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Does Inderal Represent Any Obvious Contraindications In Alzheimer Disease?
Posted on
Tue, 18 Aug 2015
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Tue, 18 Aug 2015
Answered on
Tue, 8 Sep 2015
Last reviewed on
Question : I am writing this regarding my 88 years old mother. She has been taking the drug Inderal LA 60 mg for over 30 years for Arrhythmia and Tackecardia. Her cardiologist wants to take her off due to her onset of Alzheimer within ten days , tapering her off every other day for 5 days. Does this pose danger of heart attach?
Brief Answer:
A supervised therapy would be the best alternative.
Detailed Answer:
Hello!
Thank you for asking on HCM!
Regarding your concern, I would like to explain that beta-blockers including Inderal) do not represent any obvious contraindications in Alzheimer disease.
Perhaps the only drawback in such settings is the increased risk of the disordered treatment, or even overdoses (as Alzheimer patients face with severe short-term memory loss).
The way how your doctor has decided to stop Inderal is trying to minimize abrupt withdrawal symptoms (rebound phenomenon), leading to appearance of tachycardia and even arrhythmia.
As your mother has a previous history of cardiac arrhythmia, leaving without an antiarrhythmic treatment would risk to greater probability of arrhythmia recurrences.
A gradual tapering off, would avoid rebound phenomenon (and hence dangerous tachycardia, which could trigger increased myocardial demands with potential consequent cardiac ischemia, or even heart attack).
So no consistent risk of heart attack would follow a correct gradual Inderal take off (as your doctor is performing), but may leave your mother unprotected from potential arrhythmia recurrences.
I would suggest that the best way to face with both XXXXXXX conditions would be to supervise your mother's cardiac therapy by a household caregiver.
In such way no risks imposed by Alzheimer disorder would interfere with her chronic therapy.
Hope to have been helpful to you!
Feel free to ask me whenever you need! Greetings! Dr. Iliri
A supervised therapy would be the best alternative.
Detailed Answer:
Hello!
Thank you for asking on HCM!
Regarding your concern, I would like to explain that beta-blockers including Inderal) do not represent any obvious contraindications in Alzheimer disease.
Perhaps the only drawback in such settings is the increased risk of the disordered treatment, or even overdoses (as Alzheimer patients face with severe short-term memory loss).
The way how your doctor has decided to stop Inderal is trying to minimize abrupt withdrawal symptoms (rebound phenomenon), leading to appearance of tachycardia and even arrhythmia.
As your mother has a previous history of cardiac arrhythmia, leaving without an antiarrhythmic treatment would risk to greater probability of arrhythmia recurrences.
A gradual tapering off, would avoid rebound phenomenon (and hence dangerous tachycardia, which could trigger increased myocardial demands with potential consequent cardiac ischemia, or even heart attack).
So no consistent risk of heart attack would follow a correct gradual Inderal take off (as your doctor is performing), but may leave your mother unprotected from potential arrhythmia recurrences.
I would suggest that the best way to face with both XXXXXXX conditions would be to supervise your mother's cardiac therapy by a household caregiver.
In such way no risks imposed by Alzheimer disorder would interfere with her chronic therapy.
Hope to have been helpful to you!
Feel free to ask me whenever you need! Greetings! Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I am sorry to be annoying my understanding is that since the cardiologist sees fit for the taper of 5 alternate days to be sufficient that would not pose cardiac arrest in her case. Am I correct? I understand that in all cases there is still chance but my concern is that there are no high risks and I just would need to check her blood pressure and ask how she feels for the next two to three weeks.
Brief Answer:
No increased risk of heart attack.
Detailed Answer:
Hello again!
You are right! No increased risk of cardiac arrest seems to arise from Inderal tapering off.
Just relax!
If Inderal withdrawal is gradual (as is recommended for all beta-blockers), there is no risk for rebound phenomenon (as I explained you above), and consequently no increased risk for reactive tachycardia, other arrhythmic events, or heart attack.
Nevertheless, As I have explained you, the best option to follow would be a therapy (Inderal) continuation under close supervision of a household caregiver (instead of stopping the drug, because of potential suboptimal therapy application).
Best wishes,
Dr. Iliri
No increased risk of heart attack.
Detailed Answer:
Hello again!
You are right! No increased risk of cardiac arrest seems to arise from Inderal tapering off.
Just relax!
If Inderal withdrawal is gradual (as is recommended for all beta-blockers), there is no risk for rebound phenomenon (as I explained you above), and consequently no increased risk for reactive tachycardia, other arrhythmic events, or heart attack.
Nevertheless, As I have explained you, the best option to follow would be a therapy (Inderal) continuation under close supervision of a household caregiver (instead of stopping the drug, because of potential suboptimal therapy application).
Best wishes,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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