Hello again. Questions with AF medic... - Atrial Fibrillati...

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Hello again. Questions with AF medications

gbn_ profile image
gbn_
32 Replies

Hi. Need to ask this question on current medications. Furosemide (water pill) 40 mg. once per day. Metoprolol (heart pill) 75 mg. twice a day. And Xarelto (blood thinner) 20 mg. once per day. Has anyone experienced any type of anxiety while on these types of AF medications? I occasionally suffer with anxiety, and I guess with this latest health problem, this hasn't helped me too much with it. I have read though that beta-blockers, such as what I'm currently taking (Metoprolol) and others are actually sometimes prescribed for people with anxiety. Has it actually helped anyone with this, or has anxiety possibly stayed the same for those that suffer from it and maybe even for it to get worse? As mention in previous post, the Metoprolol seems to be causing increased sleep issues, and the Furosemide seems to be causing much "drying out" with sinuses at night which increases anxiety for me.

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32 Replies
mjames1 profile image
mjames1

Yes, beta blockers like Metoprolol can lessen anxiety but sometimes they can also increase anxiety. That was the case with me, so I was switched to a calcium channel blocker, Diltiazem. It does essentially the same thing as Metoprolol, but I tolerated it a lot better. Sometimes it's just trial and error with the side effects of drugs. If switching to Diltiazem doesn't help, you could try a different thinner, etc.

Jim

.

gbn_ profile image
gbn_ in reply to mjames1

Hi mjames1. Thanks much for the reply. I'll check into diltiazem and read up on it, I just hate the thought of trying different types of medications only because of needing to be on them in the first place. The trial and error part of it brings on it's own anxiety issues.

mav7 profile image
mav7

mayoclinichealthsystem.org/...

I have been on .50mg Metoprolol for 2 plus years and main side effects are sleep issues and fatigue. But it does control my heart rate which is most important. And no problem with kidney, liver, or thyroid function.

Beta blockers may cause anxiety. From your past posts, I know anxiety is a primary concern for you. Check the above link and search for other info. Also discuss with your doctor your concerns about anxiety and side effects of your medications.

Best to You !

gbn_ profile image
gbn_ in reply to mav7

Thank you mav7. Have you done anything about the sleep issues, or are you just putting up with it? Is it 50 mg you are taking, or .50(1/2 of a mg.) . And, are you only taking your dose just once a day?

mav7 profile image
mav7 in reply to gbn_

I take .50mg once a day.

At one point, my cardiologist increased to .75 once a day but the difference in heart rate was minimal (70's - low 80's) and I asked to go back to .50mg due to less sleep issues.

My primary care doctor offered a sleep aid prescription (can't recall the name) but I chose not. I try to relax before bedtime, meditate, and other actions. It is not the worse sleep problems but could be better. Main issue at present is waking after 3-4 hours and not being able to return to sleep right away. Not every night, but much too often.

Like anxiety, it can be a mental issue as well as Metoprolol. So basically, I have chosen to "put up with it" in lieu of going the sleep aid prescription route. Should note aging can cause sleep issues.

You mentioned you also take Furosemide. Note Dilitiazem "may" cause fluid retention.

gbn_ profile image
gbn_ in reply to mav7

mav7, seems like I'm having similar issues, waking after 3 or 4 hours and not being able to get back to sleep right away. Forgot to mention that I take melatonin before bed, helps with more rapid sleep, but still wake up as you. I too don't want to take any kind of prescription sleeping pill. Interesting also in that I was initially prescribed 50 mgs. of Metaprolol and was bumped up to 75 mgs. (both twice a day), and it was increased only because of elevated heart rate with first doctor visit, but I tried to explain about probable "white coat syndrome", so maybe on next visit I'll be a bit more persistant and mention about dropping the dose back to where it was to see if that helps first.

mav7 profile image
mav7 in reply to gbn_

Do discuss with your doctor about "white coat syndrome". I have the same including elevated blood pressure during doctor's visits.

May I also recommend do some research on Melatonin and its relation to other medications including anticoagulants. See below.

Based on your statements, it seems anxiety may be the main culprit in your sleep issues. Best to You !

mayoclinic.org/drugs-supple....

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to mav7

Hi

My Diltiazem 120mg doesn't lead to water retention.

Remind yourself that you are getting into a routine by waling at 2am every morning. So I knew I was anxious as well, marriage broke up. Dr gave me a special pill which specifically stopped me waking. After about 9 months I went to Italy, left pills at home and never needed them again. I took 1 when tired. I could have had up to 5.

So getting out of a routine pattern is best.

cheri JOY. 74. (NZ)

bean_counter27 profile image
bean_counter27 in reply to mav7

I've not slept well for years but recent years seem to have taken my poor sleeping to another level. I generally don't have any problem initially going to sleep but really struggle to sleep for more than 4 hours. Then I go to the toilet and return to bed. Sometimes I go back to sleep reasonably quickly, other times I struggle. When I go back to sleep it's usually only for a couple of hours and when I wake again I no longer try to get back to sleep again. I could stay in bed for another 2 hours and not fall back asleep.

I've tried melatonin (recommended by my GP), good sleep routines etc without much success. Up until now I'd attributed my poorer sleeping to getting older (needing less sleep) and prostate issues.

However, after reading your post I now suspect Metoprolol, which I started about 4 years ago, might be a major factor. Are there alternatives to Metoprolol for rate control that don't cause sleep issues? I use it with Flecainide twice a day. I will raise with my cardiologist (GP unlikely to change my heart meds as they were prescribed by cardiologist) when I see him for annual checkup in a few months.

Thanks for bringing it to my attention.

mav7 profile image
mav7 in reply to bean_counter27

Best to discuss with your GP. The key is heart rate control. Perhaps take Metoprolol in the morning or twice a day in reduced doses.

Dilitiazem may be an alternative. Caused my heart rate to go too low and I was concerned about possible fluid retention . Ask your GP.

Your sleep pattern mirrors mine. There is a tradeoff with rate control vs sound sleep we have to battle.

Best to You. Let me know if you find an alternative.

bean_counter27 profile image
bean_counter27 in reply to mav7

Thanks. Prescribed Metoprolol and Flecainide twice daily so currently take them at 8am and 8pm. Might try to bring forward a few hours as awake at 6am 99% of time.

Ironically poor sleep is probably more problematic for my health than my PAF - given both my CHA2DS2-VASc and heart calcium scores are both 0.

BaileyC57 profile image
BaileyC57 in reply to bean_counter27

One of my friends is on Flecainide and Diltiazem instead of Metoprolol! I just got off Metoprolol and takin Diltiazem and I feel a lot better!

gbn_ profile image
gbn_ in reply to bean_counter27

Hi bean_counter27. Your sleep situation is almost like mine. I actually do take melatonin. I take usually a 2.5 mg. lozenger that has a small amount of the active form of b-6 in it. But I'll wake up about 3 or 4 hours later for the bathroom, and this is where it is usually sometimes tough to get back to sleep. Sometimes it's from anxiety going through this almost constantly, sometimes it's from nasal stuffiness, so I'll get out of bed and just trudge from room to room usually, sometimes I'll go upstairs to the 3rd. floor just to move around a bit, all this usually lasts from 1/2 to 1 hour, upon which if I'm settled down enough I'll go back to bed usually taking another 2.5 mg. melatonin, it usually works for me but I find that I wake up late in the day. And now, yet another problem just found out from the most recent blood test which I'll be posting about. Could these medications we're all on cause any type of kidney issues??

bean_counter27 profile image
bean_counter27 in reply to gbn_

My GP suggested 5 to 10mg melatonin when I told him about my sleep issues. I started with 5mg and eventually upped to 10mg. Not sure it does a great deal for my sleep but it's good for other reasons so I take it anyway. Have just changed my evening Magnesium supplement (recommended by cardiologist twice a day) from Magnesium Aspartate to Magnesium Taurate. The latter is supposed to help with relaxation/sleep but early days.

I don't have any kidney problems but you are taking some medications that I'm not. I suspect Furosemide will impact on your kidneys given that you have described it as a "water" pill.

gbn_ profile image
gbn_ in reply to bean_counter27

I also take magnesium, it is the glycinate form of it, I take it twice a day. This new kidney news has me a bit stressed out, I'll read up on it more.

Ppiman profile image
Ppiman

Many years ago in a study, some people's anxiety was shown to exist as they were, even almost subconsciously, overly aware of their heartbeat. For those, a small dose of a beta blocker such as Inderal (propanolol) was shown to calm their nerves; but betablockers have no direct anxiolytic effect at all and I am rather dubious of their actual effectiveness, myself.

The only true anxiolytic drugs, and even these are not especially effective, are benzodiazepines such as alprazolam or diazepam. These aren't prescribed without good cause, however, as up to perhaps a third of people taking them regularly struggle with side effects and dependency issues. For occasional use, they seem safe and useful.

Steve

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to Ppiman

Hi

I read a book or romance and the girl popped a BB before she went out at night to keep her from her anxiety.

cheri JOY

Ppiman profile image
Ppiman in reply to JOY2THEWORLD49

They have developed a reputation that misrepresents reality. I don't think they work for many people (or only as a placebo). I am sure some people do feel stressed when they become aware of their heartbeat and the BB might help those. I have heard that stage performers and musicians find them useful, for example.

Steve

JOY2THEWORLD49 profile image
JOY2THEWORLD49

Hi

Have you AF?

Metoprolol is banned for me. Your dosage is too high! Even on 27mg I experienced breathlessness, fatigued and 24hr H.monitor showed u pauses.

Bisoprolol is recommended for those with AF.

They are both beta-blockers and stop adrenaline from entering the heart. I read a book which read that the main character was taking a BB to stop her anxiety and she did not have AF. Take your BB at night. BP rises early morning.

I know someone taking 99mg. But no one else. BBs do not control my H/Rate but they do control my BP.

I take CCB Calcium Channel Blocker to control my rapid H/R. Now down to 60s Day and 47 Night. On Metoprolol it was 185bpm.!

There are Ace Blockers also. They give me a cough.

Frusemide will strip you of magnesium, potassium, etc and water so keeo hydrated. Add banana for breakfast, nuts, seeds etc. Have plenty of water.

Look for the brighter things of lfe.

cheri JOY 74. (NZ).

gbn_ profile image
gbn_ in reply to JOY2THEWORLD49

Hi JOY2THEWORLD49. I'm taking Magnesium Glycinate along with eating vegetables and fruit for the potassium loss. They restricted water and total liquid intake to no more than 64 ozs. of liquids a day, but I'm trying to take in a bit more than that, I feel like I'm just too dried out, which honestly carries it's own risks.

MarinaT profile image
MarinaT

Hi. I have taken furusomide for some years now. I take it at 8am. When the effects have worn off, I then drink as much as I can for the rest of the day. Hope this helps!

gbn_ profile image
gbn_ in reply to MarinaT

Hi MarinaT. Are you taking your ferosemide with any food, or just water in the morning? Also, the doctors want me to take in less water during the day. They had me down to 50 ozs. of total liquids, but after me complaining about dryness, they increased my allowence to 64 ozs. I still don't think it's enough liquid for me, the dryness of the weather now along with having the heat on in the house is causing typical dry conditions. Did they have you take in less liquids also like me??

MarinaT profile image
MarinaT in reply to gbn_

Hi. No, I am not restricted on fluid intake. I have AF so dehydration makes it worse. Have you tried a humidifier in your bedroom? This may help with dryness.

Foulplay profile image
Foulplay

I was on metoprolol 50mg 2x a day and had fainting so they cut it back to one time a day. I was on furosemide which gave me anxiety and made me feel a little crazy. I also have anxiety issues. They switched me to toursemide ( may not be spelled right) and the anxiety was less but still there. It may be the furosemide not the metoprolol .

gbn_ profile image
gbn_ in reply to Foulplay

Hi Foulplay. Thank you for the reply. Seems like I may very well be on a long road with trial and error until a better combination can be reached, I just hope the doctor listens to me, I dislike "butting heads" with them, but sometimes necessary to do.

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to gbn_

Hi

Do you have ankle swelling or wrist swelling? Hence the Frusermide.

But I have read that it can bring down BP.

My Mum was on it. I was briefly but on the Tucan Bus (no air conditioning I began to get swelling in my wrists as well as ankles. Long hot travelling times.

cheri JOY

gbn_ profile image
gbn_ in reply to JOY2THEWORLD49

cheri JOY, I have AF. Doctors said swelling (left calf, ankle, and foot) was due to heart failure from AF. Started in June of this year, when symptoms started thought it was probably due to a DVT (blood clot). After going to Emargency room in hospital after symptoms did not dissapate (didn't get better but didn't get worse either) tests showed AF and not blood clot.

BaileyC57 profile image
BaileyC57

I am on Metoprolol and have anxiety, I have been on it for 3yrs!

gbn_ profile image
gbn_ in reply to BaileyC57

Hi BaileyC57. Did you ever try to get the Metoprolol changed to something else??

BaileyC57 profile image
BaileyC57 in reply to gbn_

Yes , this week I seen my Heart Doctor and he took me off from Metropolo and put me on DILTIAZEM, so I will see how this works! My heart rate is good and blood pressure good but I do have cats in my eyes and in Feburary I am going to get my eyes done, maybe my head will inprove!

BaileyC57 profile image
BaileyC57 in reply to gbn_

My anxiety is a little better , see if it improves!

gbn_ profile image
gbn_ in reply to BaileyC57

Hi BaileyC57. Glad to hear it's better for you. I'm starting to think that most all of these medications have to some degree some side effects that just cannot be escaped from. It's just going through the process of the usual trial-and- error to see what works best for the patient. I wish I didn't have to take really anything for my current situation of AF along with diastolic heart failure caused by it, (which is different from the systolic type), but, I'll continue to try and "tweek" the protocol to see which medications are best suited for me. Also, I don't know if I mentioned this before or not, but, I'm not a big fan of "procedures", I'd much rather try the medications route instead only because there is still some risk factor involved. Not all procedures work 100% of the time. It's just a personal choice of mine. Also, I'd much rather go the "natural route" with all of this, but I know there is much controversy with that subject and most doctors absolutely just refuse to hear anything of it, at all. It's just unfortunate that if anything "natural" is introduced now it would also now cause a possible side effect with the current medications being taken now by me (Furosemide, Metoprolol, and Xarelto).

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