Metoprolol is a widely used beta-adrenergic blocker that is commonly prescribed for a variety of cardiovascular syndromes and conditions. While central nervous system adverse effects have been well-described with most beta-blockers especially lipophilic agents such as propranololvisual hallucinations have been only rarely described with metoprolol. Case 1 was an year-old Caucasian woman with a history of hypertension and osteoarthritis, who suffered from visual hallucinations which she described as people in her bedroom at night.
They would be standing in front of the bed or sitting on chairs watching her when she slept. Numerous medications were stopped before her physician realized the metoprolol was the causative agent. The hallucinations resolved only after discontinuation of this medication. Case 2 was a year-old Caucasian man with an inferior wall myocardial infarction complicated by cardiac arrest, who was successfully resuscitated and discharged from the hospital on metoprolol.
About 18 months after discharge, he related to his physician that he had been seeing dead people at night. He related his belief that since he 'had died and was brought back to life', he was now seeing people from the after-life. Upon discontinuation of the metoprolol the visual disturbances resolved within several days.
Case 3 was a 68 year-old Caucasian woman with a history of severe hypertension and depression, who reported visual hallucinations at night for years while taking metoprolol. These included awakening during the night with people in her bedroom and seeing objects in her room turn into animals.
After a new physician switched her from metoprolol to atenolol, the visual hallucinations ceased within four days. We suspect that metoprolol-induced visual hallucinations may be under-recognized and under-reported. Patients may frequently fail to acknowledge this adverse effect believing that they are just dreaming, or may be embarrassed to report visions that they feel will not be perceived by others to be real. Similarly, healthcare providers can also fail to recognize this visual toxicity or attribute visual hallucinations to concurrent illness or other medications.
Clinicians must maintain diligent surveillance when managing patients receiving this drug. The central nervous system CNS adverse effects of beta-adrenergic blockers, including visual hallucinations, have been largely associated with highly lipophilic agents such as propranolol, timolol and pindolol [ 12 ].
Metoprolol is one of the most commonly prescribed beta-adrenergic blocking agents but visual hallucinations associated with its use have been reported only rarely [ 3 - 5 ]. Here, the cases of three patients with visual hallucinations induced by metoprolol are reported; we review the literature on this topic and hypothesize why this neurologic toxicity may be under-recognized and under-reported.
An year-old Caucasian woman with a history of hypertension and osteoarthritis suffered from visual hallucinations for several years.
She would awake at night to see people standing at the foot of her bed or sitting on a chair in her room watching her sleep. These people would not converse with her but were frightening. She had no history of neurological or psychiatric illness nor were there any significant neuropsychiatric findings on physical examination. Her medications consisted of aspirin, a calcium channel blocker, an angiotensin converting enzyme inhibitor and metoprolol tartrate 50 mg orally twice a day for blood pressure control.
She used acetaminophen for control of her arthritis symptoms. She did not have any hallucinations any other time of day or night. A neurological work up included a magnetic resonance imaging of her brain, an electroencephalography and neurocognitive testing, which was unrevealing. A full complement of laboratory tests showed normal thyroid functions, vitamin B12 and folate levels.
She had no history of alcohol or drug use. She was unsure how long she had been on all of her medications but knew that she had been taking metoprolol for at least two years. All of her antihypertensive medications were discontinued besides the beta adrenergic blocker before her physician realized the causative agent was metoprolol. Her visual hallucinations stopped completely within several days of ceasing this medication. A year-old Caucasian man had an inferior wall myocardial infarction that was complicated by cardiac arrest shortly after arrival to the emergency department.
He was successfully resuscitated after approximately one to two minutes of ventricular fibrillation with electrical defibrillation. He otherwise had an uneventful recovery and was discharged from the hospital on aspirin, isosorbide, lisinopril and metoprolol tartrate mg orally twice a day.
He had no history of neurologic or psychiatric abnormalities or significant findings in this regard on physical examination. He used alcohol rarely but there was no illicit drug use.The following information is NOT intended to endorse any particular medication.
While these reviews might be helpful, they are not a substitute for the expertise, skill, knowledge and judgement of healthcare practitioners. What next? Compare all 2 medications used in the treatment of Performance Anxiety.
Absolutely cool as a cucumber, thanks to Propanolol. I've tried everything in the past, hypnosis, meditation - all of which makes you feel like more of a failure when it doesn't work. I found out about this because my boss takes them, so I did a bit of research, read these reviews, then ordered some immediately from an online pharmacy. Best decision I've ever made, I'm never doing a presentation without these bad boys ever again.
I get all the classic symptoms - weeks of torment in the build up, throat tightening, feeling like I'm going to faint, wobbly voice and shaky hands - knowing people are looking at you in pity. I hate presentations so much to the point where I will drop classes and do everything possible to not present.
Metoprolol-induced visual hallucinations: a case series
I even hated introducing myself, any type of interviews, and a lot of social situations. I kept this page open for the past 2 weeks because I wanted to read through everyone's reviews before I presented. My doctor told me to take 10mg 30 min before the speech and I tested it out and it didn't work.
I ended up taking 30mg 1 hour before and 10mg 30 min before that was probably too much because I am short and don't weigh a lot. I have never felt more confident and calm. I've been suffering all my life from performance anxiety, to an extent it began to affect my career!
I work in marketing and communication, where presentations are required all the time, I always screw up!!!!! But today was a completely different thing with propranolol!!!! I was presenting in front of the the GM and he was stunned!!!! But boys and girls please remember there is no such thing as a free lunch. Propranolol is a powerful prescription drug and has side effects.
Specifically it dampens your emotions and your creativity. So whilst you can give that speech confidentlysustained use will have a negative impact on your relationships and your performance. Ultimately the best solution is to work on techniques to change your emotions and make you more confident when you speak.
Specifically practice for the moment when things might go wrong. What will you do to overcome it? I would find out about a presentation in college and think about it every day for the next few months, getting sick at the thought.Situational anxiety is a specific type of anxiety that occurs during unfamiliar situations or important events.
Maybe it was during a presentation that you spent weeks preparing for.
Propranolol will make addicts forget they want a drink
But when the moment came to show off all of the hard work you put in, you instantly became a nervous, sweaty wreck. Or maybe it was when you finally met with a recruiter for your dream job.
All of a sudden, your thoughts became so cloudy you could barely get out enough words to answer her questions.Propranolol - Mechanism of Action
Or perhaps it was your first time going on a date after ending a long relationship. Situational anxiety, or performance anxiety, is a specific type of anxiety that occurs during unfamiliar situations or events that make us so nervous that we lose control of our ability to stay calm. This shows up differently in different people. For some, it results in sweaty palms or tremors while others experience blushing or dry mouth.
But unfortunately, many people often spend years, if not their entire lives, suffering through or just avoiding social situations that make them uncomfortable. Anytime Y Combinator Founder Richard Nelson had to do any sort of presentation, his body would automatically go into panic mode.
His hands would begin to sweat and he would experience a shortness of breath. Worst of all, his mind would go completely blank. Despite all of his hours of practice, despite knowing the information better than anyone else in the room, he would completely lose his train of thought. It was as if his brain would shut down entirely. Richard was experiencing situational anxietyan overwhelming sense of stress associated with a specific situation or event.
For Richard, that situation was public speaking. It was only when he found himself expected to speak up in a room full of people that his symptoms of anxiety would arise. And he had no idea what to do about it. He had tried a few different things but nothing completely took away the problem. It would be years before Richard finally found the answer to his problem, the same solution offered by Kick.
Other examples include:. Situational anxiety is not the same as Generalized Anxiety Disorder GADwhich is a continuous state of worry despite the situation. Someone with general anxiety feels a heightened sense of stress and worry regularly. Even when a stressful situation, such as a big presentation, ends their symptoms stick around.
In fact, anxiety can cause both a mind and body response.By Jane Bunce for MailOnline. Alcoholics will be given a prescription drug currently used to treat anxiety and heart conditions in the hope that it will help them quit drinking for good. Scientists at Cambridge University believe that propranolol may block some of the cravings that addicts have for alcohol, and will reportedly begin a world-first clinical trial later this year to test their theory. The researchers apparently hope the drug may help prevent what they call 'cue-drug memory' — when recollections of certain people and places that are closely linked to alcohol create a subconscious impulse to drink.
A widely-used prescription drug could help stop the urge to drink that alcoholics feel around certain people and places. The clinical trial follows studies on rats that showed the drug could erase a stimulus in the animal's brains when they had a craving for a drink. Propranolol is a beta-blocker that was originally used to treat heart and circulatory conditions, including tremors and high blood pressure, and is also in use to reduce the symptoms of anxiety such as a rapid heart rate or sweating.
It targets the beta-adrenergic receptors in the brain which help to create a strong emotional memory. Scientists believe the drug may work by stripping emotion from the memory.
Lead researchers Dr Amy Milton, from Cambridge's Behavioural and Clinical Neuroscience Institute, told The Independent: 'Traditionally, memory was viewed as similar to a book, which can be shelved but never changed once printed. We now think that memory is more like a word processing document — you can save it and then recall it, at which point you can adapt or even delete its contents.
Dr Milton will be presenting the team's initial findings at this week's Cambridge Science Festival. If successful, it could revolutionise approaches to the treatment of chronic alcoholism.
The announcement comes after a separate small-scale study earlier this month suggested that propranolol may also have the unusual side-effect of combating subconscious racism. Volunteers given the drug scored lower on a standard psychological test of 'implicit' racist attitudes, compared to those given a placebo.
Given the key role that such implicit attitudes appear to play in discrimination against other ethnic groups, and the widespread use of propranolol for medical purposes, our findings are also of considerable ethical interest,' Experimental psychologist Dr Sylvia Terbeck, from Oxford University, said. The views expressed in the contents above are those of our users and do not necessarily reflect the views of MailOnline.
Argos AO. Cure for alcoholism on the way? Share or comment on this article: Propranolol will make addicts forget they want a drink.Drug information provided by: IBM Micromedex. Propranolol is used alone or together with other medicines to treat high blood pressure hypertension.
High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure.
Lowering blood pressure may reduce the risk of stroke and heart attacks. Propranolol is also used to treat severe chest pain anginamigraine headaches, or hypertrophic subaortic stenosis thickened heart muscle. This medicine may also be used to treat irregular heartbeats, tremors, or pheochromocytoma adrenal gland tumor.
It may also be used to reduce the risk of death in patients who have heart attacks. This medicine is a beta-blocker. It works by affecting the response to nerve impulses in certain parts of the body, like the heart. As a result, the heart beats slower and decreases the blood pressure. When the blood pressure is lowered, the amount of blood and oxygen is increased to the heart.
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Insomnia on Propranolol
This content does not have an English version. This content does not have an Arabic version. Make an appointment. Visit now. Explore now. Choose a degree. Get updates. Give today. Drugs and Supplements Propranolol Oral Route. Products and services. Free E-newsletter Subscribe to Housecall Our general interest e-newsletter keeps you up to date on a wide variety of health topics.
Sign up now. Mayo Clinic Marketplace Check out these best-sellers and special offers on books and newsletters from Mayo Clinic.Posted 5 years ago5 users are following. I was prescribed propranolol for migraines 3 weeks ago and it has helped brilliantly with the headaches, I've not had one migraine and if I do get a bad head then paracetamol take it away so from that perspective its great.
However, I'm struggling to get to sleep and only getting about 5 hours a night which in turn kicks off my anxiety. Has anyone else experienced this? The leaflet says 'sleeplessness' is a symptom that will disappear but I'm not sure how long I can wait. Feeling pretty down as the effect its having on the migraines is brillant. Posted 5 years ago. Insomnia and sleeplessness are common effects unfortunately. They will definitely get better though and in my experience you don't need as much sleep.
I had to come off them as I'm oregnant just now and I do sleep much better, however once the baby I ihere I'll be back on them. Couple of things you can try, I take 80mg a day and take it first thing in the morning, they are slow release so shouldn't effect sleep too much so make sure the dose is a slow release one and your taking in the morning.
The other thing is don't think oh no it's the tablets making me now sleep as the brain has a funny way of causing the sleeplessness!!! Give it a bit longer and try nit to be too anxious about it. I did also find that although I slept less and it took me longer to nod if, I funvtioned well on the less sleep as well.
I have been on this medication for over 12 months now, like you my migraines are reduced and i can deal with the odd headache with normal paracetamol. I did suffer with broken sleep for ages, but often used to think it was nothing compared to the pain i used to suffer with the migraine Join this discussion or start a new one? We want the forums to be a useful resource for our users but it is important to remember that the forums are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters.
Insomnia on Propranolol Follow. New discussion Reply. Hi, Louise I struggled to sleep at first but it will calm down give it another couple of weeks.
Hi Louise so amazing that the headaches and migraines are better! Kermodesmum louise Hi Louise I have been on this medication for over 12 months now, like you my migraines are reduced and i can deal with the odd headache with normal paracetamol. Thanks very much for all your replies so far, really appreciated.Drug information provided by: IBM Micromedex. Along with its needed effects, a medicine may cause some unwanted effects.
Although not all of these side effects may occur, if they do occur they may need medical attention. Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:. Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Call your doctor for medical advice about side effects. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.
This site complies with the HONcode standard for trustworthy health information: verify here. This content does not have an English version. This content does not have an Arabic version. Make an appointment. Visit now. Explore now. Choose a degree. Get updates. Give today. Products and services. Free E-newsletter Subscribe to Housecall Our general interest e-newsletter keeps you up to date on a wide variety of health topics.
Sign up now. Mayo Clinic Marketplace Check out these best-sellers and special offers on books and newsletters from Mayo Clinic.