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?
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.
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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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:
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.
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.
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).
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:
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.
Szeleszczuk L, et al. (2022). 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. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9456064/