Beta-Blocker Therapy with Metoprolol in the Hyperventilation Syndrome

Abstract

16 patients suffering from a hyperventilation syndrome were treated with metoprolol 2dd 100 mg and an identical placebo in a double-blind, cross-over trial. Before therapy and after metoprolol and placebo therapy a ventilatory response to CO₂ was taken, VC and FEV₁ a hyperventilation provocation test, blood gas values, and the subjective experiences of the patients were documented. The ventilatory response to CO₂ was described in terms of decrease or increase of ventilation: before therapy ventilation decreased in 10 out of 16 patients, after metoprolol ventilation decreased in 3 of 16 patients (p < 0.01). The end tidal Pco₂ increased with a mean of 3.86 mm Hg (p = 0.0005) after metoprolol as compared to placebo. No differences were found in respiratory frequency or depth, base excess, provocation test. It is concluded that the cardioselective beta-blocker metoprolol is a useful drug in the therapy of the hyperventilation syndrome

Beta-Blockade in the Hyperventilation Syndrome. A Retrospective Assessment of Symptoms and Complaints

“…Fur thermore, this study shows that the effects persist longer than the 4-week period we used in our previous study [Folgering and Cox, 1981]. The /Fblocker is at least as ef fective as other kinds of therapy or place bo in this respect.…”

“…In a double-blind cross-over study we treated this group of hyperventilation patients with metoprolol (2x 100 mg dd) during 4 weeks and found a significant de pression of ventilation and consequently an increase in Pa.co:-The subjective com plaints of the patients were assessed semiquantitatively: more complaints, less com plaints or no change. No clear-cut effect on the subjective feeling of well-being was found in that investigation [Folgering and Cox, 1981]. Everyday practice deviates considerably from a carefully planned prospective double-blind cross-over study.…”

Vestibular hyperreactivity and hyperventilation after whiplash injury

“…The latter structure may be involved in emotional disorders and be under the influence of the " mental state" which has an important bearing on both breathing be haviour and the VOR. Folgering and Cox (1981) have shown that noradrenaline excretion is significantly in creased in patients with the HVS. This would fit into a stress model in which both VH and the HVS can occur concomitantly.…”

Differential Effects of Beta-Adrenergic Blockade on P_0.1 and Mean Inspiratory Flow

“…More recently, a sympathetic rest ing tone was shown in the carotid body of the cat [ 16], Fitzgerald et al [ 12] states 'that any physiological condition that increases sympathetic activity and catecholamine release could be expected to stimulate re spiration by stimulating the peripheral chemoreflex'. We suggest this might also be true for anxiety [15,38] or for the sub ject's mental state evoked by experimental conditions [18,24], which have been shown to alter the breathing pattern [2].…”