Atenolol: Side Effects and Heart Health Concerns

Hello, Dr. He. I'm sorry to bother you again?

During my follow-up appointment, I described my symptoms to the doctor, who expressed concern that they might not be neurologically related.
He noted that the pain symptoms were quite extreme, occurring even at rest without any movement.
As a result, he prescribed Atenolol 50 mg, which I found out is a sympatholytic medication used not only for hypertension but also in psychiatry.
I noticed an effect on the same day I took it; however, the next day I suddenly experienced a sore throat.
Given my history of medication allergies, I wondered if this drug was the cause.
I then consulted a rheumatologist, who advised me to stop the medication to see if my symptoms would improve.
However, I noticed that this medication should not be abruptly discontinued.
Additionally, I do not have hypertension; my blood pressure has consistently been around 90/60.
While taking this medication, my blood pressure dropped to the 70s and 50s, and my heart rate decreased to 57 beats per minute, whereas my usual heart rate is around 80 beats per minute without medication.

I have now stopped the medication, and today is the second day; my sore throat has started to lessen.
However, I am uncertain if this improvement is indeed due to discontinuing the medication, as I only have a sore throat without any cold symptoms like coughing or runny nose.
Therefore, I would like to ask the doctor if this medication can cause such side effects.
Should I continue to stop the medication or resume taking it? If this medication effectively alleviates chest discomfort, does that necessarily indicate a heart condition (even though the original doctor suspected the pain was due to arrhythmia) or could it be related to anxiety?
Additionally, I have heard that this medication may cause sexual dysfunction.
Besides this antihypertensive medication, I also take a sustained-release formulation of Sertraline, which seems to have no reported side effects related to sexual dysfunction.
Should I switch to just taking this medication? The original doctor believes that it is unlikely I have a heart condition due to my age and low blood pressure, which has been consistently low throughout my life.
There was only one instance in the emergency room where my blood pressure rose to 120, which occurred at 2 AM when I experienced compressive pain in the left chest near the upper abdomen and sweating.
However, the discomfort subsided just before I was about to be transported by ambulance.
The blood pressure readings during the ambulance ride were similar, and after blood tests and an ECG, the doctor confirmed that everything was normal.
The emergency physician suspected a chronic condition, with the onset occurring on October 17 at 1 AM.

I am also planning to undergo a comprehensive health check-up since I have already seen both a neurologist and a rehabilitation specialist, both of whom believe my symptoms are more indicative of a heart condition.
However, the cardiology tests, including a 24-hour Holter monitor, echocardiogram, and blood tests, all returned normal results.
The doctor suggested that if it’s not a gastrointestinal issue, it might be neurological, which feels a bit like passing the buck.
I have not consulted a gastroenterologist yet, but my family thinks it would be more efficient to go directly for a comprehensive health check-up.

Chen KUI, 20~29 year old female. Ask Date: 2016/10/25

Dr. He Dongjin reply Cardiology

Hello, please check your overall health.
You may consider stopping atenolol since your blood pressure is not high and it has unwanted side effects.
Changhua Hospital cares about you.

Reply Date: 2016/10/25

More Info

Atenolol is a beta-blocker commonly prescribed for managing high blood pressure and certain heart conditions. It works by blocking the effects of adrenaline on the heart and blood vessels, leading to a decrease in heart rate and blood pressure. While it is effective for many patients, it can also lead to various side effects, some of which you have experienced.

One of the concerns you raised is about the potential for Atenolol to cause insomnia. While insomnia is not one of the most commonly reported side effects of Atenolol, it can occur in some individuals. The mechanism behind this could be related to the drug's effects on the central nervous system. Beta-blockers can sometimes lead to changes in sleep patterns, and some patients report vivid dreams or disturbances in sleep. If you notice that your sleep quality improves when you stop taking Atenolol, it may be worth discussing this with your healthcare provider. They might consider adjusting your dosage or switching you to a different medication that does not have this side effect.

You also mentioned experiencing throat pain after starting Atenolol. This symptom is less common and could indicate an allergic reaction or sensitivity to the medication. Given your history of drug allergies, it is prudent to stop the medication and consult your doctor to determine whether Atenolol is the cause of your throat pain. Your healthcare provider may suggest alternative treatments for your condition that do not carry the same risk of side effects.

Regarding your blood pressure readings, it is important to note that Atenolol can lower blood pressure, which is beneficial for those with hypertension. However, if your blood pressure is already low (as you indicated, with readings around 90/60), Atenolol may not be necessary or appropriate for you. Your healthcare provider may need to reassess your treatment plan, especially since you have reported episodes of very low blood pressure and bradycardia (a slow heart rate).
You also expressed concerns about whether your chest discomfort is related to heart disease or anxiety. Given your low blood pressure and the fact that you have undergone extensive cardiac evaluation with normal results, it is less likely that your symptoms are due to a significant heart condition. Anxiety can indeed manifest as physical symptoms, including chest discomfort and palpitations. If your healthcare provider suspects that anxiety is contributing to your symptoms, they may recommend therapy or medications that specifically target anxiety without the side effects associated with beta-blockers.

Lastly, you mentioned concerns about sexual dysfunction associated with Atenolol. This is a known side effect of many beta-blockers, including Atenolol. If this is a significant concern for you, discussing alternative medications with your doctor is advisable. There are other classes of antihypertensive medications that may not have the same impact on sexual function.

In summary, Atenolol can cause side effects such as insomnia and throat pain, especially in individuals with a history of drug allergies. If you are experiencing significant side effects or if your blood pressure is consistently low, it is essential to have an open discussion with your healthcare provider about your treatment options. They can help you find a medication regimen that effectively manages your symptoms while minimizing adverse effects. Regular follow-ups and monitoring are crucial to ensure your treatment remains safe and effective.

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