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Thursday, December 18, 2014
Anxiety and Stress Disorders
Test taking anxiety and the best beta blocker
I am going to be taking a licensing oral board exam in the coming month and have a history of having anxiety melt downs before a significant exam, ie, USMLE step one, Radiology Physics exam, etc. My melt down involved GI symptoms with vasovagal reactions that last for about an hour until I take antispasmotics, which make me sleepy. I have tried metroprolol half dose, and it gave me stomach cramps, diarrhea and bradycardia. Is there a certain drug that is better than others? I am currently on wellbutrin for post partum depression, and have been on it for 17 months, 200mg per day.
One of the unknown bits of information on bupropion is that it inhibits the metabolism of many drugs.(metoprolol) I would test the benefit of a different beta-blocker propranolol at a smaller dose that might minimize the GI difficulties and and not have concentrations increased by bupropion. Try this 1-2 times well before important testing.
Nicholas A Votolato, RPh BCPP
Assistant Professor of Pharmacy
College of Pharmacy
Assistant Professor of Psychiatry, Emeritus
College of Medicine
The Ohio State University