Hi there. I posted a week or so ago about Bisoprolol. I’ve been on it for 2 months (1.25 mg) following my first SVT and hospital admission. Prior to that I had no known heart problems and was fit and healthy 46 (exercise 3/4 times per week). I was extremely stressed and anxious leading up to the SVT (could this have caused it)? And I had lots of palpitations, high HR and ectopic beats (which I have been told are benign). I’ve had tests done and been told my heart is structurally good (EF 60%) . The cardiologist has told me to come off the Bisoprolol at the end of Feb. Anyway, I thought that I would start to taper the Bisoprolol very slowly as I’m so scared of my HR increasing which makes me feel so anxious, which increases my HR more so it’s a vicious circle.
My aim was to take 3/4 of the tablet for 2 weeks, then half for 2 weeks and then 1/4 for 2 weeks in the hope that my body wouldn’t notice the drop.
So yesterday morning I took 3/4 of the tablet at the normal time. I felt good all day and exercised no problems but noticed during the evening I was feeling anxious and my HR was a little higher (resting high 70s) and I was very conscious of my heart beating.
Would dropping the dose (1.25mg) by a quarter really effect the HR that much or is this just all in my head? I’m scared that I will never be able to get off of it.
Any weaning off advice would be very gratefully appreciated. Thank you so much x
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I would contact either your Doctor or Consultant about how best to come of this medication or you could contact the BHF Nurses
I have just been told to stop a different med I am on after 16 months and basically no tapering of just stop taking it but I did get this information from my Doctor as well as Consultant what they wanted me to do
I hope you can get to talk to someone who will be medically trained to tell you the safest way to this x
Thank you for your reply. I should’ve said that the cardiologist told me to reduce to half a dose for 2 weeks and then come off. But knowing how anxious I get I think it would be beneficial to taper more slowly? Xx
The medication I have stopped today is one I have been on 16 months it is a blood thinning one and I have to be honest my anxiety is going through the roof stopping it even though I am glad to be getting rid of another med
But as much as I am anxious I just think this is what they told me to do so they should know hopefully what they are doing so I better get on with it despite feeling so anxious
But if I wanted to do it different I would still ask my Doctor if it was ok x
It’s so hard to get anxiety under control especially when it comes to medicines. I’m scared to be off the beta blocker but also scared to take it for much longer. Hope it goes well for you. Thanks for replying, it really helps x
I suffer with severe anxiety and have done years and two of the major anxieties are health and here I am having now had 3 heart attacks and Bypasses and the other is a medication fear which now I am on a cocktail of meds which both have just about sent me over the top regarding the anxiety part of it all so I really do know how you feel
So know you are not alone with this but we can do it we somehow took them we can come of them to x
Going from 1.25mg to zero after two months should not be an issue, firstly 1.25mg is quite a small dose, in fact the smallest you can be on, and as you have been on it a relatively short time, any rebound HR would I think be minimal. However I am not your doctor or you, everyone is different.
No harm in tapering at all, bar the cutting of Bisoprolol pills, they are tiny and not easy to get an accurate cut, so even if the pills are evenly filled with the active ingredient you could be getting anywhere from 0.5 to 0.9 I would say, its a wide range given the small dose you are on.
I've come down from 10mg to 5mg in two 2.5mg steps with zero issues, 10 to 7.5mg was in one go, no problems, the 7.5mg to 5mg I did taper for a week or so, but cutting the pills is a pain so gave up and I was fine.
In short maybe go to 0.65 for a week, and then off them, I doubt you have completely down regulated your HR by a huge amount so any rebound would be small.
But before you do maybe just check with your cardiologist or GP, they should be the ones advising, I can only talk about my personal experiences.
Thank you so much for your reply. I do think that it’s my own anxiety causing the HR to increase, as you say 1.25mg is a small dose so shouldn’t have that much of an effect. I just want off of these pills but at the same time I’m scared of having another SVT so it’s a catch 22 situation for me.
Part of me thinks sod it, just stay on them forever as they control the SVT and somewhat lower the HR and blood pressure (which spikes when I’m anxious). Anyway I’m rambling 😊
Thanks for taking the time to reply. It helps so much x
No anxiety feelings outside of normal worries, I think the thought of anxiety is probably worse than the tapering. Bisoprolol is cardio specific in that it targets adrenaline acting on the heart specifically, so shouldn't increase anxiety when stopped.
As an aside I am certified coach and therapist in NLP now and recognise anxiety for what it is, usually an irrational negative thought, your body unfortunately doesn't know the difference between a thought and reality and produces the same chemicals (adrenaline, cortisone etc) in reaction. I would think in your case its the thought that is producing the raised heart rate and anxiety and not the "lack of" Beta Blocker, it's such a small dose.
Try and practice some calming thoughts when you feel anxious, picture your favourite holiday place or a previous time when you were really relaxed and calm, and make the picture bright and vivid as if you were there, and try and see what you saw at that time, feel the emotions you felt, hear the sounds and breathe slowly and calmly for a short time. I use this technique with my clients and make them anchor it to themselves so they can use it at any time, very effective and quick!
That's such great advice. I think you are right in that it's my anxiety which is worse. I can't see that reducing by 1/4 of a pill would make such a difference. My brain is definitely controlling the situation. I will try your method of practicing calming thoughts and picturing a favourite holiday, I've never tried this before. Thank you again for taking the time to help me. I truly appreciate it xx
I would start tapering off when he tells you to stop and he should give you a procedure.
The one that normally works is to lose a day a week. Week 1 miss monday, week 2 miss monday and thursday, week 3 miss monday, wednesday and saturday and continue until week 6. You can taper even slower by losing a 1/2 or 1/4 tablet each week as I did with my benzos.
Thank you for replying. The cardiologist said 1/2 a tablet a day for 2 weeks but from what I've read (horror stories) this might be too big a reduction. I've not heard about tapering the way you suggested but might be a good one to try actually. I'm so scared of coming off this drug as I'm so sensitive to what my heart is doing and feeling it beat hard makes me super anxious which then makes the whole situation worse. I've been reassured my heart is structurally 'normal' but don't know why I would be getting SVTs and palpitations when I've never had it before if nothing is wrong 😔 Thanks again i really appreciate the advice x
As I said this was a technique for weaning off benzos and it is a theory, the actual time I took getting off 1mg of lorazepam was almost 18months. So don't be afraid to go back a little if you feel you need it. The good thing about both these drugs is they are quick acting. Be kind to yourself when you are doing it.
One thing you mentioned was you had only been on the a few weeks, so maybe it will be easier, I was on the benzos for 6 months.
Good luck, anyway and don't worry, much is in your imagination. There are two ways imagination can go...to anxiety...or creativity, so try to use it for the latter.
I was on 1.25 for a while, was told to stop for a cardiac stress test 4 months after my HA and suffered no issues just stopping completely, but felt better as resting heart rate increased by about 4 bpm and I felt less tired. No anxiety
Absolutely. I suffer with anxiety disorder and hearing other peoples experiences is so reassuring to me. And also just to know that others have gone through the same thing. I feel quite alone sometimes and connecting with others helps so much. Of course I would take the advice of my dr but they having not gone through it themselves, they don’t always know best. Thanks xxx
I went from 3.75mg to 2.5mg to 1.25mg in quick succession with no issues whatsoever. The 1.25mg pill is very small, so how you cut it to taper the dose accurately I wouldn't know.
It is interesting to note your heart rate. Mine is 55 on 1.25mg and I'm almost 70 years old. I do wonder whether there is more effect from the stress / worry involved in coming off the medication than the effect of reducing the medication itself. For that reason alone, I would contact the medical team and discuss how you should stop taking it.
I also was on 1.25 bisoprolol and had ablation in October 2021, the arrhythmia nurse told me to stop taking it 4 weeks ago and she said it would be ok to stop immediately as it is such a low dose. I have to be honest other than my resting heart rate rising by about 3bpm (I have very low heart rate anyway) I haven’t noticed any difference
Thank you for replying. How did you ablation go? Was it a success? Glad to hear that you didn’t have any problems coming off the 1.25 dose. Did you feel any anxiety at all? I have anxiety disorder and sometimes hard to tell what’s causing my HR to go up xx
Hi I think the ablation went ok touch wood, other than some etopics I haven’t had any AF. I also do suffer from anxiety and have quite a stressful job which doesn’t help but I didn’t notice any difference when I stopped taking the bisoprolol other than a slight rise in resting heart rate and when I go for walk my heart goes at a higher rate when going up hill etc as the limiting factor of the bisoprolol is no longer there
Coming off as per the cardiologist shouldn’t be a problem. Remember a lot of people just write on blogs about the bad experiences they have had, those that have had no issues rarely record that. The only experience I’ve had coming off a drug was on stopping my clopidogrel and that was done cold turkey with no issues.Having said all of that you need to feel comfortable doing so so I’d suggest the a call to your cardiac team or gp being the best option and explain your feelings to them.
I had svt. As it got worse I was put on 1.25mg of Bisoprolol. Prior to my ablation I was told to stop. I just stopped, no cutting down. All ok. I had an ablation and haven’t had any episodes since.For interest, when I had an svt episode I found that I could reset my hr by lying on my back and relaxing. It would reset within about a minute. Might be worth trying.
Thank you so much for replying. I will definitely try lying on back and relaxing if it happens again. So glad your ablation worked. Did you have any feelings of anxiety when you stopped the bisoprolol or notice a fast HR? xx
Originally I only had episodes of svt infrequently (say about every 2 week). I noticed it through cycling, I wear a hr monitor. I found out about lying on my back by accident. My episodes got more and more frequent. I was diagnosed as having svt eventually. I put off having an ablation but my my episodes got more frequent and lasted longer and I couldn't always stop them. I was put on Biso and then opted to have the ablation. No anxiety or fast hr on stopping Biso. No meds and no svt since Oct 19 ablation.
I started 2.50mg of Bisoprolol in October this year after two AF attacks after the stress of losing my daughter-in-law to breast cancer. I was then advised to reduce my dosage to 1.25 mg thereby dropping by that amount immediately which I did . Three months on and I haven’t had another attack and I have now been told to stop taking the tablets altogether: no weaning off just stopping… which I have done. In two weeks my heart rate has not gone up and neither has my blood pressure and I haven’t had another attack although I do check my watch regularly to check it. Whilst I’m not a doctor I can see that dropping from 2.5 to 1.25 then stopping altogether is the same as you are talking about. It does sound as though your anxiety may be leading to the increased heart rate. I would follow some of the good advice on here and check it out with your doctor and also listen to some meditation tapes of which there are many on YouTube as I find them incredibly helpful.
Thank you so much for your great advice. So sorry to hear about the loss of your daughter-in-law, so sad. I definitely need to start listening to meditation tapes. Really helps to hear others experiences, so thank you for taking the time to reply xxx
Hi there, I had svt’s for 17 years and was put on bisoprolol during that time. I was told by my cardiologist that I needed an ablation as it was my electrics round my heart that was causing it. Being really scared of having an operation I decided to continue with the bisoprolol . I ended up in hospital sometimes 3 times a week! My heart rate was so high. I found that just looking up or scanning my eyes across shelves in the supermarket used to start the svt. I used to have to lie down on the floor wherever I was and start deep breathing to stop. It. THEN I had one in Austria whilst visiting my relatives. I was taken into hospital and they brought a jug of ice water and told me to drink 4 glasses quickly. IT WORKED, my heart rate went straight down immediately.I continued doing this every time I had a do. It seemed to shock my heart back to normal.My husband had three heart attacks in three days and had to stay in hospital quite a while after they also found cancer.
This prompted me to have my ablation and that was two years ago…… not had an svt since so really wish I had sorted it sooner.
I came of the bistropolol just before operation.
I wish you all the best and I understand your anxiety, try to keep calm x
It might be an idea to try and get something for your anxiety while you taper off it. I am on 1.25mg daily and would have no problems taking halef a tablet daily for a week, then a quarter for a week and then stopping. My Bisop has almost eliminated my SVTs and ectopic beats.
I came off bisoprolol about 12 mths. I am naturally anxious so I was careful in taking about a month of cutting the 2.5mg tablet in half, then a quarter, then an eight (or best attempt). My naturally anxious state didn't really change, although in bed I did feel my heart when I thought about. Now I dont 12 months later. However I have noticed my blood pressure has gone up so its my tablet review in a weeks time with the pharmacist ! It will be interesting to see if they up my ramipril , or prescribe an alternative beta blocker? I really dont want to be on beta blockers so I am getting anxious about the telephone call!
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