Help me take my albuterol!
October 20, 2014 9:59 AM   Subscribe

The thought of taking medications that make one feel nervous/anxious makes me anxious because it's a focus of my anxiety problems. I'm therefore nervous about taking my albuterol inhaler (I have bronchitis, it sucks, so I should really take the inhaler). Can you give me information about what to expect in terms of restlessness, anxiety, nervousness, etc.? Duration, symptoms, etc.? I'd ask my doctor but she was totally uninterested in my special snowflake needs (university clinic, she's not my permanent doctor).
posted by c'mon sea legs to Health & Fitness (29 answers total)
 
Whenever I've been sick enough to need albuterol, the positive effects of it helping me breathe outweighed any weird temporary jittery feelings. And even then, it just felt like I was a little over caffeinated for a few minutes, nothing major lasting hours.
posted by joan_holloway at 10:13 AM on October 20, 2014 [3 favorites]


It has been my experience as a user of an albuterol inhaler for asthma, that I feel a little jittery after I use it, but it doesn't last very long. I haven't timed it, because I'm not that into metrics, but it can't be longer that 30-45 min.

I am not your doctor.
posted by Billiken at 10:14 AM on October 20, 2014


I've been on albuterol a number of times over the years for various reasons. I never experienced any anxiety-like symptoms from it - just an unpleasant taste and easier breathing. YMMV.

(I don't mean dismiss your concerns - I'm a fellow anxiety sufferer, so I understand those concerns. Just wanted to say that it's possible you won't notice anything at all.)
posted by okayokayigive at 10:14 AM on October 20, 2014 [1 favorite]


I have an albuterol inhaler.

I generally get a little physically shaky for maybe 10-20 minutes. The first couple times were definitely worse -- I have less of a reaction now. But even the first couple times, that shakiness wore off within 30 minutes, tops. Nowadays, I don't use it when I'm driving or doing anything potentially dangerous, but beyond that, it's not a big deal.

I generally don't notice any symptoms once that initial shakiness wears off. I also don't generally notice any increased anxiety once I've taken the drug. (I do feel anxious before taking it, sometimes -- because I'm using it for breathing problems, and those can contribute to feeling anxious for me.)

I totally understand being stressed about possible side effects, but bronchitis isn't something to mess around with. You can totally get through the first dose, and once you do that, it'll get easier on each subsequent dose, both because you'll know what to expect and because your body will adjust to the med. Do it for your lungs!
posted by pie ninja at 10:15 AM on October 20, 2014


I have an albuterol inhaler. Those side effects are possible, not mandatory. It may not give you any of those side effects at all. It may give you side effects once and then not the next time you use it. Personally, I've never had any anxiety or nervousness issues from it, but I have very occasionally felt slightly jittery like I've had one too many cups of coffee for about 10 minutes afterwards.
posted by erst at 10:16 AM on October 20, 2014


I have pretty bad anxiety symptoms and have an albuterol inhaler for asthma. The post-inhaler jitters do not last for me. However, being unable to breathe will definitely make me more anxious. As well as non-breathing being bad in general.

Moral: If you skip the inhaler when you need it, your worsening symptoms might make you more anxious than the inhaler ever could.
posted by Coatlicue at 10:19 AM on October 20, 2014 [1 favorite]


When I last had to take it for bronchitis, the feeling I had was on par with a little too much coffee, maybe with a little too much sugar. Like the others are saying, more on the order of minutes, not hours.

Although, at that point, I was so run down by being sick that I think it may have actually helped me function.

I did once have to have the "you're not leaving this office until you suck on this nebulizer for 20 minutes" kind of albuterol which left me feeling a little over-distracted on the drive home, but it didn't stop me from taking a much-needed nap less than an hour later.

I wouldn't even describe it as especially "anxious" as a feeling. Just a little speedy, but kind of in a pleasant way. That may have been the increased oxygen, though.
posted by Lyn Never at 10:24 AM on October 20, 2014


I use albuterol occasionally and I am well acquainted with panic attacks. Although I do feel hyper and jittery after taking albuterol, it is short lived - 20 min or so - and nothing like a panic attack, at least for me. Mostly just shaky hands and fast heart rate. Not pleasant but way less unpleasant than coughing and wheezing.
posted by Cygnet at 10:25 AM on October 20, 2014


Jittery for no longer than 30 min but I take it via nebulizer. Afterwards, if it's evening, I'll take a shower and unwind a bit before I go to bed. Meditation helps me as well.

I find that my head clears up afterwards as I feel so much better when I'm done. I can breathe better and feel as though I can think better.
posted by Buttons Bellbottom at 10:26 AM on October 20, 2014


I'm terrified of medications, and actively work on this terror in therapy. I was diagnosed with asthma a few years ago and was prescribed the inhaler.

What helped me that may or may not help you is to look up exactly what's happening in my body when I take the inhaler - something about seeing the physiological processes in black and white calmed me.

The inhaler is a hard one for people with anxiety because it can mimic anxiety symptoms, and I also had a doctor who wasn't understanding. However, I discovered that my tight, inflamed lungs were ALSO mimicking anxiety symptoms and that the inhaler took these away. Suddenly, I was getting bigger breaths and was feeling less light-headed, less dissociated and sleeping better, which all contributed to a less-anxious existence for me.

The few minutes of shaking I sometimes feel with my inhaler are much outweighed by these benefits. I actually look at those few minutes of inhaler side effects as good practice for my own anxiety by understanding that the symptoms are short-lived and not dangerous. The only anxiety-like symptoms I'll sometimes feel (and not always) are shaking hands and a short-lived racing heartbeat, which goes away. Otherwise any other anxiety symptoms I feel are if I attach fear to these symptoms. I've now taken my inhaler so many times that I'm not scared of the symptoms.

I know how hard it can be to take anything that will exacerbate your anxiety. I'm with you on that.
posted by Zosia Blue at 10:28 AM on October 20, 2014 [1 favorite]


I have very bad PTSD and any stimulant medication sends me into yucky territory. I also have bad asthma since I was a little kid. The inhalers effect wear off way faster than nebulizer treatments. I find that atravant leaves me a little less anxious. Most of the time I just power through. An hour or so the feelings pass. Depending on where my anxiety levels are that day I may avoid it until I'm in a situation where I can be anxious and not have to deal with people. But not being able to breathe also causes anxiety and exhaustion. Sometimes it is difficult for me to figure out of I'm dreading the inhaler or if I'm more anxious about the difficulty breathing. I just take it if I need to. It will be okay. If you're having really bad anxiety you may be able to get someone to prescribe you a small dose of a benzodiazapine to help take the edge off. The only time that had happened for me when I was taking nebulizer treatments every 4 hours and on steriods. I was such a mess they did a mental health assessment in the doctors office and figured it wouldn't be a bad idea.
posted by AlexiaSky at 10:41 AM on October 20, 2014


Another vote for the above statement that when you really really need your inhaler the relief of being able to breathe again far outweighs the twitchy anxiety. (This also helped me learn the important lesson that not all instances of perceived breathlessness are from asthma, some of them are from having been a lazy goober for 8 months whose most intense workout was walking to the fridge.)

If you really have problems with the albuterol inhaler you could see if your doctor thinks it's appropriate for you to take a daily tablet like Singulair instead. IIRC it is non-twitchy and also non-steroidal.
posted by poffin boffin at 10:42 AM on October 20, 2014 [1 favorite]


(sorry, should have said "find a better doctor and ask them if..." etc)
posted by poffin boffin at 10:43 AM on October 20, 2014 [1 favorite]


Response by poster: These are really helping, guys, thank you!
posted by c'mon sea legs at 10:44 AM on October 20, 2014


The over-the-counter antihistamine diphenhydramine (Benadryl) also has an anti-anxiety effect, if you need something to take the edge off the jitters.
posted by Jacqueline at 10:47 AM on October 20, 2014


This doesn't answer your question but would it help to plan for something to do immediately after using your inhaler? Some little self-treatment to deal with any anxiety? Like factoring in time to count to 50 or use a worry stone or a short meditation or something simple like that. Just so you have a few minutes to use the inhaler, deal with the anxiety then go on your way. I mean it seems like you are anxious about having anxiety so having a plan in place to deal with any anxiety that crops up might help alleviate it.

I don't use an inhaler or deal with anxiety in this context so disregard if this isn't relevant.
posted by Beti at 10:47 AM on October 20, 2014


So much sympathy! I have problems with anxiety as well as abysmally low B12, but the supplements for that have side effects nearly identical to those of a panic attack, so too often I skip it (boooo; don't be me).

The good news is that IME albuterol is a different kind of jittery and even that lasts minutes, not hours.

Any chance you can watch a sitcom when you try it? Or if that's not your cup of tea (sometimes TV makes me more anxious bc I'm too aware that I "should" be relaxing), do 10 minutes of really easy stretches, knowing that as you do so, the side effects will run their course and be done?

I know it seems scary, but you can do it!
posted by whoiam at 10:58 AM on October 20, 2014


One little thing to encourage you: the nice part about albuterol inhalers is that you can have a real control over the dose you get (based upon how deeply you breathe, how long you hold your breath, et cetera). If you only feel you need a little, you can take a smaller dose... if you know you're struggling, you can take a larger one.

Inhalers can make me a little jittery like everyone else in here, but with my asthma, I've learned how to manage the dosage. When my breathing just needs a little help, I take a much more shallow breath and hold my breath only for a moment, and that's enough to open my airways. Besides, the jitters aren't that awful anyway, and they don't last that long. For me, it's only a few minutes, and then it's gone, and the feeling is exactly like having a little too much caffeine.

No matter what, though, use that inhaler. For bronchitis, if it's bad enough that your doctor's prescribed it, you need to make use of it. It will really help you get well faster!

Hope you feel well soon.
posted by Old Man McKay at 11:01 AM on October 20, 2014 [1 favorite]


My son was a toddler the last time he had albuterol, and within a breath or two his whole body would relax in an amazing "oh, yeah, *breathing*" sort of way. Other breathing meds were not fun (baby roid rage yay!) but any anxiety provoking effect was FAR outweighed by how good breathing felt with albuterol. (I know, not a personal experience but picturing a toddler being happy to take the thing you're anxious about might help.)
posted by tchemgrrl at 11:15 AM on October 20, 2014


Agreed that planning yourself a little self-care session (or whatever you like to call a couple hours on the couch with Netflix periodically asking if you're still watching, thanks for judging me Netflix) around it will help if it's scary to do it for the first time. You totally deserve a treat for doing this, and for feeling crappy.
posted by Lyn Never at 11:20 AM on October 20, 2014


I have all the anxieties. All of them. Panic attacks, flashbacks, body memories, OCD, everything. I also have asthma. What albuterol does to me: makes it easier to breathe. No jitteriness, no shakiness, no anxiety-like symptoms at all. IANAD, YMMV.
posted by The Almighty Mommy Goddess at 11:58 AM on October 20, 2014


You would really benefit by going to see your local pharmacist. They can answer all your questions about this. And if it's the pharmacy you bought it from, they could probably even call your doc and make her more interested in helping.
posted by discopolo at 12:50 PM on October 20, 2014


I have asthma and mild anxiety. I use my albuterol enough that I don't feel much anymore but the worst I'd felt was equivalent to having a 2nd cup of coffee for about 30 minutes. So a bit jittery in a physical way but not anxiety triggering (for me). Since it helps me breathe better I actually think it takes away some anxiety because a lot of my anxiety comes with me not breathing fully and deeply anyway. When I know I have that physical crutch available I can use it and then focus on feeling my lungs and breathing get better, and that has the nice side effect of generally helping to calm me down.
posted by marylynn at 1:02 PM on October 20, 2014


Just another vote for the over caffeinated feeling (again, minutes not hours) followed by "YAY OXYGEN". Having enough oxygen makes me feel more energetic, relaxed, alert, and LESS anxious.

Try taking it mid-afternoon immediately followed by a nap. You'll sleep through the jittery bit and wake up feeling great. ;)
posted by jrobin276 at 1:02 PM on October 20, 2014


Do you know why albuterol can sometimes make people feel shaky/jittery? Sometimes understanding the mechanism for something is helpful for people with anxiety and sometimes it's not, but just in case it would help and since I didn't see it mentioned elsewhere:

Albuterol is a beta2-adrenergic agonist, which means it's a drug that affects the beta-2 adrenergic receptors within cell membranes. These receptors are normally mainly there to react to adrenaline (epinephrine) as part of how the body manages the muscular system (as well as the circulatory system, eyes, all sorts of other stuff that isn't directly relevant to this right now). Albuterol affects the receptors in sort of the same way as epinephrine, causing the smooth muscle in your bronchi (lung passages) to relax and hopefully making it easier to respire (breathe). But that's not all that's happening!

What a doctor is trying to do with the albuterol in a way is to mimic the way your natural fight-or-flight response would work in your lungs (where normally epinephrine would increase lung function in preparation for intense muscle activity like running away from a lion). But the action of the drug isn't just limited to the lungs and so other parts of that fight-or-flight response can also kick in. So heart rate can go up, some blood vessels can be constricted while the blood vessels going to your muscles dialate, shifting blood from from other parts of your body to the muscles. The whole range of fight-or-flight responses, really. That can cause that jittery feeling, and all this can also trigger emotional responses, like anxiety. So anxiety isn't a crazy thing to feel as a side effect of albuterol; it's a real physiological side effect that evolved for understandable reasons. This stuff can sometimes be relieved by stretching or other relaxation techniques as mentioned above. If your dose is set correctly it should pass pretty quickly (or not even happen at all).

I don't know if that helps, but I hope it does. Bodies are cool, and I feel more in control of my responses to medications when I know what they're doing and why I feel weird.

(I am not a doctor. This is obviously a simplified summary but I don't think I've made any mistakes in my biology here - please let me know if I did!)
posted by Wretch729 at 1:16 PM on October 20, 2014 [2 favorites]


I'm a special snowflake who has anxiety and ADHD, and allergies that got so bad this summer that I got my very own albuterol inhaler too because Singulair wasn't enough sometimes. Seriously, I take enough Adderall to put a sloth into killing rage overdrive, and I drink coffee and tea, and even with all of that the albuterol only makes me a bit jittery for half an hour at most.

Breathing is AWESOME! Much more relaxing than not breathing so well.
posted by monopas at 1:46 PM on October 20, 2014


Second and thirding that the mild jitteriness that albuterol gives me is a small price to pay for better breathing; and even at very high doses I have had only mild and transient jitteriness and hand tremor. I would add that terbutaline AKA Bricanyl (which is similar to albuterol, but not the same drug) gave me vicious jitteriness and anxiety, so if by chance you get a stronger reaction to albuterol (which I think is unlikely) or have occasion to be given another bronchodilator, know that you can different reactions to drugs which are at least theoretically likely to have similar side effects, so it may be very possible to find one which works best, with least objectionable side effects, for you. Best of luck with feeling better soon.
posted by Northbysomewhatcrazy at 4:47 PM on October 20, 2014


Nthing the minutes-not-hours reaction. I get very slight tremors in my arms/hands for about 10 minutes, and feel a bit light-headed. Because of that I usually sit on the edge of my bed or on the couch so that I can lay down and focus on breathing.

Maybe, if you're old enough, you remember the permanent markers that stank horribly and got you kinda high if you used them for more than a minute? For me, the feeling of using an Albuterol inhaler is similar to breathing in too much marker while doing my science fair projects.
posted by PorcineWithMe at 6:03 PM on October 20, 2014


What about a script for Xopenex. Long story short, organic molecules come in right and left handed varieties. Often one is responsible for the therapeutic effects and the other causes the side effects (at least this how it was explained to me. Xopenex is the version that has the good effects and less of the bad side effects.

About 15 years ago, I had to use Xopenex in a nebulizer because albuterol buzzed me way too much (where I couldn't do my job).

A quick Google looks like Xopenex is available in inhaler form.
posted by kathrynm at 2:37 PM on October 21, 2014


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