Propranolol for hypertension and detachment / aggression side effect

Thank you. Yes he has an appointment to discuss the meds with doctor but the difficulty is getting him to see his own personality changing and he’s a little bit blunted by the propranolol.  Out of interest how did you find your personality changed or what were the flags you noticed?  Has it settled in over time? 

hi, Bridget, it was more with tapering  off the stuff, some get a surge of stress hormones etc.  I would suggest, just to stop the medication, but over a longish period of tapering, carefully, with the docs consent of course. All bp meds are simply chemicals, which have various effects on people.  see the good ref by jx41870, on the possible effects on body chemistry - your husband's first ask of the GP is a blood test for thyroid profile, glucose, long term glucose (HbA1c),  lipid profile, liver hormones, etc - all these were affected in my own case.  I imagine your husband has previous reasonably up to date blood tests from before he was on bbs to compare.  My bloods took months  to change back after stopping. Re my liver, levels of one chemical were borderline many weeks after stopping,  and the doc asked about my alcohol intake (i do not drink any alcohol!). hope things better now

just re read your query, my changes while on were more to do with extreme tiredness, unable to move about or breathe, a sort of depression etc all on the web re side effects, after all, stress hormones are blocked by bbs, and they keep one ticking over, existing, etc, you need some of them to function, and different people might feel very differently about this., and each person might have different amounts blocked, was on them for a lot less time than your husband, but i feel i lost nearly a year of my life, its all a haze as memory - i assume - also needs stress hormones. not sure about this but that is how it seems now, looking back.

Hi Lily

He’s 39 and hasn’t had any other health or noticeable change in lifestyle apart from the beta blockers.  I feel a quiet sense of unease as maybe, it is unearthing something much deeper which isn’t so much of a side effect but a trigger (if that makes any sense).  I was just curious if there was anyone else out there who’d experienced a sense of ‘no consequence of different actions’ when on beta blockers. It’s so hard to describe but it’s almost like he’s become fearless. His fight or flight mechanism is certainly blunted which the doctor explained would be from the B.B. but I did some reading about a drug being developed for soldiers to create the perfect fighters and that made me feel a little bit uncomfortable as they mentioned propranolol. 

Sorry if I seem to be off on all sorts of tangents but I’ve never experienced anything like this and having known him for 17 years I feel like I’m waking up next to a stranger. 

Bridget 

I'm so sorry to hear about all this, Bridget. It must be very frightening.

It's certainly true that beta blockers, including propranolol, are often prescribed for anxiety, and may well reduce perception of consequences of actions as part of this. This would account for his detached emotional state and failure to recognise your distress. However, beta blockers usually have the opposite effect on sexual appetite, damping it down. In fact, propranolol is frequently prescribed specifically for hypersexuality.

That being said, on a quick Google search just now, I spotted an article on the factmed site, entitled: "Is hypersexuality a side effect of propranolol?" I was unable to read it as the site was requesting I download pdf conversion software, and I generally avoid that kind of thing. You might however want to check it out yourself. The Patient site doesn't allow links except to its own approved sites, but you should be able to find it with the information given above.

As I'm sure you've worked out for yourself, many of your husband's symptoms could match with the onset of bipolar disorder, which can start abruptly in middle age. This comes to mind because I worked in a specialist neuro unit for a couple of years. During that time I looked after several men in their 40s, who'd been admitted for investigation of a possible brain lesion after a sudden personality change, but were eventually diagnosed with late-onset bipolar disorder after exhaustive testing.

Another possibility that has to be addressed is that your husband may indeed be suffering from some kind of brain lesion, though that's unlikely in my opinion since the change seems to have come about as a result of taking propranolol.

As others on this board have suggested, the obvious first step would be to change his medication or reduce the dose. There are other beta blockers, as well as other avenues of treatment for hypertension that don't involve this class of drugs. If that doesn't produce a rapid improvement, I would want to start pushing for referral to a neurologist if this was a member of my family.

I realise all of this depends on your husband being willing, or able, to describe his psychiatric symptoms to his doctor, especially if he doesn't acknowledge them himself.

Do you think you could persuade your husband to let you accompany him on his upcoming visit to the doctor, and to give your side of the story? Easier said than done, I know.

Doctors can be cagey about talking to relatives of a patient without consent, due to confidentiality issues, and I suspect hard-pressed, target-battered UK GPs may use this as an excuse not to spend too much time on individual cases. However, it's often possible to get round this attitude by quiet insistence. I managed it myself when my father became psychotic after being prescribed high doses of steroids in the late stages of cancer, but I admit it wasn't easy.

I'm also wondering whether you and your husband share a GP, or at least the same practice. A friend of mine, who was living with her mother, took this route when the mother became mentally ill but was hiding this from her GP. My friend arranged a consultation for herself with her mother's GP, during which she complained she was being made ill by her mother's actions. The doctor then made an unannounced home visit to the mother, accompanied by a mental health nurse, as a result of which medication was prescribed to control her aggression.

I'm hoping that none of the above will be necessary, and that a simple change of medication will be all that's needed to restore your husband to his usual mental state. I also hope you'll keep us all posted of any developments.

All the very best,

Lily