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Pregnancy

Talk about every stage of pregnancy, from early symptoms to preparing for birth.

Doctor won't give me Propranolol

196 replies

bernieaa · 28/07/2023 21:47

Not sure why as Google says it's ok. 22 weeks pregnant and having panic attacks

OP posts:
Cloud992 · 29/07/2023 06:14

@bernieaa you seem to have already made up your mind that you want to take it despite your doctor telling you otherwise. You said yourself earlier that every one is different, so given that your GP is aware of your medical history, maybe there’s a reason why they’ve said No?

But anyway, you say you’ve already been given the meds pre pregnancy - so why not just take it then when You clearly want to? why ask random people on MN and then argue with those who would personally choose to listen to their doctor if they were in your position?

You have been made aware of the consequences of possible side effects via a BNF link which majority of healthcare practitioners use.
Nobody can force you to do or not do anything.

I avoided all medication that could of had a side effect to my baby when I was pregnant, but I personally didn’t think it was worth the risk. It was my decision and I stuck to it.

you’ve made your decision already, you’re just trying to justify it with others on MN.

knitnerd90 · 29/07/2023 06:28

BabbleBee · 28/07/2023 22:22

He’s right.

Beta blockers carry significant risk in pregnancy with severe adverse effects on the baby.

This is flatly untrue. It depends on the specific medication. I took a beta blocker for my entire second and third pregnancies because I have hypertension. They're considered one of the safer classes of medication for hypertension.

For everyone saying "the doctor surely knows better": I don't know if OP should have the medication, but I wouldn't rush to assume that the doctor is right. Propranolol does not have evidence of harm (there's the very woolly "it might cause growth restriction", but we don't actually have evidence), but also doesn't have evidence of safety. With medications like this, it's an enormous grey area that is down to the judgment of the doctor. They have to weigh risk vs. benefit and decide whether it's worth it, and they won't all decide the same way even for the same person.

I have a friend who got really rudely questioned by her GP over her decision to continue her antidepressant during pregnancy. The GP asked "how would you feel if there was harm to the baby?" and this is really an awful question because how could she know for sure it was the medication? And what about the risk to her from untreated depression? My friend wasn't shy about saying that to her GP. She stayed on her medication and the baby was fine.

because of the risk/benefit equation, you will have doctors deciding that women should stay on medications (for example mood stabilisers) that are known to have a definite risk to the baby. In my later pregnancies, there was a theoretical risk of harm from my blood pressure medication, but a definite known harm from untreated hypertension.

I will say this though: as-needed propranolol is probably safer than a continuous use SSRI, and it's definitely safer than a benzodiazepine.

febbabies2023 · 29/07/2023 06:32

Not sure why you asked for advice when you clearly don't give a flying fuck about the responses anyway.

Sounds like you wanted everyone to just agree with you that it would be fine to make yourself feel better

Go see another doctor if you're that adamant Jesus

sashh · 29/07/2023 06:49

Pregnancy can do serious damage to your heart on its own, it doesn't need a beta blocker as well if you can do without it.

@knitnerd90 has made a very sensible post. It is a risk benefit equation.

CR7 · 29/07/2023 08:29

@bernieaa I have just been prescribed it during pregnancy for arrhythmias. I am not allowed to take more than 20mg per week and only then when absolutely necessary. I'm being closely monitored. I have been given it because I'm having heart arrhythmias every two minutes. Day in day out. And still I can only have one tablet twice a week.

That should give you an idea of why others are prescribed it.

How much are you planning on taking? I would seriously say don't do it. Even though I've been prescribed it in a tiny dose by a private cardiology consultant I'm trying not to take it.

Khanga27 · 29/07/2023 08:31

bernieaa · 29/07/2023 01:52

Thanks.

I'm already getting growth scans due to bmi.

My GP has contacted the perinatal.

Can't believe how much support I'm getting whilst being pregnant.

We can't say via a forum whether it is right or wrong for you to take as we dont have your medical history. However you did initially say you had no risk factors, but you say here that you have been monitored due to your BMI. Your BMI alongside your pregnancy may be the additional risk that your doctor is considering when declining your taking of them. If your monitoring is due to a high BMI, then beta blockers can lower metabolic rates, and one of the initial possible side effects is weight gain (which could be risky for your pregnancy as well if you are already being monitored for BMI).

I'm not saying this is your doctors reasons but what I am saying is if you seek another professional medical opinion then you should ask for reasons if it is declined to understand better the risks to your baby but also to you while your body is under so much physical pressure growing a person. * *

Ladypenelopesdog · 29/07/2023 08:34

Some aspects of beta-blocker use in pregnancy are contentious among providers. Evidence on their safety, although well documented, is variable, and recent research reveals areas of controversy. Besides intrauterine growth restriction, other neonatal and obstetric complications remain a concern and should be explored thoroughly.

Justashley · 29/07/2023 08:38

You mentioned BMI (but not whether it was high or low) which will be a factor in their decision I'm sure. Again absolutely get a second opinion if you feel so inclined, but this demonstrates that GPs make decisions based on individuals and its not as simple as comparing with others or googling.

Jazzybean · 29/07/2023 08:43

https://www.medicinesinpregnancy.org/Medicine--pregnancy/Propranolol/

Generally speaking, propanolol is considered safe. If you have been taking it previously, you usually wouldn’t have to stop for example. There are lots of other anti anxiety medications that are also considered relatively safe (promethazine, SSRIs etc.).

GPs are not experts in pregnancy or mental health. Some GPs are over-cautious or not recently trained in medications and pregnancy (I used to spend my life as a community midwife emailing GPs asking why on earth they had told women to come off their medication when we know that generally the benefits of being emotionally stable outweigh the small risks to pregnancy). We obviously can’t say whether your GP is one of these or if they have other knowledge about your health/pregnancy that has informed this decision.

You should ask your midwife to book you an obstetrician appointment or, if appropriate, refer you to the perinatal mental health team. In the meantime, you may also benefit from self-referring for talking therapies.

bumps - best use of medicine in pregnancy

https://www.medicinesinpregnancy.org/Medicine--pregnancy/Propranolol/

CR7 · 29/07/2023 08:46

PS I should have mentioned - my GP referred me to a cardiologist. He wouldn't make the decision to put me on the meds (quite rightly I believe)

bellac11 · 29/07/2023 09:02

OP you didnt answer my query about how you would plan to use this medication.

You say you would only be taking it occasionally and therefore you imply by saying that that the risk of using it would be lowered

But panic attacks dont come along at pre planned moments so that surely would require you to take it daily

Secondly, you've had a go at a number of posters who you feel are using their personal circumstances to say you shouldnt use the medication, at the same time you keep repeating that 'other women have been given it' so you're doing the same thing, those other women might not have the same circumstances as you

I use propranolol from time to time, its situation specific with me, I also dont have panic disorder but sometimes need some help to cope with a situation so I know how valuable that is.

bernieaa · 29/07/2023 09:33

bellac11 · 29/07/2023 09:02

OP you didnt answer my query about how you would plan to use this medication.

You say you would only be taking it occasionally and therefore you imply by saying that that the risk of using it would be lowered

But panic attacks dont come along at pre planned moments so that surely would require you to take it daily

Secondly, you've had a go at a number of posters who you feel are using their personal circumstances to say you shouldnt use the medication, at the same time you keep repeating that 'other women have been given it' so you're doing the same thing, those other women might not have the same circumstances as you

I use propranolol from time to time, its situation specific with me, I also dont have panic disorder but sometimes need some help to cope with a situation so I know how valuable that is.

I've answered it. When I'm having a panic attack..... which is how I would have used it before.

But it seems you don't believe me anyway,,,.

OP posts:
bernieaa · 29/07/2023 09:35

Jazzybean · 29/07/2023 08:43

https://www.medicinesinpregnancy.org/Medicine--pregnancy/Propranolol/

Generally speaking, propanolol is considered safe. If you have been taking it previously, you usually wouldn’t have to stop for example. There are lots of other anti anxiety medications that are also considered relatively safe (promethazine, SSRIs etc.).

GPs are not experts in pregnancy or mental health. Some GPs are over-cautious or not recently trained in medications and pregnancy (I used to spend my life as a community midwife emailing GPs asking why on earth they had told women to come off their medication when we know that generally the benefits of being emotionally stable outweigh the small risks to pregnancy). We obviously can’t say whether your GP is one of these or if they have other knowledge about your health/pregnancy that has informed this decision.

You should ask your midwife to book you an obstetrician appointment or, if appropriate, refer you to the perinatal mental health team. In the meantime, you may also benefit from self-referring for talking therapies.

Hi the perintantal team has been discussed at length in other posts

OP posts:
bernieaa · 29/07/2023 09:35

Justashley · 29/07/2023 08:38

You mentioned BMI (but not whether it was high or low) which will be a factor in their decision I'm sure. Again absolutely get a second opinion if you feel so inclined, but this demonstrates that GPs make decisions based on individuals and its not as simple as comparing with others or googling.

Bmi has nothing to do with it. .

OP posts:
bernieaa · 29/07/2023 09:36

@Khanga27 bmi isn't a factor in this
Medication.

OP posts:
LittleBearPad · 29/07/2023 09:36

What else do you do to help manage your panic attacks?

bernieaa · 29/07/2023 09:36

CR7 · 29/07/2023 08:29

@bernieaa I have just been prescribed it during pregnancy for arrhythmias. I am not allowed to take more than 20mg per week and only then when absolutely necessary. I'm being closely monitored. I have been given it because I'm having heart arrhythmias every two minutes. Day in day out. And still I can only have one tablet twice a week.

That should give you an idea of why others are prescribed it.

How much are you planning on taking? I would seriously say don't do it. Even though I've been prescribed it in a tiny dose by a private cardiology consultant I'm trying not to take it.

I haven't had an attack for a few days but I can feel one brewing now :(

OP posts:
LittleBearPad · 29/07/2023 09:37

bernieaa · 29/07/2023 09:36

@Khanga27 bmi isn't a factor in this
Medication.

It is a factor in pregnancy however and may be adding to your GP’s decision.

bernieaa · 29/07/2023 09:37

sashh · 29/07/2023 06:49

Pregnancy can do serious damage to your heart on its own, it doesn't need a beta blocker as well if you can do without it.

@knitnerd90 has made a very sensible post. It is a risk benefit equation.

My heart is fine. Being an unmedicated mental health mother is also bad.

OP posts:
bernieaa · 29/07/2023 09:38

febbabies2023 · 29/07/2023 06:32

Not sure why you asked for advice when you clearly don't give a flying fuck about the responses anyway.

Sounds like you wanted everyone to just agree with you that it would be fine to make yourself feel better

Go see another doctor if you're that adamant Jesus

Apparently everyone is a doctor here and everyone knows what's best..... And get the rare nuggets of info that actually help.

OP posts:
LittleBearPad · 29/07/2023 09:40

None of this helps because no one on this thread is your GP or on your perimental health team.

No one can tell you it’s ok to take the tablets.

If you are struggling contact your midwife and ask for their help to escalate with the peri mental team and get a second opinion.

bernieaa · 29/07/2023 09:42

Cloud992 · 29/07/2023 06:14

@bernieaa you seem to have already made up your mind that you want to take it despite your doctor telling you otherwise. You said yourself earlier that every one is different, so given that your GP is aware of your medical history, maybe there’s a reason why they’ve said No?

But anyway, you say you’ve already been given the meds pre pregnancy - so why not just take it then when You clearly want to? why ask random people on MN and then argue with those who would personally choose to listen to their doctor if they were in your position?

You have been made aware of the consequences of possible side effects via a BNF link which majority of healthcare practitioners use.
Nobody can force you to do or not do anything.

I avoided all medication that could of had a side effect to my baby when I was pregnant, but I personally didn’t think it was worth the risk. It was my decision and I stuck to it.

you’ve made your decision already, you’re just trying to justify it with others on MN.

Bnf - "may cause"

Prozac - Manufacturers advise avoid during pregnancy unless the potential benefit outweighs the risk. There is a small increased risk of congenital heart defects when taken during early pregnancy. If used during the third trimester there is a risk of neonatal withdrawal symptoms, and persistent pulmonary hypertension in the newborn has been reported.

Sertaline - Manufacturers advise avoid during pregnancy unless the potential benefit outweighs the risk. There is a small increased risk of congenital heart defects when taken during early pregnancy. If used during the third trimester there is a risk of neonatal withdrawal symptoms, and persistent pulmonary hypertension in the newborn has been reported.

Etc.....

OP posts:
bernieaa · 29/07/2023 09:42

Whentwobecomesthree · 29/07/2023 05:30

Your gp is probably being overly cautious. Ask your midwife for an urgent referral to see a consultant. They will have much more experience of drugs and pregnancy and how to safely take them. In my experience if the consultant advises it's ok (by letter) the gp is normally ok with things. They just want to cover themselves

See posts about perinatal

OP posts:
bernieaa · 29/07/2023 09:43

Ladyj84 · 29/07/2023 00:17

I took my propanalol during all 4 pregnancies nobody advised me to stop and since I only take as and when I need its not often either

Which is why I'm surprised gp said no.

OP posts:
CR7 · 29/07/2023 09:51

@bernieaa As I mentioned, the cardiology consultant has prescribed no more than 20mg per week for me at the very most. This is with extra monitoring. How much are you planning to take?