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What would cause lightheadedness, muscle cramps and some anxiety while on Atenolol, Olmesartan, Diazepam, Alprazolam and Doxylamine Succinate?

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Posted on Wed, 13 Jan 2021
Question: I have been taken from 100 mg to 25 mg of atenolol, and from 5 mg to 20 mg of olmesartan. I also take 5 mg of diazepam 4xday and 0.25 mg of alprazolam 1xday for anxiety. I was taking 75 mg of doxylamine succinate for sleep, but didn't feel it was doing anything and have cut down to 12.5 and still falling asleep OK.
Problems are that at the halfway point of the medication switch I was feeling great. The tiredness almost gone and energy to do things (that was the reason for the change), but now at the lowest dose of atenolol/highest of olmesartan I am feeling awful. Tired again, some lightheadedness, muscle cramps, feeling some anxiety. What of what I've been doing would be the likely cause? Too little atenolol? Too much olmestartin? One of them interacting with the benzos and causing symptoms because the benzos are not as effective? It didn't start until a couple of days after the last cuts to the doses I'm stating as current. Any help please?
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Answered by Dr. Sameer Maheshwari (22 minutes later)
Brief Answer:
Not because of Atenolol or Olmesartan

Detailed Answer:
Hi,
Welcome.
This is Dr Sameer, cardiologist.
Our sweet cardiac medications (Atenolol and Olmesartan) does not generally cause light headedness, tiredness or weakness untill your bp is not getting low.
So please tell me what bp are you maintaining with the above medications.
The symptoms you are telling seems to corelate with low bp. So kindly monitor it.
Benzodiazapines can also cause such symptoms. I am not a specialist with neurology, but if you can decrease the dose to thrice daily or so, than kindly do it.
Rest this is not the side effect of atenolol or olmesartan. You can continue them as usual but kindly monitor the bp.
Thanks and take care
Above answer was peer-reviewed by : Dr. Nagamani Ng
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Follow up: Dr. Sameer Maheshwari (17 minutes later)
Thanks, but my symptoms are listed as possible side effects of olmastartan. My BP is in a good range, as us my pulse rate. Have been monitoring both. Been on the same benzo dose for 2.5 years. Does atenelol make the benzo stronger acting? In other words, could a lower dose of atenolol make it seem like I'm taking less diazapam? These symptoms I'm having are very close to anxiety, except the muscle cramps, which is also listed as a side effect of the olmastartan.
doctor
Answered by Dr. Sameer Maheshwari (16 hours later)
Brief Answer:
Detailed answer as follows

Detailed Answer:
Hi,
Welcome back.
If your bp is in good range than yes this possibly could be side effects of olmesartan (which are actually seen in <1% patients).
Benzodiazapines are actually enzyme inducer, means they increase the metabolism of other drug and decrease its patency. So Olmesartan should work less with it.
So one thing you can do is change olmesartan to another drug of same catagory which has relatively less adverse effect profile. You can change Olmesartan 20mg to Telmisartan 20mg once daily. Both have similar effect on bp and equally good.

So try this and I hope you should be better.
Thanks and take care
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Sameer Maheshwari

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Practicing since :2010

Answered : 823 Questions

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What would cause lightheadedness, muscle cramps and some anxiety while on Atenolol, Olmesartan, Diazepam, Alprazolam and Doxylamine Succinate?

Brief Answer: Not because of Atenolol or Olmesartan Detailed Answer: Hi, Welcome. This is Dr Sameer, cardiologist. Our sweet cardiac medications (Atenolol and Olmesartan) does not generally cause light headedness, tiredness or weakness untill your bp is not getting low. So please tell me what bp are you maintaining with the above medications. The symptoms you are telling seems to corelate with low bp. So kindly monitor it. Benzodiazapines can also cause such symptoms. I am not a specialist with neurology, but if you can decrease the dose to thrice daily or so, than kindly do it. Rest this is not the side effect of atenolol or olmesartan. You can continue them as usual but kindly monitor the bp. Thanks and take care