Treating Chronic Fatigue Syndrome (ME/CFS): Propranalol
Propanolol Is a beta blocker. Developed in the 1950's
Propanolol won its creator a Nobel Prize in 1988 for the development of the
first beta blocker. Propanolol has been used in a fairly wide set of disorders
including angina, tremor, migraines, post-traumatic stress disorder it has been best known for its use in hypertension.
Propanolol may be effective in the treatment of post-traumatic stress disorder
because it inhibits norepinephrine activity which plays a role in consolidating
memories. It's currently being
explored as a treatment for malaria.
A non- selective beta blocker propranolol blocks activity of both epinephrine
and norepinephrine. Beta blockers reduce the excitation of the sympathetic
nervous system. During exercise, for example, they would reduce the heart rate
and the contracting force of the heart muscle. Beta blockers reduce blood pressure by
inhibiting renin release and thus aldosterone levels resulting in reduced sodium
and water retention. They also have the side effect of reducing anxiety and are
used by some performers to tame their jitters before they take the stage.
Beta Blockers and Chronic Fatigue Syndrome (ME/CFS) - no studies of the efficacy of beta blockers in chronic
fatigue syndrome have been done the patient reports have been all over the map
with some patients doing very well and others having very negative reactions to
the drugs.
Chronic Fatigue Syndrome (ME/CFS) Studies - None
Chronic Fatigue Syndrome (ME/CFS) Patients Report - None
Chronic Fatigue Syndrome (ME/CFS) Doctors Report - In an
email, fatigue and pain researcher Dr. Light, reported an experience he had with
Propanolol.
"Theoretically, beta and alpha blockers should actually make CFS
patients worse, because the prevailing theory (with some pretty good evidence)
is that vascular smooth muscle alpha and beta receptors are DOWN regulated (are
effectively non-functional) due to an “overdrive” of the sympathetic nervous
system. Activation of these receptors is essential for proper control of blood
flow in skeletal muscles and perhaps also the brain. Without proper control, the
amount of metabolites signaling fatigue and muscle pain could swing wildly,
leading to the sensation of fatigue with even modest movement, and even at
rest. Worse, it could lead to orthostatic hypotension (a very common symptom in
CFS patients) that could cause the patient to faint when standing, or even
sitting upright.
What we found is that there are also alpha and beta receptors on both the
muscle sensory neurons that signal fatigue and also those that signal muscle
pain, as well as on circulating immune cells. We further found that the
receptors on the sensory neurons and immune cells were blocked at lower doses (1
tenth the dose) than is necessary to block alpha and beta receptors on vascular
smooth muscle.
This means that low doses of propranolol (again 1/5 to 1/10 the dose that
is prescribed for blood pressure control) can block the sensory receptors,
reducing the total signal to the sympathetic nervous system, allowing the normal
sympathetic reflexes to be re-established, leading to much more normal control
of metabolite levels in muscle and brain.
(Much of this last section is
still speculation—only inferred from the data we have on blood pressure and
vascular control in FM patients, published in Adrenergic dysregulation and pain with and without
acute beta-blockade in women with fibromyalgia and temporomandibular disorder. Light
KC, Bragdon EE, Grewen KM, Brownley KA, Girdler SS, Maixner W.J Pain. 2009
May;10(5):542-52.)."
The Phoenix Rising website is compiled by a layman. It is not a substitute for a
physician and is for informational uses only. It does not present complete
information on this drug. Please discuss any treatments in these pages with your
physician.
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