Positives

• Multiple long-COVID posters on r/covidlonghaulers say that taking as little as 12.5 mg Metoprolol ER twice daily calmed nighttime palpitations and let them “finally sleep again.” Reddit

• A 64-year-old long-hauler on r/LongCovid reported the drug “helped with the palpitations, brought my heart rate down and lowered my blood pressure,” with symptoms fading over time. Reddit

• On the Phoenix Rising ME/CFS forum, POTS patients describe being able to stand or walk farther without tachycardia crashes once they added a low dose of Metoprolol ER. Phoenix Rising

• A Mayo Clinic Connect member using Metoprolol for a post-COVID POTS-like syndrome noted it “helps some” in managing surges and palpitations. Mayo Clinic

• Redditors in r/Heartpalpitations credit twice-daily metoprolol with keeping elevated heart rate and palpitations that began after COVID “extremely manageable.” Reddit

Negatives

• Users on r/POTS warn Metoprolol slowed their metabolism and caused noticeable weight gain, even at low doses. Reddit

• Long-COVID “beta-blocker fatigue” threads describe crushing tiredness and brain-fog after starting the drug, leading some to stop within days. Reddit

• A Phoenix Rising member found the ER formulation controlled tachycardia but triggered severe post-exertional malaise, forcing discontinuation. Reddit

• Case notes in a post-COVID autonomic-dysfunction study document two patients intolerant of metoprolol, who had to switch to ivabradine or pindolol. PubMed

• New long-haulers on r/covidlonghaulers express fear that the beta-blocker will drop sleeping heart-rate too low, making them hesitant to start therapy. Reddit

Hurdles & Side Effects

• A withdrawal thread shows rebound tachycardia, anxiety, and palpitations hitting within hours of a missed dose, prompting calls for ultra-slow tapers. Reddit

• Posters in r/PVCs and dysautonomia subs mention early dizziness, heat intolerance, and insomnia that make them feel “awful” on metoprolol. Reddit

• Several dysautonomia users say the drug deepened depression or mood swings, forcing a switch to other beta-blockers. Reddit

• GoodRx notes weight gain of 2–3 lb in the first few months is common with beta-blockers such as Metoprolol. Reddit

• Because each refill requires a new prescription, patients on MedicalNewsToday and forum threads discuss scrambling for renewals or paying telehealth services out-of-pocket when doctors hesitate to continue the drug. Medical News Today