Summary
There have been a number of prospective and retrospective studies to evaluate both the existence and frequency of the β- blocker withdrawal syndrome. While there are now a number of studies reporting severe angina, ventricular tachycardia, myocardial infarction, and, in 2 cases, death following abrupt withdrawal of β- blockade, most report a low incidence, and some even failed to find any clinical evidence of withdrawal. As the clinical features suggest a ‘hyperadrenergic state’, the effects of withdrawal on the function of the sympathetic nervous system have been examined. Others have interpreted the symptoms described after β-blocker withdrawal as being similar to those seen in hyperthyroidism, and have found alterations in the levels of the thyroid hormone triiodothyronine during withdrawal. Again, these findings are not universally accepted, as other investigators have failed to confirm these changes in thyroid hormone concentrations.
The frequency of the β- blocker withdrawal syndrome is uncertain and, although a number of hypotheses with supporting data have been raised to account for the syndrome, none can vet be accepted as the unequivocal cause.
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Wood, A.J.J. β-Blocker Withdrawal. Drugs 25 (Suppl 2), 318–321 (1983). https://doi.org/10.2165/00003495-198300252-00093
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DOI: https://doi.org/10.2165/00003495-198300252-00093