Managing Bisoprolol Discontinuation: Heart Palpitations and Anxiety Concerns - Cardiology

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Managing the discontinuation of Bisoprolol, especially in the context of anxiety and heart palpitations, requires careful consideration and a comprehensive understanding of both the medication's effects and the underlying psychological factors involved.

Bisoprolol is a selective beta-blocker commonly used to manage hypertension and certain heart conditions. It works by blocking the effects of adrenaline on the heart, which can help to reduce heart rate and blood pressure. When discontinuing Bisoprolol, especially after a prolonged period of use, patients may experience withdrawal symptoms or a rebound effect, which can include increased heart rate, anxiety, and palpitations. These symptoms can be particularly distressing for individuals who already have anxiety disorders.

In your case, it appears that after stopping Bisoprolol, you experienced a significant increase in heart rate and feelings of tightness in the chest, which prompted an emergency visit. The tests performed (blood tests, X-ray, and ECG) returned normal results, indicating that there was no acute cardiac event occurring at that time. This is reassuring, but it does not eliminate the possibility that your symptoms are related to anxiety or the discontinuation of the medication.

The fact that your heart rate remains elevated (85-95 bpm) upon waking could be attributed to several factors, including anxiety, the body's adjustment to the absence of the medication, or even the effects of the anti-anxiety medication (Oxazolam) you took. It's important to recognize that anxiety can manifest physically, leading to symptoms such as palpitations, tightness in the chest, and even numbness in the extremities. These symptoms can create a vicious cycle where anxiety exacerbates physical symptoms, leading to more anxiety.

Given your situation, it is crucial to consult with your healthcare provider about whether to resume Bisoprolol. If your blood pressure is low (90/50), it may not be advisable to continue the medication, as it could further lower your blood pressure. However, if your heart palpitations and anxiety symptoms are significantly impacting your quality of life, your doctor may consider a lower dose or a different medication that could help manage these symptoms without causing hypotension.

Additionally, it may be beneficial to explore therapeutic options for anxiety management. Cognitive Behavioral Therapy (CBT) has been shown to be effective in treating anxiety disorders and can help you develop coping strategies for managing anxiety-related symptoms. Combining therapy with medication may provide a more comprehensive approach to your treatment.

In summary, the decision to continue or resume Bisoprolol should be made in consultation with your healthcare provider, taking into account your current symptoms, blood pressure readings, and overall health. It may also be beneficial to address the anxiety component through therapy or alternative medications that do not interfere with your heart rate or blood pressure. Monitoring your symptoms closely and maintaining open communication with your healthcare team will be key in managing your condition effectively.