3weeks . Once I saw the cardiologist a year ago now- he was scornful of me for being at all worried about the high rate a year prior to my seeing him-though it had started happening ever more frequently and has since really increased. He said I had a kind of SVT (EAT)which was not deemed a serious condition (which must have come up in the holter readings which the referring doctor- an internal medicine guy at my local hospital - (there is no actual cardiologist in my town)- had initially read and thought might be atrial flutter. And the reason I was triaged as only semi urgent-but nobody thought to tell me or my GP that it was not flutter. So I suffered a year of these debilitating side effects thinking that I had a potentially serious condition and had to endure them while I waited .) After talking to the cardiologist- also very busy and acting like I was wasting his time- I determined from what he said that I didn’t actually “need” the beta blocker to prevent a stroke or heart attack - though he also insisted I should stay on it -indefinitely -for the SVT and totally poohed poohed my claim that it seemed to be the thing making me sick. He said that the chest pain and other symptoms were likely anxiety and unrelated to the SVT. He prescribed propofanol which I tried for three days and had such a huge reaction to it (more tachycardia even at night- and unable to even do yoga without pulse rate shooting up to 150 and staying up) that I knew it would be a disaster to stay on it. Propafenal has a “box warning” and is -from what I read AND heard from a pharmacist -not recommended for anyone who does not have serious heart disease. But my refusal to continue on it -I felt like I was poisoning myself frankly- just made the cardiologist and my GP further write me off as an anxiety case. I had already spent the year worrying and feeling like hell, had bought a smart watch because I felt that there was not enough medical oversight which made things worse because I then truly did become neurotic about looking at my heart rate. I now am labelled as “anxious” on top of everything- have spent a fortune on therapists who are calling my SVT and other seemingly cardiac symptoms, “somatic illness”. I have chest pain, shortness of breath, blurred vision, heart rate that spins up to 150 to 170 bpm multiple times a day. Despite a year of the best psychological therapy money can buy. (Here in Canada mental health care is private pay… but regular medical care is free for all but somewhat limited as a result-and the private pay medical advice available is limited to entrepreneurs who charge more than I can afford. I have even tried naturopaths and other alternative medicines and every dietary supplement available and exercise. I’ve tried -despite this continued medical advice to stay on it -many times to wean off the metoprolol because that feels like the moment -(now two years ago) when I started actually feeling sick- but whenever I do, my SVT gets a lot worse and all of the chest pain and other feelings of malaise I get before and after it increase-so I, having had no medical support in the first place to wean off it, just give up and go back on it. I recently tried again and just gave up the weaning (I was down to 10mg twice daily) yesterday. I am so desperate now- something has to give. It’s why I googled and saw this. And why I’ve written this long crazy reply to your post. I’m really really interested in knowing anything else you have found out. It’s been two years for me and my gut says it’s the beta blocker that’s making me sick and I really want to try to get off it. But how? Thanks again. Keep me posted? Best of luck to you. 😊

I also had unexplained spikes in BP 250/130 and pulse over 200 with a bit of arrhythmia thrown in AF and VF which was rather exciting and lots of ambulances but it all calmed down without explanation whilst in A&E. It was happening about 4 times a year. Doctors increased the dose of bisoprolol which made the problem worse. This was whilst on bisoprolol and rivaroxaban and ramipril. I started feeling really rubbish and was feeling really ill and very tired all the time. I thought my life was basically over but I was sure it was the tablets that was causing it all and was linked to how it affected my digestive system, it was causing my gut to balloon which seemed to cause the heart issues. All heart scans were fine. I argued with my doctor who gave me metoprolol instead of bisoprolol. This improved things a bit but after a while I was feeling ill again. So I experimented with the combinations and found the solution quickly. It turned out that the combination of Rivaroxaban and Bisoprolol shut down my digestive system which caused the spikes in BP, pulse and arrhythmia . I am now on aspirin, metoprolol (low dose) and ramipril and it has been a miraculous recovery. No spikes at all, lots of energy and lots of hope and everything works again properly and it has even cured my psoriasis. The tablets were causing the problems they were designed to stop which was a little disappointing. I hope this story helps.