How many of us have taken or are taking beta blockers? Is there a link to PD?

[Mlvh]

Alpha synuclein is regulated by the beta-2 adrenergic receptor. The same receptor that some beta blockers work on… Beta-2 adrenergic receptor agonists (that do the opposite) are also being trialled as a treatment for PD. I wonder if beta blockers are one of the causes of my father’s PD? It would be good to get a straw poll of how many of us are using these meds?

[redhawk1]

Hello Mivh . . . I used Atenolol beta blocker to treat hypertension for approximately 25 years prior to my PD diagnosis.

[Ep0522]

Hi: I was given toprol as part of my diagnosis. Then was sent to a neurologist for confirmation. Have been taking it ever since then. Diagnosis 22 years ago.

[park_bear]

link.springer.com/article/1...

Chronic Use of β-Blockers and the Risk of Parkinson’s Disease

"Overall, 145,098 patients received β-blockers, and 1,187,151 patients did not. The adjusted hazard ratio for Parkinson’s disease among β-blocker users was 1.51"

That is a substantial increase in risk.

[fnedorez70 in reply to park_bear]

yes, but why? Is there a statistical connection because ppl who get bblockers are having hypertension that makes them more likely to have vascular issues in the brain? Or is there a bio-chemical connection between the two? If the new test that "changed everything" is as good as it is advertised we might know the answer.

[park_bear in reply to fnedorez70]

It is wise to recognize that association does not prove causation. It is possible that conditions requiring beta blockers could also increase Parkinson's risk. I have not studied this matter sufficiently to have an opinion as to which is the case here.

[Daisies22]

And also anti-depressants:

bmcpsychiatry.biomedcentral...

[mcpha]

Hi Mlvh: I have used Atenolol for atherosclerosis for 21 years - diagnosed PD in March 2018 - changed to Rosuvastatin in Jan 21 following heart triple bypass!

[azure64 in reply to mcpha]

could you have meant atorvastatin instead of atenolol?

[mcpha in reply to azure64]

Sorry, Apologies -I should have said I changed from Atenolol to Bisoprolol in Jan2021 after Bypass Op.

[Jana86]

I do not take a Beta blocker but I am facing a valve repair in mid June and have been told that I will likely be given a beta blocker post procedure. If these drugs increase a-syn does that mean they may PD worse?????

[azure64]

i have been on one beta blocker or another since 1985 to treat mitral valve prolapse. i was diagnosed with PD in 2021 although i lost my sense of smell a decade or so before diagnosis.

[McJimBob]

I’ve been taking Atenolol since the late 90s. I lost my sense of smell before 2009 and attributed that to cigarette smoking. I quit smoking in 2009 and have never regained smell. I don’t use carbidopa/levodopa because the long term risks outweigh the benefits. I have been doing a high thiamin (B1) and I feel some benefit from that.

[NONNA1306]

I started having tremors and then I was put on a beta blocker thinking it was essential tremors When I was diagnosed with Parkinson's they took me off the beta blocker and I felt worse ..I had this sense of internal tremors. So now they allow me to take them both beta blocker and dopamine agonist.

[kaypeeoh]

When I was DX'd with PD I was really PO'd. During the exam my BP was high enough they decided I had hypertension. I bought an OmRon, same model used at the hospital. At home my BP is normal; If I take it ten times while seated the readings average to 120/80.

[Goldencbc]

I was put on propranolol several years before my diagnosis and am currently on bisoprolol for afib.

[Following_closely]

To address your question about taking beta blockers and possible mechanisms related to PD, here's my long response.

I was taking propranolol for years for treatment of essential tremor (ET) before my PD diagnosis, and I still take it because I have both ET and PD. I started following this when a paper was published in Science (a top journal) suggesting that beta blockers increase risk of PD and beta agonists reduce it. The paper reported both epidemiological and in vitro data:

Mittal S, Bjornevik K, Im DS, et al. Beta2-adrenoreceptor is a regulator of the alpha-synuclein gene driving risk of Parkinson’s disease. Science 2017;357:891–898.

Since then, this has been a subject of much controversy, with some saying that many people with PD get misdiagnosed as having essential tremor and then treated with beta blockers for that reason, which could make it appear that beta blockers are causing PD when they are not. Similarly, beta agonists get used to treat conditions such as COPD, which are often caused by smoking, which is associated with a lower risk of PD. Others disagree. The best summary of the arguments I've found is in the exchange between the authors of a later paper opposing the conclusions of the Science paper and a reader in the letters to the editor section of Neurology (PMID: 32423986 and 32423987). Unfortunately, this is behind a paywall. The lists of citations provided by the authors and the reader (with duplicates removed and umlauts handled poorly(!)) are listed below, with reference 1 being the Neurology article mentioned above:

1. Hopfner F, Wod M, H¨oglinger GU, et al. Use of β2-adrenoreceptor agonist and antagonist drugs and risk of Parkinson disease. Neurology 2019;93:e135–e142.

2. Mittal S, Bjornevik K, Im DS, et al. Beta2-adrenoreceptor is a regulator of the alpha-synuclein gene driving risk of Parkinson’s disease. Science 2017;357:891–898.

3. Gronich N, Abernethy DR, Auriel E, et al. β2-adrenoreceptor agonists and antagonists and risk of Parkinson’s disease. Mov Disord 2018; 33:1465–1471.

4. Koren G, Norton G, Radinsky K, et al. Chronic use of β-blockers and the risk of Parkinson’s disease. Clin Drug Investig 2019;39:463–468.

5. Searles Nielsen S, Gross A, Camacho-Soto A, et al. β2-adrenoreceptor medications and risk of Parkinson disease. Ann Neurol 2018;84:683–693.

6. Hopfner F, H¨oglinger GU, Kuhlenb¨aumer G. β-adrenoreceptors and the risk of Parkinson’s disease. Lancet Neurol. 2020;19:247–254.

4. Qian L, Wu HM, Chen SH, et al. β2-adrenergic receptor activation prevents rodent dopaminergic neurotoxicity by inhibiting microglia via a novel signaling pathway. J Immunol 2011;186:4443–4454.

5. Van Laar A, Keeny M, Zharikov A, et al. Pharmacogenomic reduction of alpha-synuclein with beta2 adrenoreceptor agonist is protective in a delayed rotenone model of Parkinson’s disease. Soc Neurosci 2018;655:21.

Considering the controversy, I tried dropping my propranolol, but then my ET returned, so I didn't feel I had any choice but to resume taking it. I'm still not sure whether the proposed effects on PD are real or artifact.

[Rhyothemis]

You've probably read this already, but just in case -

scienceofparkinsons.com/202...

Hydrophilic beta blockers are mainly eliminated via the kidney & kidneys have very high a syn expression - proteinatlas.org/ENSG000001...

Don't know if that has anything to do with anything. Would be interesting to know what hazard ratio is for beta blocker use & MSA risk. Of course, the dysautonomia symptoms from early, undiagnosed MSA could be treated with BB's & that would confound the heck out of everything.

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just a little note to self so I don't forget this train of thought - could beta blocker cause alkalosis? look up pH effect on beta-receptor agonist binding