Latest news with #betaBlockers
Medscape
25-06-2025
- Health
- Medscape
Fast Five Quiz: Risk Factors, Symptoms, & Treatments for AD
Alzheimer's disease is the most common form of dementia. Researchers believe that converging environmental, lifestyle, and genetic risk factors trigger a pathophysiologic cascade that, over decades, leads to Alzheimer's pathology and dementia. Depending on such risk factors and related symptoms, certain treatments can be utilized to help manage and slow disease progression. Do you know the risk factors, symptoms, and potential treatments for Alzheimer's disease? Test your knowledge with this quick quiz. Midlife hypertension is an established risk factor for Alzheimer-type dementia. Further, a brain autopsy study evaluating the link between hypertension and Alzheimer's disease found that patients using beta-blockers to control blood pressure had fewer Alzheimer-type brain lesions on autopsy compared with patients taking no drug therapy. Other risk factors for Alzheimer-type dementia include: Advancing age Family history APOE4 genotype genotype Obesity Insulin resistance Vascular factors Dyslipidemia Inflammatory markers Down syndrome Traumatic brain injury Caffeine is generally not a recognized risk factor for Alzheimer-type dementia or Alzheimer's disease. In fact, some studies have demonstrated a lower incidence of Alzheimer's disease in patients who consume caffeinated coffee. Similarly, moderate alcohol consumption is generally not recognized as a risk factor. In the 1960s and 1970s, exposure to aluminum was thought to be a possible risk factor for the development of Alzheimer's disease, leading to concerns about the use of cookware, antiperspirants, foil, antacids, and beverage cans in everyday life. Although studies have shown the neurotoxic effects of aluminum, particularly via exposure through dietary sources, they have failed to confirm a direct correlation between aluminum exposure and the development of Alzheimer's disease. Learn more about the risk factors for Alzheimer's disease. A 2025 report from the Alzheimer's Association indicated that older Black males and females are twice as likely to develop dementias, including Alzheimer's disease, compared with older White patients. Further, the same report noted that older Hispanic patients are at an increased risk for dementia and Alzheimer's disease when compared with older White, non-Hispanic patients. Specifically, the report states this population is 'one and one-half times as likely to have Alzheimer's or other dementias as White older adults.' Modifiable health factors include midlife obesity, which has been associated with the largest proportion of Alzheimer's disease cases in Black individuals, as well as physical inactivity. Additionally, cardiovascular and metabolic conditions, all of which elevate risk for dementia, disproportionately affect this demographic. Socioeconomic and psychosocial factors that correlate with dementia risk among older Black individuals include limited access to education, financial stability, and marital status. Missed and delayed diagnoses are more common in Black communities, and cultural bias in screening tools often leads to under-detection. Learn more about the epidemiology of Alzheimer's disease. By the time Alzheimer's disease reaches the moderate stage, damage has spread further to the areas of the cerebral cortex that control language, reasoning, sensory processing, and conscious thought. Affected regions continue to atrophy, making signs and symptoms of the disease more prominent, particularly as they relate to memory, judgment, and impulse control. The symptoms of this stage are typically: Increasing memory loss and confusion Shortened attention span Problems recognizing friends and family members Difficulty with language; problems with reading, writing, and working with numbers Difficulty organizing thoughts and thinking logically Inability to learn new things or to cope with new or unexpected situations Restlessness, agitation, anxiety, tearfulness, and wandering, especially in the late afternoon or at night Repetitive statements or movement, and occasional muscle twitches Hallucinations, delusions, suspiciousness or paranoia, and irritability Loss of impulse control (shown through such behavior as undressing at inappropriate times or places or using vulgar language) Perceptual motor problems (such as trouble getting out of a chair or setting the table) Pyramidal tract lesions, also known as upper motor neuron lesions, cause a wide range of motor deficits, including hyperactive reflexes, a positive Babinski sign (toe extension when stroking the sole of the foot), and spasticity. These can occur from any damage to the brain or spinal cord as a result of a stroke, trauma, tumors, meningitis, multiple sclerosis, or neurodegenerative disease, such as amyotrophic lateral sclerosis. While these lesions do occasionally occur in patients with Alzheimer's disease, their appearance is uncommon in this patient population. Hypothyroidism and hyperthyroidism can affect cognitive function and should be assessed during the initial workup for Alzheimer's disease. Although it is possible for either one to co-occur in patients, neither is a common symptom of moderate-stage disease. Seizures are not a common symptom associated with moderate Alzheimer's disease but are possible, particularly in late-stage disease and are potentially owing to poor disease course. Learn more about the clinical presentation of Alzheimer's disease. Structural neuroimaging with MRI (or noncontrast CT) to detect lesions that might cause cognitive impairment (eg, stroke, small vessel disease, and tumor) is typically most appropriate during the initial evaluation of patients with dementia or Alzheimer's disease. Imaging studies are part of initial diagnosis and are particularly important to assess for and rule out potentially treatable causes of progressive cognitive decline, such as chronic subdural hematoma or normal pressure hydrocephalus. Brain scanning with single-photon emission CT or PET is usually not recommended for the workup of patients with typical presentations of Alzheimer's disease. EEG is also not generally recommended but is valuable when Creutzfeldt-Jakob disease or another prion-related disease is a likely diagnosis. However, imaging studies are no longer the only method used in the initial evaluation of patients suspected of having Alzheimer's disease. In May 2025, the FDA approved the use of the Lumipulse G pTau217/Beta-Amyloid 1-42 Plasma Ratio for the early detection of amyloid plaques associated with Alzheimer's disease in adult patients, aged 55 years and older, who are exhibiting signs and symptoms of the disease. Although not intended as a stand-alone diagnostic test, it serves as an additional resource to clinicians in a specialized setting as a less invasive diagnostic option. The test increases diagnostic accessibility to patients who might not have easy access to imaging. Learn more about the workup of Alzheimer's disease. Early detection combined with timely treatment enables patients with Alzheimer's disease to preserve their cognition and functional capacities at optimal levels. Cholinesterase inhibitors, along with mental exercises, are prescribed to help prevent or delay the deterioration of cognition in patients with Alzheimer's disease. Cholinesterase inhibitors that have been approved in the US and Europe for the treatment of Alzheimer's disease include donepezil, galantamine, and rivastigmine. Further, certain antiamyloid monoclonal antibody treatments have been approved to slow disease progression as well. According to the Alzheimer's Association, nonpharmacological treatments used to initially and routinely manage symptoms include 'physical activity, reminiscence exercises, music ‐ and art ‐ based therapies, pet therapy, and light therapy.' Some studies suggest that long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) might have a protective effect against Alzheimer's disease, potentially through their anti-inflammatory effects and possible ability to reduce amyloid. However, findings from observational studies and short-term randomized controlled trials have been mixed, and optimal dosage and duration of (NSAIDs) for this purpose remain unclear. Studies suggest that long-term (but not cumulative) use of NSAIDs might be associated with decreased dementia risk. However, further investigation is warranted. Neuroleptic agents are not generally used to prevent or delay deterioration of cognition in patients with Alzheimer's disease. Some data have indicated that they are linked to an increased risk of cognitive decline. While some studies have shown that vitamin E can reduce amyloid-beta oxidative stress, as well as improve memory and cognitive deficits, conflicting results were noted in clinical trials assessing the efficacy of vitamin E as a preventive or treatment for Alzheimer's disease. Further, they are not typically used as an initial therapy to prevent or delay deterioration of cognition in patients with Alzheimer's disease. Learn more about the treatment and management of Alzheimer's disease.
Daily Mail
10-06-2025
- Health
- Daily Mail
Common pill is putting millions at risk of life-threatening breathing problems, doctor warns
They are pills prescribed to millions in the UK to treat heart conditions and anxiety. But beta blockers may pose a hidden risk to the 7.2 million people living with asthma, an NHS GP has warned. According to the British Heart Foundation, UK doctors issue more than 50 million prescriptions for beta blockers every year. However, Dr Sooj, a family doctor with over 250,000 TikTok followers, cautioned that the drugs can interfere with the way asthma medications work—potentially putting some patients at risk during an attack. Asthma causes symptoms such as wheezing, coughing and chest tightness. While generally manageable, it can become life-threatening, when severely inflamed airways make it extremely difficult to breathe. Asthma UK reports that around 1,200 people die from asthma attacks each year in the UK, while in the US the figure is over 3,500. In a TikTok, Dr Sooj explained: 'If you have asthma you need to be cautious and we need to make sure you're aware of any of the risks and potential complications of taking a beta blocker.' He continued: 'The medications we use in an acute asthma attack are called beta agonists—these help to dilate the pipes in your lungs.' Dr Sooj explained that these beta agonists, found in many common inhalers, work by relaxing the muscles in the airways, making it easier to breathe. But beta blockers—used to slow the heart rate and lower blood pressure—can blunt this effect. 'By doing that, they can worsen the symptoms of asthma,' he said. And it's not just people with asthma who may be affected. Inhalers are also routinely prescribed to those with chronic obstructive pulmonary disease (COPD), an umbrella term covering long-term lung conditions such as chronic bronchitis and emphysema. These incurable conditions can also cause severe breathing difficulties, and for this group too, beta blockers may pose a risk. The NHS advises patients with asthma or lung disease to inform their doctor before starting beta blockers, to ensure the medication is safe. That said, Dr Sooj added: 'I've seen lots of patients with COPD or asthma who are on beta blockers and they're completely fine with them.' 'But this is a discussion that you should be having with your own doctor.' Dr Sooj added that he still believed beta blockers to be 'excellent medications', and explained developments in the drugs that has improved them. 'We now have cardio selective beta blockers, which... affect the body a bit less.' The new warning follows concerns that a type of beta blocker called propranolol can put patients at risk of 'toxic overdose'—triggering seizures, depression and even cardiac arrest in high doses. Recent research showed the number of prescriptions for propranolol to treat anxiety in the UK doubled between 2003 and 2018. In theory, by keeping blood pressure low, feelings of panic and anxiety are reduced. However some experts have claimed there 'no evidence' that drugs are effective for mental health, and that patients often aren't adequately warned about risk of an overdose. In a recent letter to The Guardian, pharmacist Christopher Sullivan warned that the drug 'is associated with significant adverse outcomes' and urged GPs to exercise 'extreme caution when prescribing these medicines for anxiety'. 'Prescribing these medicines for anxiety is not recommended in national evidence-based guidelines,' he added. It followed comments from GP Dr Amir Khan, who told the newspaper that propananol had been linked to 'higher rates of depression' and warned GPs not to prescribe it to anxious patients who also suffer low mood. 'If you are taking them long term, you can't suddenly stop them,' he added. 'You need to be weaned off them.' The risks are not thought to pertain to those taking the medicine for heart problems and other physical issues like migraine—but experts say patients with mental health troubles are vulnerable to either accidentally or purposefully taking an overdose.
Daily Mail
26-05-2025
- Health
- Daily Mail
Experts warn against anxiety drug prescribed to millions due to little-known risk of 'toxic overdose'
Experts have issued a safety warning over a popular anxiety medication that can cause 'toxic' effects including seizures, depression and even cardiac arrest in high doses. Beta blockers, such as propranolol, have traditionally been prescribed for heart problems, but are increasingly offered by doctors to treat episodes of anxiety—as they slow the heart rate, supposedly reducing the physical symptoms of panic. Recent British research showed the number of prescriptions for propananol to treat anxiety doubled between 2003 and 2018. Roughly 7million prescriptions for the drug—which is also given for high blood pressure—are dispensed in the UK every year, according to official data. But now, experts say not only is there 'no evidence' to prove the drugs work for anxiety, too few patients, who are typically given large numbers of pills, are warned of the risk of overdose. In a recent letter to The Guardian, pharmacist Christopher Sullivan warned that the drug 'is associated with significant adverse outcomes' and urged GPs to exercise 'extreme caution when prescribing these medicines for anxiety'. 'Prescribing these medicines for anxiety is not recommended in national evidence-based guidelines,' he added. It followed comments from GP Dr Amir Khan, who told the newspaper that propananol had been linked to 'higher rates of depression' and warned GPs not to prescribe it to anxious patients who also suffer low mood. 'If you are taking them long term, you can't suddenly stop them,' he added. 'You need to be weaned off them.' The risks are not thought to pertain to those taking the medicine for heart problems and other physical issues like migraine—but experts say patients with mental health troubles are vulnerable to either accidentally or purposefully taking an overdose. The pharmacist's warning comes amid two high profile deaths related to the drug including accidental overdoses. In 2019, an inquest heard a mother-of-two, who was an NHS manager, accidentally overdosed on propranolol which she was initially prescribed for anxiety in 2018. Philippa Hulme, 46, died less than two hours after taking the lethal dose, with tests showing toxic levels in her system. A statement from Mrs Hulme's GP surgery said: 'Pippa had a history anxiety and depression and was well known to the practice. 'In July 2018 she was prescribed anxiety medication— propranolol and was given 60 tablets to take—one a day a maximum of two in 24 hours.' The coroner concluded that her death was most likely explained by an 'exacerbation' of anxiety that led her to 'consider it would be beneficial if she took more tablets to help her with the anxiety. 'I do not consider that she knew how toxic propranolol can be.' Another heartbreaking case is that of a mother-of-five who is thought to have accidentally killed herself with propranolol. A 2015 inquest heard how Janine Southwell, 37, a former beauty therapist was prescribed the drug, which she was 'reckless' about taking. She was found dead in bed, in August in 2015, with almost five times the potentially fatal level of the medication in her blood after a meal and glass of wine with her cousin. Her mother Janet Southwell said: 'She didn't take tablets when she was supposed to so she could have had a stockpile.' The coroner, Alan Walsh, concluded Ms Southwell did not intend to end her life. The fresh warnings follow guidance published by the General Pharmaceutical Council in October last year that warned about the 'wide variation' in individuals' response to toxic levels of propanolol. 'Peak plasma concentrations of propranolol occur 1-2 hours after ingestion, so symptoms of overdose will not be seen immediately,' the warning read. 'Rapid deterioration can occur following a propranolol overdose, this can include confusion and loss of consciousness as well as cardiovascular complications including cardiac arrest. 'As propranolol can cross the blood brain barrier, the risk of convulsions is higher than with other beta blockers. 'Delay in treatment increases the risk of fatality, therefore it is important to seek emergency help as soon as possible following overdose.' The danger of toxic propranolol overdose was a subject of the healthcare safety investigation report in 2020. This report revealed that vulnerable patients with existing migraines, anxiety and depression were at risk of using propranolol for self-harm. In 2022 to 2023, the National Poisons Information Service (NPIS) received 358 enquiries involving intentional propranolol overdose.
The Guardian
25-05-2025
- Health
- The Guardian
Dangers of using beta blockers to treat anxiety
Your article (I'm taking beta blockers for my anxiety – and so are many of my friends. Is that a problem?, 20 May) highlights the increasing use of beta blockers, especially to manage situational anxiety. These medicines are the subject of a healthcare safety investigation report in 2020, specifically the toxicity of propranolol in overdose. In October 2024, the General Pharmaceutical Council published advice for pharmacy professionals also highlighting the risk of toxicity. GPs must exercise extreme caution when prescribing these medicines for anxiety, which is not recommended in national evidence-based guidelines for the treatment of anxiety and is associated with significant adverse outcomes. Christopher Sullivan Pharmacist, Newton Abbot, Devon After being diagnosed with atrial fibrillation in 2020, I was prescribed beta blockers to lower my heart rate. I hated taking them as they made my symptoms – tiredness and brain fog – much worse. I stopped taking them and now have a pacemaker. I'm astounded to read that they are routinely prescribed for anxiety. I understand the need for a quick fix, but long term there have to be better coping strategies than taking medication for which there is 'no conclusive evidence' for its effectiveness and might be linked to higher rates of Richardson London Have an opinion on anything you've read in the Guardian today? Please email us your letter and it will be considered for publication in our letters section.
Yahoo
22-05-2025
- Health
- Yahoo
Everything You Might Want to Know About Beta Blockers for Anxiety, According to Doctors
"Hearst Magazines and Yahoo may earn commission or revenue on some items through these links." Not sure about you, but nervous energy comes at me like a bat out of hell. And, of course, it's always at the literal worst moments. Big job interview? My heart races like it's at the Olympics. Stressful meeting with a boss? My skin gets all flushed and hot. If you've been there, then you know that all these pesky physical symptoms only make you feel even more out of control. But what if I told you there could be a secret weapon found in the most unlikely of places? That place would be beta blockers. Okay, okay, if you're thinking, Aren't beta blockers for, like, my dad? You're not wrong. Beta blockers are a type of medication used to treat heart conditions and cardiovascular diseases, like congestive heart failure, heart attacks, coronary artery disease (aka when a bunch of gunk builds up in an artery and blocks regular blood flow to the heart), to name a few. But in some instances, doctors can prescribe them for migraines, certain shakes and tremors, and off-label for situational anxiety. For those of you with regulated nervous systems (how does it feel to be God's favorite?), situational anxiety is when you feel anxious before an event, like performing in a play or giving a speech, says Scott Breitinger, MD, a psychiatrist at the Mayo Clinic. Some people are able to work through these feelings and still do their thing without missing a step, while others feel like their body is betraying them *raises hand*. Celebrities like Khloé Kardashian and Robert Downey Jr. have said they take beta blockers before red carpets and other Hollywood moments, and reality star Paige DeSorbo has been open about how life-changing they've been for her on her podcast, Giggly Squad. Situational anxiety shouldn't be confused with generalized anxiety, though, which is way more persistent, can become dysfunctional, and impairs day-to-day function, says Dr. Breitinger. So basically, if you're anxious all the time, even when everything's chill, it's probably not situational anxiety. But! If you feel nearly paralyzed from nerves before big moments, that could be situational anxiety, and a beta blocker could be a useful tool to help it out. If you have been toying with the idea of starting a beta blocker or are now suddenly intrigued to learn more, keep on reading for everything you need to know about taking them for those moments when you're freaking the hell out. In short, it's a medication that helps slow your heart rate. Without getting too deep into it, there are two different kinds: selective, which are focused on the heart only, and non-selective, which work on your whole body, heart included. For context, selective beta blockers are typically used for things like when chest pains start after the heart doesn't get enough blood. On the other hand, non-selective beta blockers may be preferred by doctors for preventing things like migraines, and these are the ones prescribed for situational anxiety. Remember all those pesky symptoms like sweating, shaking, and shortness of breath? Well, these bad boys are caused by a spike in adrenaline, the hormone known to make you feel amped up, says Sanjiv Shah, MD, a professor of cardiology at Northwestern University's Feinberg School of Medicine. Beta blockers work by blocking the effects of adrenaline, slowing your heart rate and reducing those physical signs and symptoms of nervousness and anxiety, he explains. Essentially, think of using beta blockers like turning down the volume on your fight or flight response. Unlike antidepressants or other SSRIs, beta blockers don't directly aid in quieting worries or nervous thoughts—this is a heart medication, lest we forget. But for some people, they do help you to feel more in control of your body, especially since they can also help increase blood flow to the brain to allow it to function at its best, explains cardiologist Nishant Shah, MD, an associate professor at Duke University School of Medicine. If you're taking beta blockers for situational anxiety, the dosage is typically one or two pills about an hour ahead of the specific event. Of course, your doctor who prescribed them should give you clear instructions too! Your doctor will also tell you to take the beta blockers for a test-drive first—say, during a normal working day or when you don't have a high-pressure situation on the horizon—just to see how your body responds. Raw dogging a dose before a major moment (be it a date, family event, or stressful work presentation) and having a bad reaction is definitely not the vibe, so this part is pretty crucial. It's important to note that beta blockers should be more of a tool in your kit for navigating situational anxiety, rather than a long-term solution. To really get in control of your situational anxiety, you likely need a full-blown arsenal, including a therapist or psychiatrist (ideally in your insurance network). They'll likely use a variety of techniques to help, like exposure therapy, which means continuing to put yourself in the situations that make you nervous. Yes. Like most meds, beta blockers come with a list of potential side effects, such as low blood pressure, low heart rate, fatigue, reduced libido, and sleep disturbances, according to Dr. Breitinger. Dr. Nishant adds some people may experience hair loss, weight gain, and erectile dysfunction for patients with penises. I know, I know, that sounds like a lot, but Dr. Nishant also says most people tolerate beta blockers just fine, and some never feel side effects at all. Just be sure to keep a super close eye on how you feel, and make sure you keep your doctor up to date on your medical history. There are also certain people who shouldn't take beta blockers, including people who already have low blood pressure or anyone with diabetes, says Dr. Breitinger. That's because beta blockers can mask the symptoms in those patients, he explains. Before you do anything, talk to your therapist, psychiatrist, or doctor—they'll help you determine if you have situational anxiety or generalized anxiety. Start by describing how you feel and what triggers your symptoms. If your physician agrees that what you're experiencing seems like situational anxiety, mention that you'd like to give beta blockers a try. After that, the next step would be to get a prescription and take it for a test drive. Again, just make sure your physician knows your full medical history (no, seriously—tell them all the things) because beta blockers may affect people on certain medications and those with asthma or chronic lung diseases differently, Dr. Sanjiv explains. And remember that while beta blockers may serve as a sort of Band-Aid for getting through stressful events, they're not a cure. 'When we work to confront the things we're fearful of, that fear gradually extinguishes itself,' Dr. Breitinger said. 'The role of the medication is just to get the patient to the point where they feel like they can confront the fear.' Always consult your health care provider, dietitian, or other medical professional before taking a new medication or supplement. You Might Also Like Here's What NOT to Wear to a Wedding Meet the Laziest, Easiest Acne Routine You'll Ever Try
