Symptoms after stopping atenolol
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Symptoms After Stopping Atenolol: A Comprehensive Overview
Blood Pressure and Heart Rate Changes
Gradual Return to Baseline Levels
Upon cessation of long-term atenolol therapy, patients typically experience a gradual return of blood pressure and heart rate to baseline levels. This process can take longer than the time required for the drug to be eliminated from the body. Studies have shown that both systolic and diastolic blood pressure, as well as heart rate, revert to pre-treatment values without significant rebound effects .
Potential for Rebound Effects
While some studies report no significant rebound in heart rate or blood pressure under unstressed conditions, others suggest that increased adrenergic sensitivity can occur, particularly under conditions of emotional stress or physical exertion. This indicates that while the risk of serious consequences from abrupt withdrawal may be low in stable conditions, caution is still advised, especially in patients with severe coronary artery disease .
Central Nervous System (CNS) Symptoms
Subjective CNS Symptoms
Atenolol has been associated with mild CNS-related subjective symptoms such as reduced vitality and contentment, particularly a few hours after intake. These effects tend to diminish over time. Additionally, atenolol has been reported to negatively impact sleep quality compared to placebo.
Specific Withdrawal Syndromes
Systemic Lupus Erythematosus (SLE)-like Syndrome
There have been rare cases where long-term use of atenolol has induced a lupus-like syndrome, characterized by symptoms such as fever, pleuropericarditis, and the presence of antinuclear antibodies. These symptoms typically resolve after discontinuation of the drug.
Hemodynamic and Hormonal Changes
Heart Rate Overshoot
After abrupt withdrawal of atenolol, some patients may experience an overshoot in heart rate, particularly in the standing position. This phenomenon, although variable among individuals, suggests a withdrawal syndrome in a subset of patients.
Thyroid Hormone Fluctuations
Minor fluctuations in thyroid hormones, specifically an overshoot of free-T3, have been observed following the sudden cessation of atenolol. However, these changes are generally not correlated with significant cardiovascular alterations.
Conclusion
Stopping atenolol can lead to a variety of symptoms, primarily involving gradual normalization of blood pressure and heart rate, potential CNS-related symptoms, and rare cases of drug-induced syndromes. While the risk of severe rebound effects is generally low, caution is advised, particularly in patients with underlying cardiovascular conditions. Monitoring and gradual tapering of the medication may help mitigate these withdrawal symptoms.
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