propranolol withdrawal

hi josh. sorry you're going through this. did you stop taking it? if you only took it for 2 weeks, you may improve a lot before your new job starts. seems like everyone is a little different with how long it takes. i know what you mean though. this withdrawal has interfered a lot with my work and the rest of my life.

Hey Tricia, yeah, only 2 weeks at 40 mg a day, I was having trouble breathing while taking it though. Ive seen you should taper this stuff so have been lowering the dose. Im trying to just use 10 mg on days when it becomes all too much. Its already been a month though and my heart rate is still crazy, having anxiety attacks, cant sleep, exercise, have nausea, have lost like 10kg in weight. Some of the stuff I have been experiencing would absoultley land someone in a mental hospital. Which is ironic as I work with in mental health. This stuff should absolutely not be prescribed the way it is!

Hey Josh, I'm also experiencing the same thing. I had side effects from the moment I started it (muscle spasms/palpitations/blurry vision/jitters/tremors/shortness of breath/weight loss/loss of appetite) and I was only on 10mg for a month! I stopped cold turkey and I've also been experiencing a rapid heart rate with any movement, it's been almost 4 weeks for me; however from speaking to people on here I know withdrawal lasts between 6-8 weeks so if you are able to wean off the 10mg now you might be better before your new job! good luck, and message me back whenever you need support. Btw, the side effects took this long to ease, I get muscle spasms and tremors every now and then and my shortness of breath is being treated by steroids from my GP as they suspect I might have asthma now.

I was on 40mg per day too for four weeks. I stopped it cold and it's been awful (so I don't recommend that), but it wasn't great when i was on it either. and you don't want to drag it out too long. also like yazmin I had basically stopped eating while taking it. I agree. it absolutely should not be prescribed the way it is. I think I realized that it might be a mistake when it was prescribed for me, but I thought I'd take a leap of faith and listen to the doctors... never again. let me know if you have questions.

Hey Yazmin, I pretty much got all the side effects from day 1 too, my GP convinced me to continue though, brushing off my complaints. Im actually in hospital right now, have been a few days, but generally the wild tremors and other feeling have become a little more residual. Im mainly here to look at what's going on with my heart, as that seems to be getting worse. I lost conciousness standing up, so im not taking any chances, even slight movement makes my heart jump up another 100 bpm. Maybe there is an underlying issue in certain people, that propranalol makes worse, so will update if I find out anything. I also want to know how safe it is to actually be walking around with my heart going insane. im being taken seriously by the cardiac specialists here, so hopefully I can find out a few things.

Hey Josh, that's great you're being taken seriously. What were you on it for? My doctor just brushes off my heart racing as anxiety but I know it's not. Keep us updated. Take care.

I was given it for palpitations, which in fairness was probably due to the amount of caffeine I was drinking. With your doctor, literally show them there's a physical trigger for your heart rate reaction, show them it going up and back down as you stand/ sit. I was initially brushed off as anxiety too, but point blank showed them that they were wrong and why, if you can get to see a cardiologist, even better, they know a lot more about this stuff. I'm probably going to end up with a diagnosis for PoTS. I'm going to be at the hospital until atleast monday though, for testing/ monitoring.

do you have a change in BP too? I thought I had PoTs but my dr said I had no change in BP so it must just be anxiety but I know PoTs doesn't always require a change in BP

wow... i started thinking i had PoTS right after I came off the propranolol. I've improved a lot over the past 6 weeks though, so more recently I've been thinking maybe it was just the withdrawal and low iron. I see a cardiologist tomorrow- an appointment I made weeks ago. yazmin and josh, did you have any PoTS symptoms before taking propranolol? josh, I am sorry that you lost consciousness and are in the hospital, but it's good you are being closely evaluated.i felt like I might pass out a few times early on, but never did. please update us.

I don't think anyone noticed anything super significant with my BP. To be honest, I'm not sure if I had PoTS symptoms prior, if i did, it certainly wasn't noticeable. In theory though, It could be that, withdrawing or using beta blockers somehow makes PoTS symptoms worse in those with a previously mild form of it....hopefully only temporarily.

no I did not have any symptoms before but I started to think I did after I noticed my heart rate would rise when I stood up if I missed a dose. I do think the withdrawal symptoms are similar to PoTs which eventually goes away. Has the heart racing improved for you?

No improvement whatsoever for the heart yet, in fact its gotten a little worse, im being required to not move from my bed for anything by the hospital. Still waiting for further appointments with the specialists, so no more clued in. The other withdrawals seem to be getting better, the internal tremors, shaking, and waves of anxiety, are nowhere near as intense as a week or 2 ago.

yeah you may have had an underlying cause which was causing the palpitations for you before taking propranolol as it should be improving by now. What is your heart rate standing? Hope it isn't anything too serious, take care.

Could be the case. My standing heart rate was measured at 175 during a test yesterday. Which is crazy becuase I work out alot, and have never touched that level. Theyve given me another medication to try, (which isnt a beta blocker) called Ivabradine. Alot of PoTS patients aparently use it successfully, and it doesnt seem too risky to take...i'm hoping it'll help temporarily, and my heart rate will eventually normalise...that said, they're going to be keeping me at the hospital to monitor.

It’s all really scary and kind of surreal. I am upset for all of us. It’s been 6 weeks for me and I have improved a lot, but am still not fully back to normal and am much too tired. The cardiologist brought up POTS also. He is sending me to someone who specializes in the condition, but it may take a while to get the appointment. I think it’s possible I had a mild case of it before taking propranolol. Good luck Josh, let us know how it goes on the Ivabradine.

hi Tricia, do you know what your standing heart rate is?

hi Anna. Mine is not as high anymore because I've been off Propranolol over 6 weeks. It can still be as high as 100- 120 standing sometimes, but it's not as bad as it was. why do you ask?

hi Josh. I hope you are okay!!

hi josh, how are you now? did the cardiologists say the POTS could go away?

Hey, I'm actually feeling 10x better than when I posted just 10 days ago. The only thing is the PoTS. The cardiologist did say that people just get over it sometimes, and its usually the cause which defines that. Its usually people with Neurological PoTS that have a hard time ever recovering. From what I can tell though, we likely have hyper adrenergic PoTS as a response to a increase in Cardiac receptors, from the Propranolol. From my research, it appears a lot of people get this during beta blocker withdrawal, and it can be the last thing to recover...but they do recover. Ill definiteley stick around and update people for future reference the time frame it took me to recover. But, basically its just waiting for the body to normalise receptors without a beta blocker. My theory is, increasing your activity level a little, and exposing yourself to situations which increase adrenaline may help in desensitising receptors again, and hasten recovery, so im going to try a few things. Have you got any better at all though? How long has it been, and how is your standing/ sitting heart rate?

What is your standing HR now? The highest mine was 186 on my smart watch today. I thought I was getting better but then I got my period which made things a lot worse and I'm not sure if it's related.

Josh- Do your doctors agree that we have hyper adrenergic PoTS as a response to a increase in Cardiac receptors, from the Propranolol? This makes so much sense to me. I have improved a lot, but at 2 months, I’m still not completely normal. Would you be willing to share your research? It’s hard for me to find much info out there about propranolol withdrawal- let alone propranolol withdrawal in PoTS. I have read about beta adrenergic hypersensitivity in beta blocker withdrawal more generally. I'm so glad to see your posts trying to make sense of all of this.

hi Josh, which country are you in? I'm in London and none of the doctors I've spoken to know much about PoTs and/or propranolol withdrawal so they just say I have anxiety and leave me alone. The spasms in my diaphragm have become so severe it makes my whole

body shake from the inside and causes breathing difficulties yet nobody takes me seriously enough to care.

So after 7 days at the hospital the cardiologist did officially diagnose me as having PoTS, but they did not attempt/ werent able to specify what kind of PoTS or the underlying cause. Yazmin, you are definitely right that they dont know much about PoTS as a condition, or beta blocker rebound/ withdrawal. Im actually in Cardiff. The medication they gave me helps keep my heart rate variability a little better, but Im still hitting 120+ when standing or walking, with my resting in the 50s/ 60s. I obviously did want to get to the bottom of this, so I have looked through any papers on beta blocker rebound, and PoTS itself. I do have some research background, but, do take what I say with a grain of salt. Hyper adrenergic PoTS does seem to be the only form of PoTS that makes sense to a propranolol reaction though. Not only because it makes sense to the mechanism of a beta blocker, and the physiological reaction. but, also there is no drop in blood pressure when standing from people going through withdrawal, which there is in most PoTS forms...Ive reached out several people on reddit, facebook etc. who all had similar experiences, and while it can take a while, everyone's HR did get back normal. So I think that is reason to be optimistic...I did get spasms everywhere originally, but am getting over them now. Obviously time frames etc. are going to be individual, but do come back and update. this thread is useful resource, and im sure we wont be the last people to go through this.

yazmin... this may be a resource- https://www.potsuk.org

where did you get spasms? my dr thinks i may have esophageal spasms, which I noticed started when I took propranolol. I wonder if that will ever go away.

thanks tricia, I know about this. It worries me that this could be permanent.

I initially noticed spasms thoughout my sternum, stomach etc. but I did get repeating ones everywhere, including an eye twitch at one point! Happy to say though, they've pretty much subsided for me. Im also staying super hydrated though, so maybe that is helping. At this point im really just hoping my heart rate starts to calm down when moving.

My blood pressure does drop now when I stand- but I was actually told and have read the opposite that the bp drop is orthostasis and not typical of PoTS. I have a research background also and am taken seriously by my docs, but they can’t seem to figure out what is going on.

There are different forms of PoTS and typically alot of Pots patients complain of circulatory issues, eg blood pooling in their legs due to venous insufficency, or issues pumping blood back into the upper body. That would absolutley cause a drop in blood pressure on standing, and is common in both Hypovolemic and Neuropathic PoTS, which are more common than hyperadrenergic Pots. There can absolutley be a number of reasons for a postural drop in blood pressure though, so hopefully you get to the bottom of it. My blood pressure actually increases, which would make sense, as my heart is beating way faster than it normally does. And while that is common in hyperadregenic Pots, I think the mechanism is slightly different in withdrawal, as its increased receptor sensitivity to adrenaline causing it, not actual elevated level of adrenaline in the blood.

so techically it's not PoTs just similar?

Yeah, just my opinion, but for all intensive purposes I believe beta blocker withdrawal mimics the symptoms of Hyperadenergic PoTS, almost exactly. However I believe the underlying mechanism is slighlty different. Though honestly, I dont think the majority of Doctors would actually know enough about any of this. Hence why I was given a PoTS diagnosis despite it being shown time and time again that people can get this reaction from beta blocker withdrawal...Im thinking itll take a couple of months at most for the body to re-regulate, as long as im eating/ staying healthy...fingers crossed. Unfortunately I did have to withdraw from my new job though, there's no way I can start at the moment.

that's exactly what I was thinking too. sorry to hear about your job.

how is your HR and blood pressure now tricia?

This is extremely helpful info. Thank you. Are you able to post refs for any pubmed articles or info that have helped you learn more about the different types of PoTS and/or beta blocker withdrawal? I think we all need to become better informed as unfortunately the majority of these docs are not. Also I don’t know if this site will allow you to post your cardiologist’s name, but I think it would be helpful to share names of docs that are well informed on here.

Are you staying on the Ivabradine? Is there any rebound effect/withdrawal coming off of that? I am asking because one of my docs suggested it for me.

I’m very sorry about your new job. All of this has interfered with my career also since I have very little energy and my concentration and productivity are terrible for weeks now.

I got a smart watch that monitors heart rate yesterday, so will be able to keep better track of it. My heart rate is 60-70 lying down and goes up to 100-120 standing. My blood pressure is dysregulated, but the systolic usually drops 20 points when I stand. It dropped 50 points in the neurologists office going from lying down to standing. Sometimes I can feel the blood pooling in my legs. I didn't have these symptoms before propranolol.

has your HR improved since the beginning of withdrawal?

Yes, I think so. It certainly seems like it was much worse the first few weeks. I wasn't checking my heart rate often then; I only saw it when I was taking my blood pressure. I could definitely feel it racing though. At one point today, my heart rate went to 135, and I'm pretty sure it was higher than that whenever I stood and moved around the first few weeks.

mine is the same

what is yours?

between 110-130 standing and sometimes gets worse standing still. I get tremors when standing too long and my heartbeat becomes irregular, it jumps between 60-130 sometimes

yeah mine can go to 135 too if i stop walking and stand still. did you ever monitor your heart rate prior to all of this?

no, I recently got a smart watch too. I never checked it before but I never had palpitations standing/going up stairs or walking before.

Hey Josh, how are you doing?

Hey, I would gather all the papers Ive looked at, but didn't really think to save them somewhere. I still have access to university credentials, so can still access alot of journals, cant promise, but maybe Ill try collect stuff together at some point...pretty sure Ivabradine doesnt have any rebound or anything, it seems "fairly" risk free. That said, im probably not going to use it consistently unless the increased heart rate maintains for way longer than expected. Unfortunately, nothing to report in that regard yet though, its still pretty much the same, though definitely lower than when I was at the hospital, I was hitting 150 then just moving in bed. Its nothing like that now, and feel ok generally, other than the occasional low mood, and a little anxiousness at night. Only other thing is my blood pressure is on the high side even resting, which it really shouldnt be, im 29 dont drink, smoke or anything eat very healthily, and have been very active up until now. I do actually have a record of my heart rate going back a year, because I monitor it for fitness stuff. Its pretty obvious my heart rate was fairly normal prior, only ever getting into the 100s during workouts etc...that was while being an absolute caffeine fiend too.

Hey Josh, I have access to journals through my university account too so I've read some of what you've mentioned. Basically, this is a normal reaction but there just isn't enough research around how long it takes to get back to baseline. It sucks. I'm glad you're doing better, what is your standing/walking HR now?

Yeah, most the stuff ive read only seems to cover a couple of weeks of withdrawal at most, it is pretty frustrating there hasn't been more research. My standing and walking heart rate is generally still around 120/130, not seen much improvement since the initial couple of weeks.

Hi guys. I have good journal access, but did not find a lot out there and what’s there seems very limited. My cardiologist did say propranolol rebound/withdrawal symptoms can occur in healthy individuals for weeks afterwards, but they’re typically on higher doses for longer periods. I wish I had monitored my heart rate prior to this, but never did. I did not feel like this before either Yazmin. I’m pretty convinced at this point that the blood is pooling in my legs. I think there is evidence for this in that my heart rate is even higher when I stand still than when I’m walking. I’m also most uncomfortable standing still. Josh, do you have any of this? It sounds like your heart rate is as high as ours still, but it doesn’t sound like you’re experiencing discomfort any longer, which is great. Do you think it’s the Ivabradine? I recently bought compression stockings. It made me sad to have to buy them, but they do seem to help. You may want to try them Yazmin. They look like leggings. I know you don’t have the bp changes that I do, but if your heart rate is higher staying still, they may help you too.

Hey Tricia, standing still is definitely worse for me, and I definitely get shakey and uncomfortable when hitting higher heart rates. Honestly, the Ivabradine helped me around 10%, but maybe it could help you more. I'm not currently using it right now though. I still cant comfortably exercise, or walk around for too long without my hr being really reactive. Im sure this will pass for all of us though. Ive talked to and seen accounts of so many people all over the internet who went through these kinda PoTS type symptoms during beta blocker withdrawal. It cant be a coincidence, and it appears to be a temporary occurence, even if it took some time. I think, just make sure your body is getting what needs to recover and adapt. If you find anything that seems to help though, do please share.

I'm very very upset it's taking so long to recover. It's been 6 and a half weeks and I still have severe muscle spasms in my diaphragm, chest and neck as well as palpitations and elevated heart rate. I have to be back at university in a couple of weeks and I don't know how I'll cope. My 24 hour heart monitor results came back with an arrythmia, and I don't know if this is a permanent result of the beta blockers. I was only on 10mg for a month. It's ruined my life.

Really sorry to hear this Yazmin. This certainly hasnt been easy. I just had to have paramedics around, as my heart rate was stuck at 170 while led in bed. What kind of arrythmia is it?

Oh no, sorry to hear! Did it eventually go down? What did the paramedics do? I'm not sure about what kind it is yet, still investigating with cardiologists.

Yeah eventually it came down, but my resting is still in the 90s at the moment, this has been the worse couple of days Ive had in a long time. Adrenaline, Shaking again, in bed all day, feeling sick with chest pain...Every ecg ive had has shown Sinus tachycardia. If you find out whats going on let me know, becuase the entire time I was monitored I mainly led down, and not allowed to move. Results could differ when walking around etc.

hi guys. I hate this and am so sorry. i'm wearing a holter monitor now for 48 hours. Why are we not getting better? I felt like I was and then, like Yazmin, it seemed like I got worse again after my period. Josh, I don’t think I am going to try the Ivabradine. I will continue to post if I find anything out. The only things that have helped me so far are drinking fluids, salt, and the compression.

Honestly, not sure why we are not better. Maybe its not related to your period though, as I feel worse again too, after thinking I was getting better. Ive heared that it is common for returns to withdrawal symptoms after some weeks, when withdrawing from anti depressants. As the body can take some time to fully process what has happened receptor wise...in theory beta blockers do function similarly...but, I have no idea, there really is no information on this...im taking the ivabradine now, as honestly needed something to slow my heart down at rest...im still shaking etc. even now, and feel real bad...I have a real low dose of bisoprolol here, which obviously, I dont want to use, but if I get really bad, I might have to try it, and do a very slow wean, as a last resort.

sorry to hear about this tricia. what is your resting/standing HR now?

hey josh how are you doing now? What is your HR like? Are you able to walk around?

Really, not better at all, am in hospital again, feels like my entire body is burning. Maybe it is related to something else, but my heart rate is worse, not better...how are you doing? I felt I was getting better, im considering jumping back on a low dose, and seeing if I can taper around my heart rates reaction. Because unless I test for another underlying issue, this really came out of nowhere, it was worse than week 1, and I can only assume, I shouldn't have just came off as abruptly as I did.

Sorry for not posting for a while. I’m not improving any longer and definitely get worse with my period. I’ve read that this can happen with PoTS, which for all practical purposes I seem to have at this point. Yazmin, my heart rate is still about the same… though it has gone as high as 145 when standing still after walking. But I feel much worse again… my energy and stamina for tasks, especially anything requiring concentration, is worse than ever. Josh, I am really sorry to hear that you were back in the hospital again. Please let us know how it goes with retrying the propranolol. Btw… I have noticed that when I get angry or stressed and am rushing, I actually feel a little better afterwards. This is counterintuitive to me and must be related to increased adrenaline. Thought you might have some insight.

Any updates?

Hey Tricia, sorry I havent been back for a while, been doing my best to avoid stressing over things. I never ended up going back on any medication, and dont want to jinx things, but have been doing a lot better the last couple of weeks. My heart rate even seems to be getting better. Not sure, if its just time at play, but I did also find some research suggesting propranolol can deplete our natural CoQ10 so, I did start supplementing that, seems likes its beneficial for the heart and vascular system regardless, so could be worth checking out.

Hi. I'm glad to hear from you and really glad to hear that you're feeling better! I've been taking supplements for months now including 200 mg CoQ10. How much are you taking? Sadly I'm not improving. I fully meet criteria for PoTS at this point. I even had a tilt test. My level of fatigue has been crazy and raynauds symptoms too. My doctors are testing me for more serious disorders, because my blood pressure is dysregulated. I think best case scenario for me now is PoTS. I'm glad you posted because it makes me feel more hopeful to know that you're starting to improve. I think Yazmin left the site, but I hope she sees this too.

Im taking 350mg, but I think 200mg is probably plenty anyway. Im also doing meditation, breathing exercises, and getting in a bit of cardio every day regardless of where my heart rate gets to. Monitoring myself constantly, just seems to stress me out more, which doesn't help. Like yourself I still have my PoTS diagnosis officially, but am still undergoing tests for anything more complicated. (I had the works done during my last hospital visit). Fingers crossed though, I generally seem to be ok, and hope you will be too! I also had raynauds symptoms, but I havent noticed anything for a while now.

Hi Josh & Tricia, sorry I've been off this site, I've not been doing too well and started a new semester at university amongst it all. I have figured out that it is overactivity within the sympathetic nervous system which is ultimately causing all of these symptoms, hence why Josh's breathing/meditation is improving his symptoms. I started to get better but then had a stressful life event which made me get a whole lot worse. We just need to try to find ways to activate our parasympathetic nervous system/vagus nerve and we should hopefully get back to normal. The symptoms are very similar to PoTs but it isn't exactly because it's temporary and not because of a damaged nervous system, just a dysfunctioning one. It's unfortunate we have to go through this. Hope you both get better soon!

Have you checked your TSH and T4 or T3 levels? You had the exact same symptoms as me. After 3 months and multiple emergency room visits and doctors appointments, losing 30lbs, they finally found out I had Hyperthyroidism. It was giving me POTS symptoms and random tachycardia. For the longest time they thought I just had anxiety out of nowhere and just gave me propranolol and an antidepressant. I kept going back saying something was wrong its not just anxiety that came out of nowhere. Only when they started treating my hyperthyroidism did my heart rate when standing get better besides the propranolol. I'm now weaning myself off of Propranolol. I've lowered my dose from 10mg 2x a day to 2.5mg 2x a day. But seriously, get it checked out. My TSH was .002 and my T4 was really high above range. And my ferritin was super low. Hope you get it figured out. we have the exact same symptoms so it's worth a look.

hi yazmin. just wondering how you're doing now? i've not been on this site in almost a year. unfortunately i never got fully better and am now on two meds for pots! there was a case report published about a person who got pots after being vaccinated. i'm wondering if the vaccinations could have played a role in the onset of my symptoms along with the propranolol withdrawal. hope to hear from you!