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Can beta-blockers help with anxiety?

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Beta-blockers can help reduce anxiety by lowering your heart rate. They work to control physical symptoms such as a racing heart and rapid breathing.
Medically reviewed by Monica Kean, PharmD
Written by Cathy Lovering
Updated on

Anxiety can result in physical and psychological symptoms. In addition to feeling restless, on edge, or unable to concentrate, you may also begin to feel your heart race. This can make it difficult to breathe or get enough air.

While beta-blockers can’t reduce the psychological symptoms of anxiety, they can help with the physical signs of an attack. Healthcare professionals usually prescribe beta-blockers for heart conditions, but they may also recommend these medications for people with anxiety.

The beta-blocker most commonly prescribed for anxiety is propranolol. There’s limited evidence that other beta-blockers can also help with the condition, but researchers are continuing to explore their potential.

How do beta-blockers help with anxiety? 

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Beta-blockers can lower your heart rate and reduce anxiety-related symptoms. Beta-blockers may not be able to help a person manage anxiety triggers, but these medications can reduce their physical effects.

Some physical symptoms of anxiety include:

Beta-blockers work by stopping certain enzyme receptors in the body. This can help block adrenaline from approaching the heart’s beta-receptors and ease physical symptoms of anxiety, such as a racing heart.

Each beta-blocker works differently, but in general, they result in:

  • slower heart rate
  • lower blood pressure
  • need for less oxygen

As a result, people experiencing anxiety may not have the cascade of symptoms that might happen without beta-blockers.

Propranolol is the most widely used beta-blocker for anxiety.

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Propranolol

Researchers have extensively studied propranolol for its use in treating anxiety and related conditions. It’s available under the brand names Inderal and Pronol, among others.

A 2022 review of existing research found that propranolol can:

  • lower blood pressure
  • reduce heart rate
  • relieve shortness of breath

Common anxiety-related uses for propranolol can include:

  • stage fright
  • social anxiety
  • fear of public speaking

A 2016 systematic review and research found no significant difference between the efficacy of propranolol and benzodiazepines (a group of depressant drugs) in treating anxiety.

The dosage of propranolol can vary between individuals. For anxiety, the United Kingdom’s National Health Service (NHS) recommends propranolol to be taken at a dosage of 40 milligrams (mg) per day, increasing to 40 mg three times per day if necessary.

If you’re taking propranolol, you should not stop the medication suddenly or without speaking with a healthcare professional. It can cause chest pain or heart attack for some people when stopped abruptly.

Side effects of propranolol include:

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Pindolol

A 2020 review of drug treatment options for anxiety found little evidence to support pindolol (Visken). It listed only propranolol as a beta-blocker with the potential to help treat some kinds of anxiety.

However, some research indicates pindolol can help with anxiety. A 2019 animal study found pindolol reduced anxiety symptoms related to alcohol withdrawal.

As doctors more often prescribe pindolol for high blood pressure and less often for anxiety, there’s no standard dosage for anxiety disorders.

Side effects of pindolol include:

Atenolol

A 2020 study of 92 people who took atenolol (Tenormin) for post-traumatic stress disorder, anxiety disorder, or a trauma disorder found participants experienced a positive effect with the drug. A total of 86% reported positive effects, and 90% denied adverse effects.

Despite this evidence, doctors do not usually prescribe atenolol for anxiety disorders. Instead, they prescribe it for high blood pressure and arrhythmia (irregular heartbeat).

Side effects of atenolol include:

When should you not take beta-blockers?

Beta-blockers are commonly prescribed medications, which can sometimes cause increased risk if you have other medical conditions. Before taking beta-blockers for anxiety, consider speaking with a healthcare professional if you have the following:

  • lung disease, including asthma
  • heart disease
  • kidney disease or a history of metabolic acidosis
  • diabetes
  • allergic reactions to other medications

It’s important to know that some medications can interact with beta-blockers. If you’re taking other medications, consider speaking with a healthcare professional first.

Medications that can interact with beta-blockers include:

  • medication for irregular heartbeat
  • blood pressure medication
  • antipsychotics
  • mefloquine (malaria treatment)

Each beta-blocker has its own side effects. Consider speaking with a healthcare professional to decide which option will be best for you.

Summary

Beta-blockers can help reduce the physical symptoms of anxiety, such as rapid heart rate and difficulty breathing.

The most common beta-blocker prescribed for anxiety is propranolol, but researchers are also continuing to look at the potential of other drugs like atenolol to help with anxiety.

If you’re taking beta-blockers, you should not stop taking them abruptly without speaking with a healthcare professional first.

Download the free Optum Perks Discount Card to save up to 80% on some prescription medications.

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