Prazosin & propranolol combination to treat intrusive symptoms

[bellbird]

Hi,
I'm taking 4mg prazosin nightly, which is helping with not remembering nightmares some nights.

In addition to PTSD, I also have essential tremor (neurological disorder), for which I've tried every (first-, second-line and miscellaneous) medication in the past (much like PTSD, ET meds are all borrowed from other conditions) with not much luck. Yesterday I decided to do some research into propranolol again; a beta blocker that is a first-line med for ET. Like prazosin, propranolol decreases blood pressure so I was looking into the literature on how viable of a combination this would be before seeing my doctor this morning. I thought about trying it again because I realised that the last time I tried it was probably still during my abusive relationship, so it is hard to say whether it didn't work because it didn't work, or because of everything else going on.

In doing so, I stumbled on this review paper which actually discusses the combination of propranolol and prazosin for the treatment of PTSD intrusive symptoms (daytime and night time, respectively). I shared the paper with my doctor this morning, and we are going to trial some low-dose propranolol daily in the morning. Hopefully it can help with one or both of my tremor and daytime flashbacks. C'mon, two birds...

Mostly sharing this in case anyone else is interested, but also curious if anyone else has tried this combination &/or had any success with it (for either PTSD or ET ;).
Cheers.

 

[scout86]

Slightly different, but possibly related. There is a little bit of info out there on using propranolol for treat phobias and PTSD. Link That link is to an article that's sort of a brief overview. There's more online, if you're interested & want to look. Most of what I've read is work done by Merel Kindt, from the Netherlands. (She has a web site, as well as some published journal articles.) What I found interesting about this is that the propranolol is supposed to help change how the memories are stored in the brain. It has nothing to do with it's effect on blood pressure. At least not directly.

Having said that, I tried it in Dec & it didn't work in my case. Now, "my case" was a sort of do it yourself experiment, and things........ Well, lets just say things could have been handled better if everyone involved really understood things. At least I think so. (Both my T and a nurse practitioner were involved in this, but there are some things about both trauma and phobias that the NP probably didn't get) It sounds like this really does work some of the time though, so the whole area seems like it would be worth exploring. Keep us posted!

 

[Freida]

I tried atenolol for high bp and within 24 hours it made me homicidal. Scary homicidal. Like barely able to control it homicidal.

Luckily I know I have a med reaction history so I called the pharmacists who said yep, that's a rare (but known) side affect and it would probably happen with me if I used any drug ending in lol (atenolol, proranolol, etc)

Then he told me it would probably last about 24 more hours and not to leave my house until I felt better. And, obviously, to not take it again

At the time I hadn't been diagnosed with ptsd but since then I've wondered if the two were somehow connected.

Either way, it scared the crap out of me.

 

[bellbird]

@Freida -- that sounds awful. Atenolol and propranolol are both beta-blockers, but atenolol is hydrophilic (water loving) and supposedly unable to cross the blood brain barrier, while propranolol is lipophilic (fat loving) and therefore able to cross the blood brain barrier. I haven't read much into the exact implications of that difference, nor how it relates to what you experienced, just came across the information when I was looking up atenolol (had never heard of it) and found it interesting.

Keep us posted!

Thank you, @scout86 , and thanks for linking that study.

Ok so I am now on day 4 of propranolol.
The first two days I was only taking 5 mg as my GP wanted to ease me in for a couple of days. I didn't really notice anything major; both in terms of effect and side effect.
Yesterday I went up to 10 mg.
I will say that today is the first day I am sure I am noticing an effect on my tremor. Really pleasantly surprised. I think both the amplitude and frequency of the tremor has been lessened. Slightly, but noticeably. And in turn, anxiety around tremor has also lessened slightly (normally that feedback loop works towards anxiety->more tremor->more anxiety, etc. but it seems it can also work in reverse).
I have a phone consult with my GP tomorrow so can let her know about it then. We were due to take my BP tomorrow, but my appointment is no longer in-person due to the lockdown, so I guess that won't be happening. I have checked my HR a couple of times to make sure it hadn't dropped too low (GP said I can't take propranolol if it drops below 55 bpm), but it was all good. I also haven't felt dizzy/weak.

I don't think I have noticed any effect on my flashbacks yet though.
But maybe we can increase the dose in the future (my understanding is that 10 mg is still very low). Will update again.