Posted by ed_uk on February 18, 2005, at 14:44:42
In reply to Re: Akathisia, is this it?, posted by NealMcCoy on February 18, 2005, at 14:03:49
Hello!
>I am debating whether or not to take my propranolol dosage in fear that my heart rate will go too low because of the benadryl.
I doubt that it would go too low. If your pulse is already low or you suffer from low blood pressure I would be concerned. You are on a very low dose of propranolol. (Doses of 160-320mg are used to treat hypertension. 640mg/day is sometimes considered to be the absolute maximum dose but very few people actually take that much.)
Diphenhydramine (Benadryl) inhibits cytochrome P450 isoenzyme CYP2D6, which is responsible, in part, for the metabolism of propranolol. Theoretically, diphenhydramine might be expected to increase the propranolol plasma concentration but despite widespread use of this combination there are no reports of an interaction.
What is your heart rate at the moment?
What dose of Benadryl did you take? How many doses have you taken so far? If the Benedryl is more effective than the propranolol, you could stop the propranolol and continue the Benadryl. The usual dose of Benadryl is about 25-50mg three or four times a day. Any side effects from the Benadryl?
>When I got to 1 mg, the akathisia flared up big time.
How was the akathisia when you were on 2mg/day?
>I have been taking 20 mg's of it (propranolol) twice a day. Once right after I wake up and once in the evening.
Sometimes it can help to take it more often, you could try taking 10mg four times a day.
>I took 10 mgs Valium before bedtime. So I did only one dosage.
Your anxiety was probably a mild form of withdrawal. Despite what people often say, it is frequently necessary to take diazepam in divided doses to avoid withdrawal symptoms occuring between doses eg. you could have taken 2.5mg four time a day.
>How do you feel about going back on a low dose of Valium and tapering more gradually using Valium syrup and an oral syringe?
-I think that seems like a good option.I'd suggest taking about 2mg/day in divided doses eg. 0.5mg four times a day. You can decrease the dose gradually using diazepam liquid and an oral syringe marked in 0.5ml divisions.
>I take it you are from the UK?
Yes, England. What about you?
Regards,
Ed.
poster:ed_uk
thread:459703
URL: http://www.dr-bob.org/babble/20050217/msgs/460009.html