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Related Experiment Videos

The beta-adrenergic blockade withdrawal phenomenon.

R J Walden, B Tomlinson, P Bhattacharjee

    Journal De Pharmacologie
    |January 1, 1983
    PubMed
    Summary

    Beta-blocker withdrawal can cause increased symptoms and even sudden death. Gradual dose reduction and restricted exertion are recommended to manage beta-blocker withdrawal syndrome.

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    Physical review letters·2017

    Area of Science:

    • Cardiology
    • Pharmacology

    Background:

    • Beta-blocking drugs are used for angina.
    • Abrupt withdrawal of beta-blockers has been linked to increased symptoms and sudden death.
    • Mechanisms may include increased beta-receptor sensitivity and other physiological changes.

    Purpose of the Study:

    • To investigate the phenomenon of beta-blocker withdrawal syndrome.
    • To explore potential underlying mechanisms.
    • To compare withdrawal effects of different beta-blocking agents.

    Main Methods:

    • Review of early clinical trials and reports on beta-blocker withdrawal.
    • Assessment of beta-receptor sensitivity using isoprenaline challenge after propranolol withdrawal.
    • Observation of pindolol withdrawal in normal volunteers.

    Main Results:

    • Beta-blocker withdrawal can lead to increased angina symptoms and, in some cases, sudden death.
    • Increased beta-receptor sensitivity, possibly due to receptor upregulation, is a potential mechanism.
    • Withdrawal of pindolol, a partial agonist, did not show increased isoprenaline response.

    Conclusions:

    • Beta-blocker withdrawal syndrome is a real clinical phenomenon, though likely not common.
    • Gradual dose reduction and restricted physical exertion are advised during beta-blocker withdrawal.
    • Pindolol's partial agonist properties may mitigate withdrawal effects.

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