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Medical Forum / Diseases and Disorders / Alzheimer's / February 2006Beta-blockers?
Has anyone else noticed a correlation between using the class of drugs known as beta-blockers (for hypertension) and the onset of alzheimer's-like symptoms? In the case of my 85 year-old mother-in-law the effect was virtually immediate. Within a day or two of starting the drug, she became unable to concentrate or even carry on a normal conversation without losing her thread - often stopping speaking in the middle of a sentence. We persuaded her to revisit her doctor, who immediately took her off that drug (via a few days on a half dose) and replaced it with a vasodilator. She immediately returned to her normal, bright and active self and remained so until she died suddenly of a stroke at 91. I wonder about the wisdom of reducing blood pressure with beta-blockers in elderly people. It seems to me that an increase in blood pressure in old age could just be the body's natural response to narrowing arteries in the brain, in an attempt to maintain blood flow and oxygen supply at the necessary level. Vasodilation therefore seems a much sounder approach in such cases. Trevor Morris If you read any information about beta blockers it will mention confusion as a potential side effect, particarly in the elderly. It doesn't happen to everyone who takes them. With ANY medication, you have to watch for side effects. The elderly are more susceptible to side effects from most medications. A family friend who is almost 80 has a seizure disorder in the aftermath of a small stroke. Her dilantin has to be at a "just so" dose - she's exquisitlely sensitive to it. Too much and she's loopy (confused, forgetful, spacey), too little and she seizes. M. > If you read any information about beta blockers it will mention > confusion as a potential side effect, particarly in the elderly. It > doesn't happen to everyone who takes them. With ANY medication, you > have to watch for side effects. Indeed. What I had in mind was the possible direct effect of reducing blood supply to the brain by lowering blood pressure. That might not matter much if the supply was ample, as in a healthy young person, but might be a critical effect in an elderly brain with marginally adequate supply. Maybe this is why beta blockers are not recommended for patients over 30 (as I recall from the leaflet that came with the drug.). > The elderly are more susceptible to side effects from most medications. Especially ones that reduce blood supply to the brain? TM > A family friend who is almost 80 has a seizure disorder in the > aftermath of a small stroke. Her dilantin has to be at a "just so" dose > - she's exquisitlely sensitive to it. Too much and she's loopy > (confused, forgetful, spacey), too little and she seizes. > > M. Well, I'm not a chemist but how beta blockers work is essentially to dilate blood vessels by blocking some of the effects of adrenalin and causing smooth muscle relaxation. They ARE classed as vasodilators. M > > The elderly are more susceptible to side effects from most medications. > > Especially ones that reduce blood supply to the brain? no, almost all medications, since older folks' livers and kidneys don't work as well to metabolize them or remove them from the blood, so smaller doses are often called for. Maybe this is > why beta blockers are not recommended for patients over 30 (as I recall from > the leaflet that came with the drug.). I sincerely doubt this is accurate. http://www.webmd.com/content/pages/9/1675_57818.htm best, AW > Maybe this is >> why beta blockers are not recommended for patients over 30 (as I recall [quoted text clipped - 4 lines] > > http://www.webmd.com/content/pages/9/1675_57818.htm best, AW I was on a beta blocker for years, and I was certainly well past 30 at the time. My sister who is in her early 60's is on a beta blocker too. No problems reported in either case.  SignatureBest Regards, Evelyn (to reply to me personally, remove 'sox') I would think that VERY few people under the age of 30 have the conditions that a beta blocker would be recommended for. They are used for the diseases of middle age and beyond - high blood pressure that isn't responding to diet and exercise, heart rhythm problems, congestive heart failure etc. Stuff I certainly never had to think about at 29!! M. >I would think that VERY few people under the age of 30 have the > conditions that a beta blocker would be recommended for. They are used [quoted text clipped - 5 lines] > > M. Well, as I recall, beta blockers were widely prescribed for stressed-out yuppies in the 1980s, and their use was meant to be short-term (~weeks) and confined to relatively young people suffering high blood pressure induced by stress. The main advice was to reduce the stress, not to take the pills for ever after. No doubt that class of drugs has now been extended and developed, and maybe side effects are now less common, and they no doubt suit some people very well. However, I still think that *any* drug which reduces blood pressure and supply by acting directly on the heart to slow it down and reduce its pumping pressure (and that is the way b-bs act, I gather) is bound to reduce the blood flow to the brain to some extent. To me, that seems a very undesirable outcome wherever blood supply is already restricted by narrowed or hardened arteries, as it very often is in the elderly. From seeing the effect on my mother-in-law it seems possible that there are other cases out there being diagnosed as alzheimers when what is being seen is the direct (and unsurprising) effect of blood pressure-lowering medication. That was the point of my original post. TM > >I would think that VERY few people under the age of 30 have the > > conditions that a beta blocker would be recommended for. They are used [quoted text clipped - 26 lines] > > TM The amount of blood being pumped into the brain isn't what causes dementia symptoms or makes the symptoms worse. How do beta-blockers work? Beta-blockers "block" the effects of adrenaline on your body's beta receptors. This slows the nerve impulses that travel through the heart. As a result, your heart does not have to work as hard because it needs less blood and oxygen. Beta-blockers also block the impulses that can cause an arrhythmia. Your body has 2 main beta receptors: beta 1 and beta 2. Some beta-blockers are selective, which means that they block beta 1 receptors more than they block beta 2 receptors. Beta 1 receptors are responsible for heart rate and the strength of your heartbeat. Nonselective beta-blockers block both beta 1 and beta 2 receptors. Beta 2 receptors are responsible for the function of your smooth muscles (muscles that control body functions but that you do not have control over). Rare side effects: Abdominal cramps. Throwing up. Diarrhea. Constipation. Back or joint pain. Skin rash. Sore throat. Depression. Memory loss, confusion, or hallucinations. Impotence. While a very small percentage of elderly people may have odd side effects from taking beta blockers the fact is that any changes in any medication can and will often throw dementia patients for a loop. The only younger people I ever read about taking beta blockers were Olympic biathletes (before drug testing) using them to steady their trigger finger. Since beta blockers create a type of dependency affecting heart function which can cause severe repercussions if they are stopped abruptly, I just can't believe they were ever widely used in the manner you described. They just aren't something to be used like a valium or zanax. best, AW I'm on Toprol XL but the doctor has cut it down to one half tablet a day because it had made my heart rate too slow. No problems otherwise, and I'm 77. Gwen > Maybe this is >> why beta blockers are not recommended for patients over 30 (as I recall [quoted text clipped - 4 lines] > > http://www.webmd.com/content/pages/9/1675_57818.htm best, AW |
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