Can Bisoprolol make anxiety worse.

[tom0985]

Hi all, just wondering whether bisoprolol has made anxiety worse or brought it on for any of you and if so, we’re you able to change to another beta blocker which helped?

[CDreamer]

In my none medical opinion - yes Beta Blockers can do cause and increase anxiety in some people. As a Psychotherapist the first thing I used to ask is - Are your taking Beta Blockers? They are also used to counter anxiety in some people as they are also Adrenaline Blockers. Trouble usually comes when you try to stop them, best titrated down very slowly.

If you look in the search box for coming off or stopping Beta Blockers you will find a few previous threads you might find useful.

Yes you can ask for other medications and I would do your research about which types of Beta Blockers may suit you or discuss with your doctor if another type of rate control would be better.

[tom0985 in reply to CDreamer]

Thanks. Since I’ve been on them in Nov last year my anxiety has increased most defientely. More noticeable right now due to current world events but I feel it hasn’t been right since I’ve been on them

[Teresa156]

Hi Tom,

I’m on Bisoprolol - since last September and yes, I found that initially they may have helped my anxiety, but I find that they don’t now.

I do wonder though if it is the worry of the Afib, that has made me feel worse ( I’m paroxysmal) but bisop has stopped my attacks (at the moment).

I have found though that by lowering the dose ( currently on approx 1.6 and have been for a few weeks) I feel a bit better and slightly happier overall, though the Afib is still a worry. I did try coming off in November and failed miserably, as CDreamer said, it can be hard…and it is. I am going to try again, if I can handle it, but might try switching to another beta blocker….I do wonder if it’s the very slow heart rate that effects our mood though….

Teresa

[tom0985 in reply to Teresa156]

Thanks Teresa. Have you tried any alternative beta blockers. Like you I am also have PAF since last Novemeber and just got my flecanide and Biso dose right to fend off episodes

[pip_pip in reply to tom0985]

Bisoprol, much as I have the difficulty, is perfect for keeping my af in control to some degree. I used to be on atenolol. Which played itself out. I swear by bisoprolol these days. If I have an episode I take 3.75mg instantly and 2 or 3 hours it settles. Otherwise I take 1.25 twice a day. For me I wouldn't consider any alternative. Having said that I had serious issues with digoxin, flecainide, and propofenone. Amioderone was also wonderful but played out for me these days. Phil

[Teresa156 in reply to tom0985]

Hi Tom,

I haven’t tried any other beta blockers, but if I had to, which I think I might need to in the near future, is try nebivalol. If you decide to try this ( as it gets good feedback on here as an alternative to bisop) get it at 2.5 mg or 5 mg and cut it to equivalent doses that coincide with Bisoprolol. You cannot get it at 1.25mg in the UK. I know this, as my GP prescribed this for me on a Friday evening and I couldn’t get it anywhere 😳

I tried atenolol for one day - The weekend I came off bisop, I panicked and needed to try another and as I couldn’t get the nebivalol, I called 111 and saw an out of hours GP. He also did not have a clue what to try me on ( GPs don’t seem to know in my experience sadly). They all say to ask a cardiologist 😳 which isn’t easy, as you probably know. I ended up on the equivalent of 5 mg Bisoprolol, (25 mg x2 atenolol) to take my heart rate down enough and it made tinnitus really bad within one day. Bisoprolol has already given me tinnitus unfortunately, which another reason I want to come off it!

Bisoprolol does stop my attacks though.

I would Say that if you do decide to try another beta blocker, switch from bisop straight over to it, under the direction of your GP. Coming off bisop and not going onto another beta blocker, made my anxiety go through the roof, but I think that’s the same for any beta blocker, I had only been on 2.5 mg Bisoprolol for two months and the adrenaline rush was quite shocking.

I have also started taking magnesium since Christmas- in two forms, magnesium taurate and magnesium glycenate. I also take other supplements. Get your blood tests all checked out to make sure you’re not deficient in anything. For example, I found I have a vitamin D deficiency in January, which also can affect the heart and cause anxiety, so am on a high dose of D3 at the moment. I also take other vitamins to try and help. Doctors don’t usually test for vitamin D….I had to ask specifically for it and glad I did.

I have sadly come to realise that I have to take a lot of initiative over this illness, as I can’t rely on GPs, or hospitals sadly. My GP doesn’t think I’m a priority and thinks I should just get on with it. I think covid and the state of the country certainly hasn’t helped.

Sorry for long post/rant! I hope it helps…..

Teresa

[Auriculaire in reply to Teresa156]

You may need to up your magnesium depending on your dose of vitD. Magnesium works in tandem with vit D . How much of each do you take?

[Teresa156 in reply to Auriculaire]

Hi Auriculaire,

Thankyou - I take 4000iu of Vitamin D3 ( got to take it for 3 months before I know it’s improved my score and I’ve taken it for 6 weeks) …though I do wonder if it’s enough. My GP was very laid back about it ( I wasn’t!) and I thought I’d need some loading dose or something but he didn’t suggest that, so it’s a guessing game until I have my blood test.

I’m taking 100 mg of magnesium taurate and 250mg of magnesium glycenate. The mg I’ve given here is the magnesium content, the taurate and glycenate elements are higher, but not sure of the doses as opposed to the magnesium. I take it throughout the day. Blood tests for magnesium levels show that I’m just over the minimum level, so I did read that I’m probably a bit deficient in magnesium too…as serum levels often don’t show the exact level in your body.

Thankyou,

Teresa

[Auriculaire in reply to Teresa156]

It depends how low your vit D was as to whether 4000iu a day will improve it much. 4000iu per day is supposed to be the safe upper level of tolerance so no GP is going to encourage a higher dose. It is rare for loading doses to be given in the UK unless there is some underlying pathology. My sister got loading doses when she had a parathyroid tumour as her vit D was very low. Loading doses are common here in France and I have had 400,000iu with no ill effects. Having said that the research shows that daily or weekly dosing is preferable to a loading dose given once or twice a year. The ideal is to have a loading dose to get the level into the sufficient range quickly and then daily doses high enough to keep it there. I think the dose of magnesium you are taking is probably enough for the dose of vit D as long as you eat plenty magnesium rich foods as well.

[Teresa156 in reply to Auriculaire]

Hi Auriculaire,Thankyou so much for taking the time to come back to me.

My vitamin d was 28 nmol/L .

It’s good to know I am doing the right thing with the magnesium. A couple of days a week I do also take an additional 1000ui …if Vit D3 from another lot I bought. A friend said I could take it every day in addition, but I was scared to. I might take 5000ui 3 Days a week 😊

Thankyou,

Teresa

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[Auriculaire in reply to Teresa156]

That level is very low indeed . It will probably take several months to get up to 75 nmol/l which is the beginning of the sufficient range (ignore the UK level of sufficiency of 50nmol/l which is a disgrace - among the lowest in Europe). I do not think taking 5000iu a day would harm at all. Also you have to take into consideration your weight. If you are at all overweight it will take either more vit D or much longer to get into the sufficient range. Women often need more than men because of increased body fat. I could not manage a level of 75 nmol on 3000iu a day whereas my husband was at a comfortable 120 nmol on the same dose. Frankly I think it is scandalous that UK docs are so laid back about rock bottom levels like yours. I took friends of ours from the UK down to our local lab to get their vit D tested several years ago. Her's was even lower than yours. She took the result back to her GP in England . He shrugged his shoulders and told her to buy some in Boot's. No advice on how much to take. The pharmacist was equally useless- suggested the recommended 400iu a day. You really need to aim for a minimum level of 100nmol/l.

[Teresa156 in reply to Auriculaire]

Hi Auriculaire,

Thankyou so much for coming back. I did wonder if it was very low and to be honest I was experiencing ( and still am) symptoms of deficiency, although it has improved….muscle twitches were one of them, all over my body and also aching joints..and inevitably, anxiety 😟

It doesn’t surprise me about the minimum level in the UK not being adequate. I’m not overweight, I’m in the middle of the acceptable weight chart for my age, height etc. I’m 11st and 5 ft 8 -1m71cm.

I’ve been becoming increasingly frustrated with my Gp lately. As I said, they’d only tested my levels because I asked. Carbamazepine which I have been taking for many years, is known To deplete vitamin d and it was just by chance I read that. I’m sure he would have known. It annoys me that I’ve never been tested before and j could have had this for years. I had bought myself some 4000ui Vitamin D3 in preparation for the diagnosis already as I suspected I was low and he barely looked at the pot!

So I do have an issue as well that I’m also on a drug that is leaching it out of my body, which doesn’t help.

I do have some 2000iu tabs….do you think it would be ok to take 6000iu a day until my blood test in April? Gp said if it reaches ‘acceptable’ levels, a maintenance dose would be 1000iu bug I very much doubt that will be enough. I was considering 3000iu ior more, depending on the level I reach.

If I do reach acceptable levels he will think that the 4000iu got me to it though. though I will stay quiet….

Thankyou,

Teresa

X

[Auriculaire in reply to Teresa156]

It would not surprise me in the slightest if your doctor did not know that carbamazapine leaches vit D . Most GPs know zilch about the effect of prescription drugs on vitamin and mineral depletion. Many regularly deny that side effects listed in the patient leaflet are affecting the patient. I suspect that this comes from a form of cognitive dissonance. They just cannot admit that many of the drugs they have been taught to prescribe are not only not benefiting their patients but might actually be poisoning some of them! Are you getting another blood test prescribed by the doctor? If so rather than wait you could take a blood test now ( you can get them online) to see how your present dose is working. If you are still insufficient you could up your dose. I think it is unlikely that a dose of 1000iu a day would be adequate for maintenance. You have to remember that sunbathing for 20mins exposing the whole body (bikini) in midday sun from April to mid Sept in UK can generate between 5-15,000iu depending on skin type. The paler you are the quicker you generate it. As we get older our skins make less and if you take a statin even less as the cholesterol substrate is not available. 1000iu is very little. I looked up Carbamazapine -it sounds a nasty drug!

[Teresa156 in reply to Auriculaire]

Hi Auriculaire,

Thankyou for coming back - i do like talking to you 😊 totally agree with everything you say, re dishing out drugs….mine certainly doesn’t like it if I say anything disagrees with me or I want to come off it.

Yes, carbamazepine is nasty. It was dished out to me by a neurologist when I was around 30 years old. I luckily take a very low dose - 200 mg x2 daily - some take four times that amount and combine it with other drugs too. I’d like to think that they’re a bit more selective these days in dishing it out, due to the vast interactions with many, many meds, which I’m now finding is a problem with Afib.

I’ve never had any side effects from this, it’s really well tolerated and it does the job, but at a price.

I’m seeing a neurologist soon about it and the problems with many heart meds I might need as I get older, but I’m wary of changing it, as alternatives all look unpleasant and I’ve got enough to deal with, with the Afib meds! 😳

I’ve got a form for mid April to re test my vitamin d levels. He said I can’t have one before 3 months, but what you’ve suggested is excellent - what a good idea as I’m half way through the 3 months now and yes, at least I’ll know if I’m on the right track. Thankyou 😊

I am quite pale skinned 😊 I don’t take a statin…I couldn’t anyway as Carbrmazepine interacts with them all 😳 I hope I never need one as I don’t know what will happen…

Thankyou for all your help,

Teresa

X

[tom0985 in reply to Teresa156]

Thanks for the response

[pip_pip]

Yes. Bisoprolol notorious for increasing anxiety. When I had to restart bisoprolol some years ago due to dismal re emergence of af my the first thing my GP said was "are you sure you want this with all the anxiety that goes with it". And it did and still does. HorriblePhil

[tom0985 in reply to pip_pip]

Thanks pip. Have you tried/were you offered alternative beta blockers?

[Teresa156 in reply to pip_pip]

Hi Pip_pip

It’s really interesting that your GP knew it to induce anxiety 😳 I don’t think many medics that I’ve dealt with realise that, or perhaps they do and just don’t say anything. It’s the only drug they seem to dish out at A&E.

My GP knows I suffer with anxiety, though has never suggested I switch to another beta blocker ( in fact he doesn’t even have a clue what to change me to either)

Like you found though, it is effective at stopping the attacks, for now.

Teresa

[Ppiman]

I don't think they would do that; in fact, they are given to reduce anxiety in people who react to high heart rates (not that they ever reduced mine). Feeling anxious is hard work, so I can sympathise. and, as you say, the world at this moment is enough to make anyone very uneasy.

Anxiety is such a complex phenomenon that to pin it down to one drug, I would guess, would be very difficult, I'd say, except by stopping the drug and seeing if you feel better (and even that isn't really proof, but at least it would help you). There are many beta-blockers, however, so you could try others, but their action is all rather similar. What might have happened is that you are somehow reacting to having a slightly lower blood pressure, perhaps?

Steve

[pip_pip in reply to Ppiman]

No. Anxiety increases or is even triggered by Bisoprolol. Not with everyone of course. But can do. Phil

[Giorgos1973]

good evening indeed bisoprolol is a strange pill I was taking it for a year 2.5 in the morning and at night I had something like panic attacks I did not have before and sleep disorders, now I'm not sure if the pill does it or because we have to take it the pill, at the moment I'm on atenolol 25 I asked the doctor for a change and he did it but he told me these pills are all the same but i'm just different in sleep i sleep a little better with atenolol i take it before bed, and finally and something else I noticed in these pills is the feeling of pessimism, I hope I helped

[tom0985 in reply to Giorgos1973]

Thank you

[tom0985]

Thanks all for your comments. Is there alternatives that people have taken as a beta blocker instead of Bisoprolol which is designed to work the same as Bisoprolol for AF?

[Teresa156]

Hi Tom,

I keep reading here that nebivalol works for many and is well tolerated. It is a more expensive drug, which is why Drs don’t generally pres find it to us and why Bisoprol is handed out to so many.

It’s one I might try next as I don’t want to carry on with bisop. To be honest, I’d prefer not to take any, but it’s probably not quite that simple, with Afib 😳

Teresa

[tom0985 in reply to Teresa156]

Thanks Teresa