Beta Blockers - The ” LOL “ Way to Manage Anxiety

What Are Beta-Blockers?

Beta-blockers are a group of drugs generally prescribed to treat high blood pressure, chest pain, abnormal heart rhythm, and other heart health issues. However, doctors can also prescribe off-label beta-blockers to help manage anxiety symptoms. These drugs can help to create calmness and reduce heart rate. Beta-blockers work best for short-term anxiety-related events such as social phobia and stage fright. Beta-blockers commonly prescribed for anxiety include Propranolol and Atenolol, which block the effects of norepinephrine and epinephrine. Beta-blockers are beneficial over other anti-anxiety drugs as they are fast-acting and ideal for people who need rapid relief.

How Do Beta-Blockers Work?

Beta-blockers are also known as beta-adrenergic blocking agents because these drugs block the effects of adrenaline or the stress hormones like epinephrine and norepinephrine that cause the physical effects of anxiety. They also prevent adrenaline from making the heart pump faster and relax your blood vessels.

How Do Beta-Blockers Help Treat Anxiety?

Beta-blockers are available for administration in three primary forms: oral, intravenous, and ophthalmic. When used as an anti-anxiety drug, it helps to manage the body’s physical reactions to anxiety, such as

• A fast heart rate.

• Shaky voice and hands.

• Sweating.

• Dizziness.

The beta-blockers help to feel less anxious during stressful times. Beta-blockers half-life is three to six hours and reaches peak levels as quickly as one hour. Beta-blockers are metabolized in the liver and eliminated in the kidneys as unchanged.

What Are the Benefits of Beta-Blockers Over Other Anti-anxiety Medications?

Beta-blockers work differently than other anti-anxiety medications and are a viable alternative for people who need rapid relief.

These medications are beneficial because,

• They are fast-acting.

• They work well for acute short-term anxiety.

• It helps lower blood pressure and heart rate and relieves physical symptoms.

• They can be an alternative for people with intolerance to other anti-anxiety medications.

• They control rapid heartbeat, tremors, and blushing associated with anxiety disorders and boost the confidence of people anxious about public speaking or other performances.

What Are the Side Effects of Beta-Blockers?

Some of the possible side effects of beta-blockers include

• Rashes.

• Bradycardia (slow heart rate).

• Low blood pressure.

• Impotence.

• Nausea.

• Diarrhea.

• Fatigue.

• Headache.

• Dizziness.

• Depression.

• Cold hands and feet.

The severe side effects may include:

• Irregular heartbeat.

• Low blood sugar levels.

• Swelling and fluid retention.

• Weight gain.

• Severe asthma attack.

What Precautions Should Be Taken While Taking Beta-Blockers?

• Pregnancy and Breastfeeding - Beta-blockers should be given with caution in pregnancy, especially in the first trimester, as it increases the risk of developing congenital anomalies in the fetus. The drug crosses the placenta and can cause physiologic changes in the fetus.
• Elderly - Beta-blockers should not be used to treat the elderly because of physiologic changes in people over 60, such as cardiac output, bradycardia, reduced renal blood flow, low glomerular filtration rate, and low plasma renin activity.
• Allergy - Beta- blockers can worsen allergy symptoms. It is contraindicated during allergy skin testing.
• Breathing Problems - Beta-blockers are contraindicated in asthma patients as it triggers severe bronchospasm and increases airway resistance.
• Diabetes - The anti-anxiety drug can potentially increase blood glucose concentration and may antagonize the action of oral hypoglycemic drugs.
• Cardiogenic Shock - Beta-blockers are contraindicated during an acute myocardial infarction when there are signs of pending cardiogenic shock.
• Heart Failure - Beta-blockers therapy should be avoided during or immediately after hospitalization. In addition, they should not be administered to patients with heart failure who have bradycardia or hemodynamic instability.
• Liver Failure - Using Beta-blockers in patients with acute liver failure increases the risk of hepatotoxicity and should be given with caution.
• Kidney Disease - Long-term therapy with beta-blockers should be cautiously administered in patients with kidney disease.
• Children - Beta-blockers should not be given to children under 12.
• Alcohol - It is best to avoid drinking alcohol when taking beta-blockers. Combining the two can cause a sudden drop in blood pressure.
• Smoking - Nicotine diminishes beta-blockers effect on blood pressure and heart rate. Smoking must be avoided while taking beta-blockers.

What Are the Interactions of Beta-Blockers?

Interaction with Medicines:

• Alpha-blockers such as Prazosin.

• Anticholinergics such as Atropine and Scopolamine.

• Chlorpromazine.

• Cimetidine.

• St. John’s wort.

• Antidepressants such as Fluoxetine, Paroxetine, and Fluvoxamine.

• HIV (human immunodeficiency virus) protease inhibitors like Ritonavir.

• Clonidine.

• Digoxin.

• Rizatriptan.

• Levothyroxine.

Interaction with Food:

• Multivitamins with Minerals - Combining beta-blockers such as Propranolol with multivitamin-containing minerals may decrease the effectiveness of the beta-blocker. Therefore, it is advised to administer them separately with at least two hours' differences.

• Food - Administering Propranolol with food enhances the effectiveness of the drug. Taking Propranolol at the same time of the day, preferably immediately after food, helps absorb the drug.

• Alcohol - Drinking alcohol while taking Propranolol increases drowsiness and dizziness and should be avoided.

• High Cholesterol - Patients with preexisting hyperlipidemia may require close monitoring during beta-blocker therapy.

Interaction with Diseases:

• Bradyarrhythmias - Beta-adrenergic receptor blockers are contraindicated in patients with sinus bradyarrhythmia due to their adverse inotropic, chronotropic effects on the heart.

• Cardiogenic Shock or Hypotension - Beta-blockers are contraindicated in patients with hypotension as they further depress the cardiac output and blood pressure.

• Congestive Heart Failure - Beta-blockers should not be used in patients with overt congestive heart failure as it may worsen heart failure.

• Diabetes - Beta-adrenergic receptor blocking agents may mask symptoms of hypoglycemia such as tremors, tachycardia, and blood pressure changes and should be administered cautiously in patients with diabetes or predisposed to spontaneous hypoglycemia.

• Ischemic Heart Disease - Prolonged use of beta-blockers can exacerbate angina. Cessation of beta-blocker therapy should be gradually overcome in time and in consultation with a doctor.

• Hypersensitivity - Beta-blockers with a history of allergic reactions may have increased the frequency and severity of attacks.

• Asthma - Beta-blockers use is contraindicated in patients with a history of bronchial asthma or severe chronic obstructive pulmonary disease as they affect pulmonary function by counteracting the bronchodilation

• Liver Disease - People with liver disease have a greater risk for adverse effects from Propranolol due to decreased drug clearance.

• Cerebrovascular Insufficiency - Beta-blockers should be used with caution in patients with cerebrovascular insufficiency as they may cause reduced cerebral flow.

• Glaucoma - Beta-blockers may lower intraocular pressure in patients with glaucoma and may require adjustments in the doses or discontinuation of beta-blocker therapy.

• Hyperlipidemia - Patients with preexisting hyperlipidemia require close monitoring during beta-blocker therapy, as it may alter the serum lipid profiles.

• Hyperthyroidism - Abrupt withdrawal of beta-blockers in patients receiving the therapy can exacerbate thyrotoxicosis. Cessation of the beta-blocker therapy should be gradual with reduced dosage overcome time.

• Myasthenia Gravis - Beta-blockers should be used cautiously in myasthenia gravis as they may aggravate muscle weakness.

• Renal Impairment - Therapy with Propranolol should be administered cautiously in patients with impaired renal function as there may be a decrease in drug metabolism.

Conclusion:

Beta-blockers help to relieve anxiety and may be used as an alternative to other anti-anxiety drugs. These medications improve performance in people with short-term pressure. It may be used in combination with other treatments and lifestyle changes.