To safely taper off propranolol (Inderal) and sertraline (Serta), it is crucial to work closely with your doctor on a gradual schedule. Stopping them slowly helps prevent symptoms like shivering and confusion. Your doctor can design a 'cross-taper' where you slowly lower your sertraline while starting vilazodone (Vilano). Because vilazodone also works on serotonin, it can help ease the transition and potentially improve your cognitive focus once your body adjusts. Please do not alter your doses without your physician's direct guidance to ensure your safety and comfort.

Yes, beta-blockers like propranolol (Inderal) can sometimes cause modest weight gain or make you feel like your metabolism has slowed down a bit. This usually happens because the medicine gently slows your heart rate and can make you feel a little more tired, which might slightly reduce your daily energy burn. Usually, this weight change is minor and manageable. I encourage you to discuss this with your doctor before making any changes, as they can help you manage these effects safely.

Your normal ECG is very positive news. Since propranolol (Inderal) hasn't helped, the next steps should focus on exploring other common causes. Because this happens at bedtime, we should consider a gastrointestinal evaluation for acid reflux, which often mimics chest pressure when lying down. To fully rule out heart-related causes, your doctor might suggest a Holter monitor to track your heart rhythm at home, or an ultrasound of the heart (echocardiogram). Please discuss these options with your physician to find the right path forward.

Inderal (propranolol) works quickly to manage physical symptoms of anxiety. However, please do not stop taking it abruptly on your own. Even if you feel improved after just one dose, stopping suddenly can sometimes cause your heart rate or anxiety to rebound. Depending on how your doctor prescribed iteither daily or on an "as-needed" basisit is safest to discuss a tapering plan with them. They will guide you on how to safely reduce or stop the medication without any discomfort or reliance.

It is very possible that your sleep difficulties and the low humming sound you hear are related to Inderal (propranolol). Sleep disturbances are a known side effect of this medication, and some patients occasionally report tinnitus-like sounds at night. Please be reassured that while these symptoms are uncomfortable, they are not a medical emergency. You do not need to seek immediate emergency care, but you should not stop taking your medication suddenly on your own. I recommend scheduling a routine appointment with your doctor. They can safely evaluate your symptoms and discuss whether adjusting your dose or trying an alternative medication is the best step for you.

Based on your symptoms of hand shaking that worsens with stress and activity, you may have a common condition called Essential Tremor. While I cannot prescribe medication online, the most frequently prescribed first-line treatments are beta-blockers (like Propranolol) or anti-seizure medications (like Primidone). These help reduce the shaking during tasks. Because these drugs affect heart rate and blood pressure, you must consult a doctor or neurologist for a proper diagnosis. They will evaluate your health and safely prescribe the right medication and dosage for you.