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Suggest Treatment For Fatigue While Weaning Off Atenolol
Question: I have been on atenolol for years for heart rythm problems until about a month ago when I had three near fainting spells in one afternoon. The ER doc took me off the atenolol because my pulse rate was in the low 40s....Also the machine they had me hooked to, the alarm kept going off. The next week when I could get hold of my cardiologist, he agreed with the ER doc. He ordered nuclear stess test, echogram and Holter monitor. He has not called back yet with all the results but I got copies of the stress & echo. They showed mild leakage in the mitral & tricuspid valves. Don't have the Holter results yet. What is bothering me is this weak, trembly feeling. Up until the ER visit, I could work in my yard with no problems.....now some days I can't even curl my hair without getting out of breath and feeling weak. Is this a symptom of withdrawal from taking me off the atenolol. Sometimes it feels like low blood sugar...but when I test it is never lower than 86. I do have lots of noticeable PVCs, more than I have had in the past....but this feeling of weakness and trembling is starting to get me down. Should I be worried about this? I hope to be able to talk to the cardiologist on Monday.
Brief Answer:
Arrhythmia and atenolol withdraw.
Detailed Answer:
Hi there,
Unfortunately, the fatigue, weakness, and trembling you are feeling is most likely caused by rebound tachycardia and arrhythmia. When you stop a medication that has been suppressing your heart rate, you will get a rebound effect with increased heart rate. Therefore, you are withdrawing from atenolol. Generally, the increased heart rate will last for about 48-72 hours and will slowly taper off. However, someone with predisposition to arrhythmias, can convert back into an arrhythmia or heart rhythm abnormality. I am guessing you had a very extensive work up in the ED, and thus, the most likely cause of your symptoms are from atenolol withdrawal symptoms and heart rhythm abnormality. The ideal situation would have been to decease your atenolol dose which sounds like it has been working well for you.
I would recommend avoiding caffeine, alcohol, and tobacco which can all worsen your symptoms. I wouldn't recommend restarting your atenolol because syncopal episodes are significantly worse then your current symptoms. Your cardiologist will most like have to try a new medication once all the results are in. You have had a very good and exhausting work up, and I would try to stick it out until you can see your cardiologist. There is unfortunately nothing else that can prevent or reduce the feeling of arrhythmias that you are currently having beside reducing alcohol, tobacco, and caffeine.
Arrhythmia and atenolol withdraw.
Detailed Answer:
Hi there,
Unfortunately, the fatigue, weakness, and trembling you are feeling is most likely caused by rebound tachycardia and arrhythmia. When you stop a medication that has been suppressing your heart rate, you will get a rebound effect with increased heart rate. Therefore, you are withdrawing from atenolol. Generally, the increased heart rate will last for about 48-72 hours and will slowly taper off. However, someone with predisposition to arrhythmias, can convert back into an arrhythmia or heart rhythm abnormality. I am guessing you had a very extensive work up in the ED, and thus, the most likely cause of your symptoms are from atenolol withdrawal symptoms and heart rhythm abnormality. The ideal situation would have been to decease your atenolol dose which sounds like it has been working well for you.
I would recommend avoiding caffeine, alcohol, and tobacco which can all worsen your symptoms. I wouldn't recommend restarting your atenolol because syncopal episodes are significantly worse then your current symptoms. Your cardiologist will most like have to try a new medication once all the results are in. You have had a very good and exhausting work up, and I would try to stick it out until you can see your cardiologist. There is unfortunately nothing else that can prevent or reduce the feeling of arrhythmias that you are currently having beside reducing alcohol, tobacco, and caffeine.
Above answer was peer-reviewed by :
Dr. Raju A.T
I am still on two blood pressure medications...telemisarten and amlodipine. The amlodipine was prescribed a year ago by my cardio doc because he thought my blood pressure was still a little high and that might be contributing to the increased PVCs. Is this likely to need to be changed...or do either of these drugs cause these type of side effects...I never noticed this feeling until I went off the atenolol. My pulse rate is still fairly slow...around 54-57 most of the time, but that is quite a difference from the low forties. Does my body just need to adjust to it? Also, there are times when I can actually hear my heartbeats in my ears even when I am not being active.
Brief Answer:
Related to atenolol withdraw, heart irregularity, and palpations
Detailed Answer:
Hi there,
Telmisartan and amlodipine are both very good blood pressure medications. They should not have any affect on the way you are feeling.
You are right - you did not feel like this until you went off the atenolol because the atenolol was probably controlling your heart arrhythmias/irregularity and decreasing the amount of PVCs you were feeling. The way you are feeling is probably mostly rated to atenolol (also known as a beta blocker) withdraw and heart arrhythmia, as well as palpations which is the feeling of your heart beating or racing in your chest. I suspect you are also having a lot of palpations with the frequent PVCs and heart irregularity - they are common with both. I do not think this is something you need to adjust too. I think your cardiologist will start you on another beta block on Monday to help control you symptoms. I would not be concerned if I were you. You had an extensive amount of testing and I suspect that your cardiologist will have the perfect answer for you on Monday. In the meantime, I would try to reduce your stress/anxiety, try to avoid exercise, caffeine, tobacco, and alcohol until you see your cardiologist - all of those can worsen your symptoms.
Related to atenolol withdraw, heart irregularity, and palpations
Detailed Answer:
Hi there,
Telmisartan and amlodipine are both very good blood pressure medications. They should not have any affect on the way you are feeling.
You are right - you did not feel like this until you went off the atenolol because the atenolol was probably controlling your heart arrhythmias/irregularity and decreasing the amount of PVCs you were feeling. The way you are feeling is probably mostly rated to atenolol (also known as a beta blocker) withdraw and heart arrhythmia, as well as palpations which is the feeling of your heart beating or racing in your chest. I suspect you are also having a lot of palpations with the frequent PVCs and heart irregularity - they are common with both. I do not think this is something you need to adjust too. I think your cardiologist will start you on another beta block on Monday to help control you symptoms. I would not be concerned if I were you. You had an extensive amount of testing and I suspect that your cardiologist will have the perfect answer for you on Monday. In the meantime, I would try to reduce your stress/anxiety, try to avoid exercise, caffeine, tobacco, and alcohol until you see your cardiologist - all of those can worsen your symptoms.
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Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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