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Suggest Ways To Taper Down Dosage Of Atenolol
Question: Ok I have mild anxiety. To the point where it would make my heart race to 110-120bpm. I was put on Atenolol 25mg a day on a split dosis half in the morning and the other half at night. It really helped as it brought my heart rate down to 70-80bpm on average. My primary care physician then put me on clonazepam .25mg twice a day and 50mg of sertraline. He said in reality i dont even need the atenolol as i have even visited a cardiologist and every test has come out normal. I feel like the clonazepam and sertraline have really helped. I have been on both for 10 days and im supposed to take both for one month. I am noticing though that my heart rate is relatively low during the day in the 62-65bpm range and sometimes in the morning even 56bpm. I dont feel lightheaded or anything. I do want to start tappering off these meds.I dont want to develop dependency. Should i elminate the night time dosis of clonazepam or the night time dosis of atenolol?I know sertraline is not as bad as far as habit forming. I want to prevent withdrawl effects. Where do I start?
Brief Answer:
Gradual tapering of doses.
Detailed Answer:
Hello thanks for asking from Health Care Magic
I can understand your problem. You are on Atenolol 25 mg, Sertraline 50 mg and Clonazepam 0.25 mg. Your all heart examinations came normal. Your heart rate is under control now and its in range of 60-64 bpm. You have shown a good improvement. Now your PCP has suggested you to stop atenolol as there is no cardiac issue. You want to taper the drugs because of fear of dependence.
Now coming to your discussion.
First of all I would like to tell you that Atenolol is a beta blocker drug that results in slowing the heart rate. The drug help in relieving anxiety symptoms like tremors, palpitations etc. So your heart rate has come under control because of this drug. The drug don't result in dependence and is a good anti-anxiety drug at low doses. Even all cardiac examination came normal still atenolol can be used because of anxiety.
Clonazepam results in dependence so as per my opinion it should be taken in low doses on SOS basis only. The drug doses are 0.25 mg so as per my opinion stopping the drug abruptly will not result in significant withdrawal except mild insomnia and anxiety. If your physician agrees then you can continue take drug on SOS basis only.
Sertraline is SSRI drug, abrupt discontinuation may result in withdrawal effect but the drug is not habit forming or dependence producing. I usually ask my patients to reduce the doses of sertraline about 20-25% every two weeks and then stop at about 8 weeks. You are taking low doses and will take the drug for one month only. So in such case doses can be reduced to 25 mg for two more weeks and then 25 mg on alternate days for two week and then you can stop the drug after 4 weeks. Consult your psychiatrist for detailed prescription. In this way withdrawal effects will be prevented.
Thanks hope this helps you.
Gradual tapering of doses.
Detailed Answer:
Hello thanks for asking from Health Care Magic
I can understand your problem. You are on Atenolol 25 mg, Sertraline 50 mg and Clonazepam 0.25 mg. Your all heart examinations came normal. Your heart rate is under control now and its in range of 60-64 bpm. You have shown a good improvement. Now your PCP has suggested you to stop atenolol as there is no cardiac issue. You want to taper the drugs because of fear of dependence.
Now coming to your discussion.
First of all I would like to tell you that Atenolol is a beta blocker drug that results in slowing the heart rate. The drug help in relieving anxiety symptoms like tremors, palpitations etc. So your heart rate has come under control because of this drug. The drug don't result in dependence and is a good anti-anxiety drug at low doses. Even all cardiac examination came normal still atenolol can be used because of anxiety.
Clonazepam results in dependence so as per my opinion it should be taken in low doses on SOS basis only. The drug doses are 0.25 mg so as per my opinion stopping the drug abruptly will not result in significant withdrawal except mild insomnia and anxiety. If your physician agrees then you can continue take drug on SOS basis only.
Sertraline is SSRI drug, abrupt discontinuation may result in withdrawal effect but the drug is not habit forming or dependence producing. I usually ask my patients to reduce the doses of sertraline about 20-25% every two weeks and then stop at about 8 weeks. You are taking low doses and will take the drug for one month only. So in such case doses can be reduced to 25 mg for two more weeks and then 25 mg on alternate days for two week and then you can stop the drug after 4 weeks. Consult your psychiatrist for detailed prescription. In this way withdrawal effects will be prevented.
Thanks hope this helps you.
Above answer was peer-reviewed by :
Dr. Shanthi.E
I think im going to continue with the atenolol but with half of the 25mg in the morning only. Im going to skip the night time dose. The clonazepam im only going to take .25mg once daily instead of .5mg and the sertraline i will take 50mg daily for the rest of this week as i have only been taking it for a week and then starting next week i will tapper it to 25mg daily. You think this would be ok?
Brief Answer:
Gradual tapering of doses.
Detailed Answer:
Hello,
Thanks for asking again
Yes this would be ok.
Yes, gradually tapering the doses will not result in withdrawal effects. Decreasing the dose of Sertraline gradually will not cause much difficulty on discontinuation. Atenolol will not cause much discomfort. Clonazepam 0.25 will relieve anxiety and at this doses the discontinuation will be easier.
Consult your psychiatrist if you have any problem.
Thanks, hope this helps you.
Gradual tapering of doses.
Detailed Answer:
Hello,
Thanks for asking again
Yes this would be ok.
Yes, gradually tapering the doses will not result in withdrawal effects. Decreasing the dose of Sertraline gradually will not cause much difficulty on discontinuation. Atenolol will not cause much discomfort. Clonazepam 0.25 will relieve anxiety and at this doses the discontinuation will be easier.
Consult your psychiatrist if you have any problem.
Thanks, hope this helps you.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
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