Beta Blockers for anxiety control

[Fearful]

Hi!
I'm wondering how many of you use beta blockers for anxiety control at the dentist? And how to do you use them? .......a day or 2 before the visit, or all the time?
I was put on a beta blocker several years ago for high BP and it definitely took the edge off going to the dentist. But a few months ago, I came down on the dose, because it tends to make me really spacey. It really helped with the spaciness.... BUT.........I broke a tooth last friday, and realize that perhaps my freaking out so badly since then, is because I came down on the beta blocker. I'm thinking a could just go up on it for a few days before the dentist visit. I was wondering how the rest of you deal with the beta blockers, and do they help you? Thanks.

[vicki]

Hi Fearful

I also take Beta Blockers - for anxiety control rather than blood pressure problems though. You'll probably know most of what I'm about to say but here goes anyway...

There are two sides to fear/anxiety (in my experience anyway!); the physical which includes palpitations, shaking, raised blood pressure and other physical signs, and the psychological/emotional side which is basically your thought processes or what goes through your mind before, during and after the event.

For some people the psychological side of fear starts first which then causes the physical side of things to start and for others it's the other way round. Beta Blockers as you know, will control the physical side of things to some extent so your heart won't beat as fast and your blood pressure won't be as high. One side effect of them is that they can give you a spaced out feeling (which I actually rather like!!), but they won't (to my knowledge - but I'm no expert!) affect your thoughts/emotions. So, if you're the kind of person who gets the physical symptoms first which then lead onto anxious thoughts etc, then Beta Blockers can really help. If on the other hand you're like myself and have the thoughts first, then they can make the physical symptoms less distressing but they won't actually control the anxiety.

Have you talked to your doctor about Beta Blockers in relation to your anxiety at the dentists? As far as I know, there are quite a few types of Beta Blocker drugs available, some are better for controlling blood pressure, some are better for anxiety and some are good for both. Also, with some of the drugs, they can be taken a few times a day, as a one-off dose before the 'nervous' event or as a slow-release drug which you take once and it lasts all day (all this obviously depends on your situation and what your doctor says).

Because I'm not anxious 100% of the time, I only take them when I know there's a chance I may panic or freak out, so I usually take them for 2 or 3 days before a dental appointment as well as on the day.

[Fearful]

Hi Vicki,
Thanks for that reply. Before I was on beta blockers, I would go to the dentist's (or doctor's), and start to get nervous, but then my heartrate would go crazy, and my blood pressure would spike, and that would make me even more scared, so I think that's why it works well for me. ......but not well enough, since I'm freaking out about my dentist visit this friday. But I have noticed that since I came down on my beta blocker dose from 75 to 50mg several months ago, I do tend to be anxious alot more. But.........I'm able to think so much more clearly, that I just don't want to go back up on it.
I know I can take a little more for the dentist, I just didn't know how soon I should start it. I was thinking 2-3 days, like you do. My only reservation with that is that it works for my migraines too, and I know when I come back down on the dose, I'll get headaches for a couple days. I guess I just can't have everything!!
Thanks again for your help!

[vicki]

A few more thoughts....

Fearful said:

Before I was on beta blockers, I would go to the dentist's (or doctor's), and start to get nervous, but then my heartrate would go crazy, and my blood pressure would spike, and that would make me even more scared

So, from the sounds of it, you're nervous before you go which causes your heartrate and blood pressure to increase which in turn makes you even more anxious and scared...?? It's a vicious circle - I should know !

If somehow (in an ideal world!), you could have the 'perfect' dose of beta blockers which you knew would completely get rid of all your physical signs of anxiety, would you still be as nervous before and during appointments?

Fearful said:

My only reservation with that is that it works for my migraines too, and I know when I come back down on the dose, I'll get headaches for a couple days. I guess I just can't have everything!!

I also get migraines - so I know how awful they are. Mine are usually triggered by stress or thunderstorms. I take prescribed migraine drugs to get rid of them once they start - but because they work in a similar way to beta blockers, I can't take both drugs at the same time - it's one or the other. Obviously going to the dentist's is just about the most stressful situation I can be in so once I get home after the appointment (and the adrenalin has stopped pumping!) I usually get the migraine from hell - which I can't take the migraine drugs for because I've already had the beta blockers! So, no, we can't have everything - but it would be nice if we could!

I suppose it's a question of what's more important - less anxiety at dental appointments or no migraine. For me personally, I'd have to choose less anxiety at the dentist's... but that's just me.

There are other non-drug treatments for migraine (some of which can be used along with drugs - check it out with your doctor). I also use a tens machine and menthol gel patches ('Migraine Ice' in the UK and 'Well Patch' in the US - http://www.mentholatum.com) - they don't get rid of them completely but it does make it a bit more bearable.