What was your Metoprolol withdrawal experience?

The literature for metoprolol says to not stop taking it on your own accord and not suddenly. I did, but on doctor's instructions. Like you, I had a low HR that made the back of my scalp and neck tingle. Not only that, a nurse came running into the ICU cubicle my wife and I were in only to find me chatting amicably with her. Her eyes were wide, and she held out her two forefingers about eight inches apart and said they'd all watched my heart pause 'that long' on their monitor. The attending consulted with the gentleman electrophysiologist who had performed an ablation of my pulmonary vein mouths to rid me of near-persistent atrial fibrillation. Between them, they agreed to start me on the huge hammer called amiodarone...literally the drug of last resort for people with heart arrhythmias that don't respond to more commonly prescribed AAs....anti-arrhythmic drugs. I had had my last dose of metoprolol, but the substitute, a most powerful one, was to be the dreaded amiodarone.

I do think that you might have been further ahead to have taken three or five days to get off metoprolol, but I'm not qualified to say one way or another (not medically trained and I know nothing else about your medical circumstances and history). Clearly you're in a bad way for some reason. Your heart is acting up, probably (a guess) SVT, or 'supra-ventricular tachycardia', an unfortunately very common arrhythmia. Metoprolol, as a beta-blocker, reduces the strength of each contraction and also slows those contractions. It works very well for many patients with tachy-arrhythmias. Some do very poorly on it, just as some do for the various oral anti-coagulants prescribed commonly for heart patients with arrhythmia, or with the more common anti-arrhythmic drugs like flecainide, Sotalol, and Tikosyn.

I wouldn't normally make light of your situation, especially with my own history of highly symptomatic atrial fibrillation, but you find yourself in good company twice over. You've joined the crowd with a wonky heart and the crowd that can't do well without, or with, metoprolol. 😀

@gloaming thanks for your reply. Sounds like you had a heck of a time! Hope you’re doing better. I had no heart issues before starting metoprolol for stage 1 hypertension. Saw my Dr 2 days ago and he didn’t seem concerned, but is setting me up to be monitored just in case. He also said I could take 1/2 or 1/4 every other day, then every third day and so on, if the rapid heartbeat gets bothersome. He’s looking to put me on an ace inhibitor once I’ve done the monitor. From what I’ve read, this is a normal rebound, but to me it is scary. When I first stopped, I ended up in the ER a couple of times because of spiking hr and bp. Hooked me up for hours, did bloodwork, said everything looked good. They also said to take a little dose if it happens again. So today was a bad day and I caved, taking 1/4. I just don’t want to end up dependent.

@lelemoe55 I'm pretty sure you'll be okay, and if you can steal yourself to adopt a several-day, maybe even up two two week, protocol of reduction, you should be fine.

I'm doing well, thank-you. My first ablation failed, but the second one has had me in NSR for three weeks short of three years. 14 February was my ablation date, 2023.

It's too bad people have to suffer from being mis-prescribed. We still have a long way to go, and much to learn, about the human body now well into the 21st century.

I began taking a 25mg metoprolol tab twice a day on 5/1/25 when atrial flutter was diagnosed. On 10/8/25 I had an ablation and metoprolol was reduced to 12.5mg twice a day. Three months after ablation on 1/7/26, cardiologist reduced metoprolol to 12.5mg once a day, at bedtime, with instructions to cease metoprolol seven days later, which was on 1/14/26.

Since stopping metoprolol, my sleeping heartbeat rate has already increased from high 40's to mid 50's. My resting heartbeat has increased from mid-50's to low/mid-60's, plus I feel better.

Sounds like you did well with weaning off. No withdrawal/rebounds at all? You are so lucky!

I weaned off a relatively high dose of metoprolol ( 150 mg/day) a number of years ago, just to see if 1) the metoprolol was the cause of my bradycardia ( I had tachy-brady syndrome, with episodes of both), and to see if
another heart rate drug ( diltiazem) could replace the metoprolol to control the tachycardia without lowering my heart rate so much.
My weaning schedule lasted two weeks, with the third week off metoprolol, then I was to start the diltiazem. The EP instructed me to immediately cut back to 100 mg/day of the metoprolol, take that for a week, cut back to 50 mg/day for the second week, and stop taking it the third week. I noticed as I cut back on the metoprolol, it didn't matter how low the dose, I still had the bradycardia- with heart rates going into the low 40's or even high 30's, with low 30's at night or at dawn just after I woke up. I also experienced an increase in the number of tachycardia episodes as I lowered the dose of metoprolol, and they got so bad and so frequent I started taking the diltiazem early, while I was still on 50 mg metoprolol to try and stop these. Didn't do a lot.

After I stopped the metoprolol, I noticed I had the "jitters" at times, and it seemed like any stimulant, including caffeine in the coffee I drank, even chocolate, made me "hyper", jittery and anxious. The diltiazem, which acts to slow the heart rate by a mechanism different than that of the metoprolol, didn't do anything to ease those jitters. As it turns out it didn't help the bradycardia or the tachycardia very much either.

I was instructed to stay on the diltiazem ER ( 180 mg/day) for a total of about 5 weeks to see if it could replace the metoprolol to control my tachycardia without making my heart rate go so low. I think the jitters and the hyper feeling went away in about 2 weeks or so, but I had increased incidents of tachycardia and the bradycardia was still there. The EP had determined that the tachycardia was atrial tachycardia from his study of the monitor reports I'd had over the years, and that the bradycardia was likely NOT caused by the metoprolol- this based on the patterns of when the brady occurred, ie, not the pattern expected for just a response to the medication, still occurring at the same frequency with a very low dose of metoprolol, and even with a low dose of diltiazem. He recommended and implanted a pacemaker after that, and restarted the metoprolol, albeit at a lower dose, along with continuing the diltiazem.

I'd thought perhaps I'd bite the bullet when I saw this EP and have an ablation done for the SVT ( it was not A-fib at this point) then hopefully I would not need the metoprolol anymore, and the heart rate would return to normal. I assumed the SVT was one of the AV node reentry types that reportedly can be "cured" via ablation. But he informed me that the atrial tachycardia he saw on my reports is not easily ablated, as it's very hard to induce this arrhythmia in the cath lab. As he put it, it "doesn't act in the cath lab the way it does in nature", and with the bradycardia I had acting the way he did he thought putting in a pacemaker, and treating the arrhythmia with medication would be the best way to go, at least for the time being.

I was advised to stop the 25 mg of metoprolol I'd been on for 4 years for svts, because my pulse was getting too low and my ECG was showing heart block. They wanted me off of it for 1 week and then come in for another ECG to see if it was the drug causing the heart block. But, what happened is my BP went through the roof and I felt really really awful. Perhaps it was non stop SVTs. I don't know since I'd been someone who did not feel the SVTs. I was immediately started on Losartan for the high BP.
I then wore a Holter monitor for 24 hours which showed second degree AV heart block and 3 months after that I had a duel chamber Pacemaker.

@lelemoe55 I was on Metoprolol 25 mg then due to side effects I cut back to 12.5 mg. Started in May and quit taking in October. I was taking it for Atrial Fibrillation. Just recently my heart rate, not my blood pressure, has been increasing so I have started taking 12.5 mg again to see if it will help.

@missy245 I hope you’re doing better now. Did they determine if the block was caused by metoprolol? And how are you doing on the losarton? I also had hr and bp spikes when I stopped the Meto and ended up in ER twice.

@lwools I wish you good luck getting off the Meto. I was having so many palpitations and hr spikes my Dr said take a small dose so I took 1/8 and it helped. I was on the extended release. I’m still getting spikes but not as bad.