Table of ContentsView AllTable of ContentsBeta-Blockers for AnxietyHow Effective Are They?Other Anxiety TreatmentsTypes of Beta-BlockersSide EffectsWho Should Not Take Them?Frequently Asked Questions

Table of ContentsView All

View All

Table of Contents

Beta-Blockers for Anxiety

How Effective Are They?

Other Anxiety Treatments

Types of Beta-Blockers

Side Effects

Who Should Not Take Them?

Frequently Asked Questions

Beta-blockers(also referred to as β-blockers) are a type of medication commonly used to manage heart-related health conditions like chest pain andhigh blood pressure.However, there’s also another way they are being used that’s getting attention in the field of mental health.

Beta-blockers, such as Inderal (propranolol) and Tenormin (atenolol), are also sometimes used to treat certain types ofanxiety. Beta-blockers are used off-label for anxiety. This means that the Food and Drug Administration (FDA) has not approved them for use in people with this condition, but they have proven effective against symptoms of anxiety.

This article will discuss the use ofbeta-blockersfor anxiety, including how well they work and what types of anxiety they can help manage.

Close up of person holding out hand with a pill in it

When a person feels anxious, their body releases high amounts of the hormone calledepinephrine, which is also known as adrenaline. This hormone can cause physical responses to anxiety, such as a fast heartbeat or tremors. Beta-blockers stop adrenaline from having these effects, which can help reduce these symptoms of anxiety.

Healthcare providers may consider prescribing beta-blockers to help with the following four kinds of anxiety disorders:

It’s important to understand that beta-blockers can help with the physical symptoms of anxiety, but they don’t make anxiety go away completely or fix what’s causing it. To effectively tackle anxiety, beta-blockers should be used as part of a broader treatment plan that includes talk therapy and other forms of therapy.

How Effective Are Beta-Blockers for Anxiety?

The effect of beta-blockers on anxiety disorders has been a topic of several studies. The findings are mixed due to differing scenarios and types of anxiety symptoms.

Social Anxiety Disorder

While beta-blockers like propanolol are helpful due to their ability to lessen the physical symptoms of anxiety, it’s not entirely clear if they can combat broader social anxiety symptoms such as fear of criticism or avoidant behaviors.

For this reason, beta-blockers are largely considered more helpful for the physical symptoms of anxiety disorders rather than cognitive or psychological symptoms.

One eight-week study determined no significant differences between the beta-blocker Tenormin (atenolol) and a placebo (an inactive substance given to control groups) for treating generalized social phobia.

Performance Anxiety

Performers like musicians, actors, and public speakers may sometimes use beta-blockers to manage their performance anxiety. These medications help reduce physical symptoms such as a fast heart rate and tremors that can occur when on stage. Given the short-term nature of such anxiety, beta-blockers appear suitable for these scenarios.

One double-blind study of 29 people showed that beta-blockers helped eliminate physical responses to performance anxiety, including dry mouth. As a result, performance quality improved for those who took the beta-blockers.

Panic Disorder

Some experts suggest beta-blockers can help lessen physical symptoms, such as heart palpitations, during apanic attack. In terms of preventing or managing the sudden and intense panic attacks associated with this disorder, their utility is less certain.

Studies investigating beta-blocker use in panic disorder have been small and of low quality.Guidelines typically recommend beta-blockers as a third-line therapy option for panic disorder.

Beta-blockers seem more suitable for managing situational anxiety than spontaneous panic attacks.

Post-Traumatic Stress Disorder

Based on a larger analysis that looked at many different studies (meta-analysis), propranolol may help with anxiety disorders linked to distressing memories, especially in cases like PTSD.

Also, propranolol can be effective at calming down strong emotions, reducing performance anxiety, and improving the ability to think clearly during anxiety.

Generalized Anxiety Disorder (GAD)

Beta-blockers generally don’t work as well for GAD.

GAD involves frequent, consistent anxiety or worry that interferes with daily life. Beta-blockers work best when managing physical symptoms of anxiety, but they are not as effective at controlling the psychological symptoms of anxiety.

For this reason, healthcare providers usually suggest other treatments like antidepressants,benzodiazepines, andcognitive behavioral therapy(CBT). These treatments can help manage both the physical and mental aspects of GAD.

Beta-Blockers vs. Other Anxiety Medications

When it comes to treating anxiety, there are many options. what works for you will depend on your unique situation.

On the other hand, traditional anxiety medications, likeselective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRI),are usually used for the long term because they take weeks to months to make a noticeable difference in anxiety symptoms.

Benzodiazepines are also another alternative for fast anxiety relief. However, benzodiazepines are associated with physical dependence. Therefore healthcare providers are often more cautious when it comes to prescribing them for anxiety.

So, whether you go for beta-blockers or traditional anxiety medicines depends on your specific symptoms, needs, and possible risks. Beta-blockers are a good choice for fast relief in certain situations, whereas traditional anxiety medications are better for managing anxiety in the long run.

Comparing Ativan (Lorazepam) vs. Xanax (Alprazolam)

There are many different beta-blocker medications. Examples of beta-blockers include:

Side Effects of Beta-Blockers

As with most medications, beta-blockers come with side effects. However, they are generally considered safe when used as directed.

Common side effects of beta-blockers may are:

Who Should Not Take Beta-Blockers?

Beta-blockers are sometimes given to people with anxiety because they can make the physical symptoms of the disorder feel better. However, they might not be right for everyone.

Before prescribing beta-blockers, healthcare providers will consider different factors that would prevent them from prescribing a certain drug to you. For example, propranolol is contraindicated (meaning it should not be used) in those with:

Atenolol should not be used in people with:

When considering treatment options, share your medical history with your healthcare provider, including any preexisting health conditions and prescription or over-the-counter (OTC) medications you are taking.

Summary

Beta-blockers can be a viable treatment option for certain types of short-term anxiety, such as performance anxiety. However, it may not be as effective for other types of anxiety disorders, such as panic disorder or GAD, that require longer-term treatment. This is because beta-blockers target the physical manifestations of anxiety and do not treat the underlying cause.

There’s much more to learn about using beta-blockers for anxiety, and it’s a topic that needs more study. Successful use of drugs approved to work on the heart, such as beta-blockers, for conditions such as anxiety points to the interconnection between body and mind and how drugs for one can benefit the other.

Frequently Asked QuestionsBeta-blockers are fast-acting medications. After taking propranolol, for example, you should expect to notice improvements in your physical symptoms within one to two hours. Taking 40 milligrams (mg) of propranolol one hour before an event causing performance anxiety has proven beneficialLearn MoreHow Long Does Propranolol Last for Anxiety?Other methods to help with anxiety include talking to a therapist, using relaxation techniques such as deep breathing or yoga, staying active, eating well, getting enough sleep, focusing on the present moment, joining support groups, and avoiding triggers that make you anxious. What works for one person may not help another, though.

Beta-blockers are fast-acting medications. After taking propranolol, for example, you should expect to notice improvements in your physical symptoms within one to two hours. Taking 40 milligrams (mg) of propranolol one hour before an event causing performance anxiety has proven beneficialLearn MoreHow Long Does Propranolol Last for Anxiety?

Beta-blockers are fast-acting medications. After taking propranolol, for example, you should expect to notice improvements in your physical symptoms within one to two hours. Taking 40 milligrams (mg) of propranolol one hour before an event causing performance anxiety has proven beneficial

Learn MoreHow Long Does Propranolol Last for Anxiety?

Other methods to help with anxiety include talking to a therapist, using relaxation techniques such as deep breathing or yoga, staying active, eating well, getting enough sleep, focusing on the present moment, joining support groups, and avoiding triggers that make you anxious. What works for one person may not help another, though.

The author would like to recognize and thank Norma Ponce, PharmD, MHA for contributing to this article.

17 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.DailyMed.Label: Inderal LA- propranolol hydrochloride capsule, extended release.Garakani A, Murrough JW, Freire RC, et al.Pharmacotherapy of anxiety disorders: current and emerging treatment options.Front Psychiatry. 2020;11:595584. doi:10.3389/fpsyt.2020.595584Szeleszczuk L, Frączkowski D.Propranolol versus other selected drugs in the treatment of various types of anxiety or stress, with particular reference to stage fright and post-traumatic stress disorder.Int J Mol Sci. 2022;23(17):10099. doi:10.3390/ijms231710099National Institute of Mental Health.Social anxiety disorder: more than just shyness.Anxiety & Depression Association of America.Anxiety disorders - facts & statistics.National Institute of Mental Health.Panic disorder: when fear overwhelms.National Institute of Mental Health.Post-traumatic stress disorder.Steenen SA, van Wijk AJ, van der Heijden GJ, et al.Propranolol for the treatment of anxiety disorders: systematic review and meta-analysis.J Psychopharmacol. 2016;30(2):128-39. doi:10.1177/0269881115612236Liebowitz MR, Schneier F, Campeas R, et al.Phenelzine vs atenolol in social phobia. a placebo-controlled comparison.Arch Gen Psychiatry. 1992;49(4):290-300. doi: 10.1001/archpsyc.49.4.290Melaragno AJ.Pharmacotherapy for anxiety disorders: from first-line options to treatment resistance.Focus (Am Psychiatr Publ). 2021;19(2):145-160. doi:10.1176/appi.focus.20200048Brantigan CO, Brantigan TA, Joseph N.Effect of beta blockade and beta stimulation on stage fright.Am J Med. 1982;72(1):88-94. doi:10.1016/0002-9343(82)90592-7Ziffra M.Panic disorder: a review of treatment options.Ann Clin Psychiatry. 2021;33(2):124-133. doi:10.127788/acp.0014Munjack DJ, Crocker B, Cabe D, et al.Alprazolam, propranolol, and placebo in the treatment of panic disorder and agoraphobia with panic attacks.J Clin Psychopharmacol. 1989 Feb;9(1):22-27.Lonergan MH, Olivera-Figueroa LA, Pitman RK, Brunet A.Propranolol’s effects on the consolidation and reconsolidation of long-term emotional memory in healthy participants: a meta-analysis.J Psychiatry Neurosci. 2013;38(4):222-231. doi:10.1503/jpn.120111Hayes PE, Schulz SC.Beta-blockers in anxiety disorders.J Affect Disord. 1987;13(2):119-130. doi:10.1016/0165-0327(87)90017-6National Institute of Mental Health.Generalized anxiety disorder: when worry gets out of control.DailyMed.Label: Tenormin- atenolol tablet.

17 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.DailyMed.Label: Inderal LA- propranolol hydrochloride capsule, extended release.Garakani A, Murrough JW, Freire RC, et al.Pharmacotherapy of anxiety disorders: current and emerging treatment options.Front Psychiatry. 2020;11:595584. doi:10.3389/fpsyt.2020.595584Szeleszczuk L, Frączkowski D.Propranolol versus other selected drugs in the treatment of various types of anxiety or stress, with particular reference to stage fright and post-traumatic stress disorder.Int J Mol Sci. 2022;23(17):10099. doi:10.3390/ijms231710099National Institute of Mental Health.Social anxiety disorder: more than just shyness.Anxiety & Depression Association of America.Anxiety disorders - facts & statistics.National Institute of Mental Health.Panic disorder: when fear overwhelms.National Institute of Mental Health.Post-traumatic stress disorder.Steenen SA, van Wijk AJ, van der Heijden GJ, et al.Propranolol for the treatment of anxiety disorders: systematic review and meta-analysis.J Psychopharmacol. 2016;30(2):128-39. doi:10.1177/0269881115612236Liebowitz MR, Schneier F, Campeas R, et al.Phenelzine vs atenolol in social phobia. a placebo-controlled comparison.Arch Gen Psychiatry. 1992;49(4):290-300. doi: 10.1001/archpsyc.49.4.290Melaragno AJ.Pharmacotherapy for anxiety disorders: from first-line options to treatment resistance.Focus (Am Psychiatr Publ). 2021;19(2):145-160. doi:10.1176/appi.focus.20200048Brantigan CO, Brantigan TA, Joseph N.Effect of beta blockade and beta stimulation on stage fright.Am J Med. 1982;72(1):88-94. doi:10.1016/0002-9343(82)90592-7Ziffra M.Panic disorder: a review of treatment options.Ann Clin Psychiatry. 2021;33(2):124-133. doi:10.127788/acp.0014Munjack DJ, Crocker B, Cabe D, et al.Alprazolam, propranolol, and placebo in the treatment of panic disorder and agoraphobia with panic attacks.J Clin Psychopharmacol. 1989 Feb;9(1):22-27.Lonergan MH, Olivera-Figueroa LA, Pitman RK, Brunet A.Propranolol’s effects on the consolidation and reconsolidation of long-term emotional memory in healthy participants: a meta-analysis.J Psychiatry Neurosci. 2013;38(4):222-231. doi:10.1503/jpn.120111Hayes PE, Schulz SC.Beta-blockers in anxiety disorders.J Affect Disord. 1987;13(2):119-130. doi:10.1016/0165-0327(87)90017-6National Institute of Mental Health.Generalized anxiety disorder: when worry gets out of control.DailyMed.Label: Tenormin- atenolol tablet.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

DailyMed.Label: Inderal LA- propranolol hydrochloride capsule, extended release.Garakani A, Murrough JW, Freire RC, et al.Pharmacotherapy of anxiety disorders: current and emerging treatment options.Front Psychiatry. 2020;11:595584. doi:10.3389/fpsyt.2020.595584Szeleszczuk L, Frączkowski D.Propranolol versus other selected drugs in the treatment of various types of anxiety or stress, with particular reference to stage fright and post-traumatic stress disorder.Int J Mol Sci. 2022;23(17):10099. doi:10.3390/ijms231710099National Institute of Mental Health.Social anxiety disorder: more than just shyness.Anxiety & Depression Association of America.Anxiety disorders - facts & statistics.National Institute of Mental Health.Panic disorder: when fear overwhelms.National Institute of Mental Health.Post-traumatic stress disorder.Steenen SA, van Wijk AJ, van der Heijden GJ, et al.Propranolol for the treatment of anxiety disorders: systematic review and meta-analysis.J Psychopharmacol. 2016;30(2):128-39. doi:10.1177/0269881115612236Liebowitz MR, Schneier F, Campeas R, et al.Phenelzine vs atenolol in social phobia. a placebo-controlled comparison.Arch Gen Psychiatry. 1992;49(4):290-300. doi: 10.1001/archpsyc.49.4.290Melaragno AJ.Pharmacotherapy for anxiety disorders: from first-line options to treatment resistance.Focus (Am Psychiatr Publ). 2021;19(2):145-160. doi:10.1176/appi.focus.20200048Brantigan CO, Brantigan TA, Joseph N.Effect of beta blockade and beta stimulation on stage fright.Am J Med. 1982;72(1):88-94. doi:10.1016/0002-9343(82)90592-7Ziffra M.Panic disorder: a review of treatment options.Ann Clin Psychiatry. 2021;33(2):124-133. doi:10.127788/acp.0014Munjack DJ, Crocker B, Cabe D, et al.Alprazolam, propranolol, and placebo in the treatment of panic disorder and agoraphobia with panic attacks.J Clin Psychopharmacol. 1989 Feb;9(1):22-27.Lonergan MH, Olivera-Figueroa LA, Pitman RK, Brunet A.Propranolol’s effects on the consolidation and reconsolidation of long-term emotional memory in healthy participants: a meta-analysis.J Psychiatry Neurosci. 2013;38(4):222-231. doi:10.1503/jpn.120111Hayes PE, Schulz SC.Beta-blockers in anxiety disorders.J Affect Disord. 1987;13(2):119-130. doi:10.1016/0165-0327(87)90017-6National Institute of Mental Health.Generalized anxiety disorder: when worry gets out of control.DailyMed.Label: Tenormin- atenolol tablet.

DailyMed.Label: Inderal LA- propranolol hydrochloride capsule, extended release.

Garakani A, Murrough JW, Freire RC, et al.Pharmacotherapy of anxiety disorders: current and emerging treatment options.Front Psychiatry. 2020;11:595584. doi:10.3389/fpsyt.2020.595584

Szeleszczuk L, Frączkowski D.Propranolol versus other selected drugs in the treatment of various types of anxiety or stress, with particular reference to stage fright and post-traumatic stress disorder.Int J Mol Sci. 2022;23(17):10099. doi:10.3390/ijms231710099

National Institute of Mental Health.Social anxiety disorder: more than just shyness.

Anxiety & Depression Association of America.Anxiety disorders - facts & statistics.

National Institute of Mental Health.Panic disorder: when fear overwhelms.

National Institute of Mental Health.Post-traumatic stress disorder.

Steenen SA, van Wijk AJ, van der Heijden GJ, et al.Propranolol for the treatment of anxiety disorders: systematic review and meta-analysis.J Psychopharmacol. 2016;30(2):128-39. doi:10.1177/0269881115612236

Liebowitz MR, Schneier F, Campeas R, et al.Phenelzine vs atenolol in social phobia. a placebo-controlled comparison.Arch Gen Psychiatry. 1992;49(4):290-300. doi: 10.1001/archpsyc.49.4.290

Melaragno AJ.Pharmacotherapy for anxiety disorders: from first-line options to treatment resistance.Focus (Am Psychiatr Publ). 2021;19(2):145-160. doi:10.1176/appi.focus.20200048

Brantigan CO, Brantigan TA, Joseph N.Effect of beta blockade and beta stimulation on stage fright.Am J Med. 1982;72(1):88-94. doi:10.1016/0002-9343(82)90592-7

Ziffra M.Panic disorder: a review of treatment options.Ann Clin Psychiatry. 2021;33(2):124-133. doi:10.127788/acp.0014

Munjack DJ, Crocker B, Cabe D, et al.Alprazolam, propranolol, and placebo in the treatment of panic disorder and agoraphobia with panic attacks.J Clin Psychopharmacol. 1989 Feb;9(1):22-27.

Lonergan MH, Olivera-Figueroa LA, Pitman RK, Brunet A.Propranolol’s effects on the consolidation and reconsolidation of long-term emotional memory in healthy participants: a meta-analysis.J Psychiatry Neurosci. 2013;38(4):222-231. doi:10.1503/jpn.120111

Hayes PE, Schulz SC.Beta-blockers in anxiety disorders.J Affect Disord. 1987;13(2):119-130. doi:10.1016/0165-0327(87)90017-6

National Institute of Mental Health.Generalized anxiety disorder: when worry gets out of control.

DailyMed.Label: Tenormin- atenolol tablet.

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