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1298588 tn?1330318981

Do you think that I should take a beta blocker?

As many of you in this community are well aware, I have been suffering from troublesome episodes of sinus tachycardia for quite some time. At the onset of these incidents, I thought for certain that something was seriously wrong with my heart, but after submitting to numerous tests, it has been determined that my heart is, in fact, healthy, and that my symptoms are caused by anxiety. In order to relieve them, my doctor prescribed me an SSRI, Lexapro, which has greatly reduced their frequency. However, I do continue to experience an extremely high heart rate in certain situations, and I would love to be able to prevent it. Even though there is nothing physically the matter with my heart, I remain convinced that if it accelerates to a great enough extent, it could be severely damaged or stop. Therefore, I have asked my doctor for a beta blocker. She refused, insisting that the SSRI was a much better choice. I asked her to refer me to a cardiologist, who was also partial to the SSRI but said that he would give me a beta blocker if I was truly unable to control my tachycardia. As a result, I am currently debating whether or not to take him up on the offer.

On the one hand, my tachycardia only happens in specific circumstances. For some reason, I get very nervous when walking outside, especially away from main roads, and my heart rate is always sky high in such situations. To a lesser extent, I often feel these symptoms on buses or trains (and airplanes, no doubt, if ever I am brave enough to get on one!). However, these are the only occasions when I have had the tachycardia for a long time. I don’t know if it is worth putting up with the side effects and risks of a medication like a beta blocker in order to prevent these relatively infrequent incidents. I am also afraid that if I started taking a beta blocker, my heart rate would drop too low the rest of the time, which I know can be every bit as dangerous as when it is going too fast. When I am relaxed, it is often in the 50s already, and surely a beta blocker could lower it further still.

On the other hand, I do feel that my high heart rates are extreme enough to hurt my heart and possibly even kill me. When I am walking and panicking, my heart rate will often be 150-160 for an hour or more and even can go into the 170s. On rare occasions, I have hit the 180s. The highest number I have ever seen on my heart monitor watch is 187. I am always afraid that it will go even higher, and that will be the end of my life. I’ve never been able to get a clear answer on the nature of the dangers of a high heart rate, and I don’t want to wait to find out until it’s too late.

So, given my history and situation, what do you guys think? Would you take a beta blocker if you were in my place?

Thanks in advance :)
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1298588 tn?1330318981
Oh, and I've lost three pounds since starting the medication. I'm not complaining about that, either :)
Helpful - 0
1298588 tn?1330318981
Yes, I was extremely apprehensive about taking Lexapro; in fact, I was opposed for years to taking any kind of medication whatsoever.  I was so afraid that medication would make me feel less like myself, and that the side effects would be worse than the benefit. It was only when my anxiety got so bad that I was unable to leave my house or do anything else that I enjoyed that I decided I needed to change the way I thought. At that time, I didn't feel much like myself anyway, with my constantly panicking mind, and I figured that the effect of my anxiety on my body couldn't possibly be any worse than any side effects I might experience from medication. So, I decided to take my doctor's advice and give meds a try. And yes, I am SO glad I did. For the first time in years, I feel like I can do things without worrying about the effect that the activity would have on my heart, or constantly feeling obliged to check my pulse even if I didn't feel unwell. For the first time in so long, my pulse rate is not always at the back -- or the front -- of my mind. It is indeed wonderful to be able to enjoy life again. I should have done this ages ago!

As I say, it's not perfect; I still do have periodic episodes of panic, but they are just that -- periodic. They are no longer my whole life. And it's great.

Thank you so much for your kind wishes. I hope that I can inspire other people to believe in life after anxiety. :)
Helpful - 0
Avatar universal
I am so glad you went for the Lexapro!  I seem to recall that you were a little apprehensive about trying it, but isn't it wonderful to be able to look outside yourself a bit and enjoy the things that life offers, rather than just listening to your heart?

Continuing good wishes for you, because you really are setting a fine example for how to face this problem.
Helpful - 0
1298588 tn?1330318981
Lexapro has certainly brought me success. Before I started taking it, my entire life basically revolved around anxiety and what it was doing to my heart rhythm. I was constantly obsessing about my heart -- how fast it was going, whether it was skipping beats, and on and on. I would have full-blown panic attacks, with my heart racing in the 160s-180s, on a daily basis. I thought that I had reached the end of my life more times than I can count. For several months, I became so anxious that I couldn't leave my house. It was this onset of agoraphobia that prompted me to try an SSRI at the suggestion of my doctor. I started on 10 mg of Lexapro and didn't really feel much different, even after a month of treatment. So my doctor increased my dosage to 20 mg, and that's when things started to turn around. It took time, about 6 weeks in total, but I feel sooo much better now. I still have anxious thoughts, but they don't take over my life. I am able to deal with them; rather than infecting my entire mind, they are contained in a small corner of brain space. Most notably, I just don't feel as nervous anymore. Situations which would previously send me into paroxysms of panic are now greeted with almost complete calm. The jittery feeling that I would experience on an almost daily basis is almost completely subdued. The panic attacks I do suffer are a million times less frequent, and I just feel so much more relaxed.

Surprisingly enough, I have always been a good sleeper -- my bed is the one place where I always felt very calm -- so I can't really say that the meds have improved my sleep. However, if you find that you have trouble sleeping due to anxiety, I'm certain that they would alleviate such a symptom for you. It's the same with focus: I've never had too much trouble setting my mind to a specific task, so I don't see as much of a difference in that area either, but if this is a problem for you, there's every chance that Lexapro will help. It's a great medication. if you're experiencing anxiety of any kind, I would definitely recommend it. Good luck!!
Helpful - 0
Avatar universal
I was glad to read that the Lexapro brought you some success.  Can you tell us a littleabout  how it improved things for you?  Did it slow down racing thoughts? Allow you to focus?  Better sleep?

I'm interested in the other ones -- the SSNRI meds -- because I'm slated to start taking them soon and am hoping they will improve my problems with constant PVCs.
  
Helpful - 0
Avatar universal
In the situations you describe, when fear causes your heart to race (and you know that fear is the cause), that a little tablet of fast-acting ativan would do you a world of good.  This stuff, as you probably know, gets into your system in 15 minutes or so, and generally does not leave you with a hangover.

You say, "...I do feel that my high heart rates are extreme enough to hurt my heart and possibly even kill me."

This idea is partly related to the fact that you have not studied human physiology and is also partly due to some kind of idée fixe--an irrational obsession.  You are young, without family history, and your heart is not going to stop or be damaged by frequent contractions even over a prolonged period of time.

There is no blame in your fear, because these things are by their very nature not rational, but it is something you need to talk with your current therapist about, because it is a frequent problem for you and needs to be addressed.  
Helpful - 0
1298588 tn?1330318981
This all makes alot of sense, guys ...

I guess I can legitimately conclude that taking a beta blocker on a daily basis is not the right course of action for me at this point. However, I do like the idea of taking a small dose as needed. I didn't even know that was an option! I think that it would set my mind at ease to have a well-tested method of slowing my heart when it races during a panic attack, and would therefore prevent such attacks from occurring in the first place. I will ask my cardiologist about doing this.

I am still worried about the beta blocker slowing the overall pace of the heart, because my heart rate can get very slow when I am calm. Last night it was down to 40, and didn't go up until I started freaking out from having such a low heartbeat, lol. I guess panic can be a good thing sometimes!
Helpful - 0
4186692 tn?1350823288
I hated having to take a beta blocker-Metoprolol. It made me feel worse than my WPW-I was used to that.
On the beta blocker I had very low energy for most of the day and my heart felt heavy. I had a few other side effects including nausea.

Last month I had an episode of fast irregular heartbeat that lasted around 4 hours with a heartrate mostly welll over 200 bpm and sometimes over 300bpm, with no subsequent damage to my heart.
I also have a very healthy heart.

Last week I had an ablation for WPW and was allowed to stop Metoprolol straight after. I am really happy to be off it and would rather have a few irregular beats than a lifetime of Metoprolol.

Anxiety certainly makes everything seem worse.
I find meditation type breathing helps me when I'm anxious. I learnt how to meditate some years back and used to practise daily. I found it very calming.
Choosing things to do  that distract me from my worries and physical feelings and that make me happy helps immensely.
Sharing on this forum and reading about others experiences helps me to be less anxious too. Especially when they comment back to to me -that is magic.
Helpful - 0
1423357 tn?1511085442
I'll abridge what I've said before:
Paxil (a miracle SSRI for my wife), Alprazolam, and specialized psychological counciling in panic disorder will put you on the path to a cure.
Helpful - 0
1124887 tn?1313754891
I would consider a beta blocker, but not as daily medication. I completely agree that it's not needed to take every day, but if you had, say, a couple of pills of propranolol in your pocket, you could be sure that if you had a debilitating panic attack or other tachycardia event, you could take half a pill or so to stop the event. It often helps.

Your heart is fine, so it's not needed, but it all depends on how you feel. In my case, the side effects are almost absent, so it has helped me a lot.
Helpful - 0
Avatar universal
Beta blockers can make a lot of people feel pretty lousy.  Also, if you resting HR is in the 50s already when you aren't anxious, I wouldn't be keen on trying a BB.  I'm not sure what your BP is, but if you tend to be on the low side already, it's just going to lower it even further.  It sounds like you would do better addressing the anxiety as a whole and not just the one symptom of tachycardia.  
Helpful - 0
Avatar universal
If I were in your situation I would "not" take a BB for the following reasons:

1) BB can have undesirable side-effects.
2) BB have a tendency to lower HR and BP.  If you have a low resting HR this could indeed be a problem.
3) Your PCP AND cardiologist do not think taking a BB is a good idea.  Your doctors have training and know best.
4) The HR's you describe are not dangerous and you mention they are anxiety-related.  Something like Xanax to take in these situations would likely be much more beneficial, with less side-effects, than a BB.

Just my two-cents.
Helpful - 0
Avatar universal
you need to firstly relax...your heart is a great machine and having trained alongside olympic athletes who have trained with hr's 180+ for hours. Tour de france cyclists sit on hr's above what you fear for hours while dehydrating and all sort of extreme physical demands.

Your heart if structurally fine (which you say it is) won't just break.

You are a prisoner in your own body, you need to see someone who has experience in dealing with this.

This fear you seem to be talking about is holding you back, if the doctors say your heart is fine then it is fine. Mine have said that my heart is fine apart form some electrical issues and i trust them. They know what they are talking about and we all can do our due diligence and seek a second opinion and even use the internet to research such things.

Perhaps look at joining a support group and trying to combat your issues.

I know people who play musical instruments and take the occasional beta blocker to calm their nerves on an event night. I myself use to be scared of speaking up in public and standing up in front of people and it affected me until i got sick of it, signed up to a stand up comedy class and just did it. I won't hold myself back and neither should you

in regards to beta blockers i believe they put a limit on how high your hr will go and not the other way round, but if you are physically fit and have a low resting heart rate i would stay clear and try to work out a none chemically induced way to combat your anxiety.
Helpful - 0
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