Hi. I'm about 9 months post-surgery and doing great. I continue to feel so very grateful to this community on the forum. You have all been a tremendous source of support and continue to be. I try to post any findings that might be relevant to others, and it is in this spirit that I am posting my experiences with Toprol here.
As with many post-AVR surgeries (and probably other heart surgeries), they put my on Toprol (a beta blocker) to reduce the strain on my heart during recovery by lowering my blood pressure and heart rate. A few months following surgery I had a bout of PVCs or PACs, so they increased my dosage from 25mg/day to 50mg/day, which I was told is still a relatively low dosage. In retrospect, I think the PVCs were situational (stress) and I know from past experience they can be episodic, but I think they recommended the increase just to manage the benign symptoms for quality of life. I continued to take the 50mg/day for months. In general, though, I prefer not to take medication that I don't need. So at a certain point I asked my cardiologist if I could wean myself. She suggested a protocol of reducing the Toprol to 25mg/day for two weeks, then to 25mg/every other day for two weeks, and then to none. She said if at each step, I didn't get a recurrence of the PVCs, I could proceed to the next step.
It turns out the PVCs never really increased beyond what I consider normal (a few each day), so I followed the weaning regimen all the way through. As it turns out, Toprol has an anxiolytic effect (anti-anxiety), which I never explicitly noticed while I was taking it. But when I reduced from 50 to 25mg/day, I experienced a few uncomfortable days of anxiety. Then when I reduced again from 25mg/day to every other day, I experienced yet another day or two of anxiety, which passed. The final transition, however, to no Toprol, was the most difficult. It left me with a fairly constant generalized anxiety. I think explored the Internet to discover that many people experience this to such a degree that they are never able to completely wean themselves and remain on Toprol for life. I endured this discomfort for over a month and was almost at the point of resuming toprol (with the cardiologist's consent), but I decided to wait another day or two to explore alternatives, and during that time period the discomfort finally abated. In other words, I'm off Toprol, I no longer feel anxious, and any bounce-back effect seems to have subsided.
My main reason for posting this is to give hope to anyone else who is trying to wean off Toprol and has a similar experience. At least in my case, with enough patience to endure the emotional discomfort, I am finally back to normal. I will also mention that reducing caffeine intake (which was higher while on Toprol) seems to have helped as well.
Toprol seems to be a very effective drug for its intended use, but anyone considering taking it should know about the possibility of withdrawal effects. As always, caveat emptor.
I suppose drugs like Toprol and their withdrawal or "bounce-back" effects vary from person to person, but I hope this can be useful to others and wonder if anyone else has had similar experiences.
My very best,
pem
