Drugs Q & A

What Is The Recommended Metoprolol Dosage For Anxiety?

According to the American Psychological Association (APA), anxiety is an emotion characterized by feelings of tension, worried thoughts, and physical changes like increased blood pressure. Knowing the difference between normal feelings of anxiety and an anxiety disorder requiring medical attention can help a person identify and treat the condition.

The duration or severity of an anxious feeling can sometimes be out of proportion to the original trigger, or stressor. Physical symptoms, such as increased blood pressure and nausea, may also develop. These responses move beyond anxiety into an anxiety disorder.

The APA describes a person with anxiety disorder as “having recurring intrusive thoughts or concerns.” Once anxiety reaches the stage of a disorder, it can interfere with daily function.

While a number of different diagnoses constitute anxiety disorders, the symptoms of a generalized anxiety disorder (GAD) will often include the following:

•          restlessness, and a feeling of being “on-edge”

•          uncontrollable feelings of worry

•          increased irritability

•          concentration difficulties

•          sleep difficulties, such as problems in falling or staying asleep

While these symptoms might be normal to experience in daily life, people with GAD will experience them at persistent or extreme levels. GAD may present as vague, unsettling worry or more severe anxiety that disrupts day-to-day living.

What is metoprolol oral tablet?

Metoprolol is used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks or strokes. These problems may be less likely to occur if blood pressure is controlled.

Metoprolol is also used to treat severe chest pain (angina) and lowers the risk of repeated heart attacks. It is given to people who have already had a heart attack. In addition, metoprolol is used to treat patients with heart failure.

Metoprolol is available in these two forms, which are described in more detail below:

  • immediate-release tablets, called metoprolol tartrate
  • extended-release tablets, called metoprolol succinate

Both of these forms of metoprolol can be used to:

  • prevent angina (a type of chest pain)
  • treat high blood pressure

Additionally, metoprolol succinate is used to treat heart failure. And metoprolol tartrate is used to treat a heart attack or prevent one from occurring in the future.

Metoprolol is used off-label for anxiety. Off-label drug use refers to the practice of prescribing a drug for a different purpose than what the FDA approved. This practice is called “off-label” because the drug is being used in a way not described on its package insert. This insert is known as its “label.”

Metoprolol and other beta-blockers are a useful tool for managing some of the physical symptoms of anxiety and stress—such as sweating, dizziness, and rapid heart rate—but cannot treat the actual psychological causes of the condition.

Beta-blockers work best for short-term event-related anxiety, such as social phobias and stage fright by blocking physical symptoms of anxiety including rapid heart rate, tightness in the chest, or sweating. They don’t affect the emotional and psychological aspects of anxiety such as worry.

Both metoprolol succinate and metoprolol tartrate can be used in adults. In addition, metoprolol succinate can be used in some children with high blood pressure.

Metoprolol tartrate is an immediate-release tablet, which means it works right away after you take it. Metoprolol succinate, on the other hand, is an extended-release tablet. It works consistently over a period of time after you take it.

How metoprolol work

Metoprolol is a beta-blocker. It works by affecting the response to nerve impulses in certain parts of the body, like the heart. As a result, the heart beats slower and decreases the blood pressure. When the blood pressure is lowered, the amount of blood and oxygen is increased in the heart. For anxiety metoprolol work by blocking the effects of adrenaline. They reduce the force with which your heart pumps blood and help stabilize blood pressure, heartbeat, etc. They keep jitters at bay in a similar manner, by blocking the effects of adrenaline.

How should I take metoprolol for anxiety?

Metoprolol is a prescription medication. Your doctor will recommend your dosage based on your specific needs. Typically, your dosage may start around 100 mg per day. It may be taken at once or divided up in different doses. Depending on how you respond to the initial dosage, your physician may recommend that you increase your daily intake. The maximum dosage is 450 mg per day.

You should be careful not to go over your recommended dosage of Metoprolol. Taking too much can slow down your heart rate too much and cause breathing difficulties, dizziness, and tremors.

Your doctor may start you on a low dose of metoprolol and gradually increase your dose.

Metoprolol can help with some anxiety disorders but does not cure them. Continue to take metoprolol even if you feel well.

Metoprolol side effects

Metoprolol oral tablet can cause certain side effects.

More common side effects

The more common side effects that can occur with metoprolol include:

•          tiredness

•          dizziness

•          diarrhea

•          constipation

•          breathing problems such as shortness of breath, cough, and wheezing

•          bradycardia (heart rate that’s slower than normal)

•          reduced interest in sex

•          rash

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

•          Low blood pressure (hypotension). Symptoms can include:

o          severe dizziness

o          lightheadedness

o          fainting

•          Cold hands and feet. Symptoms can include

o          hands and feet that are cold and may be painful

•          Very slow heart rate (severe bradycardia)

•          Extreme fatigue. Symptoms can include:

o          feeling more tired than usual

o          tiredness that gets progressively worse each day

•          Serious depression. Symptoms can include:

o          continuous feelings of sadness or anxiety

o          feelings of hopelessness or worthlessness

o          lack of interest in hobbies you once enjoyed

o          eating too much or too little

o          trouble concentrating

Metoprolol may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

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Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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