Beta Blockers For Anxiety: Options And Side Effects

Medically reviewed by Julie Dodson
Updated February 20, 2024by BetterHelp Editorial Team

Beta-blockers (also known as beta-adrenergic blocking agents) for anxiety are typically prescribed to manage the physical side effects that anxiety can bring. They are just one of the many treatment options for anxiety. Sometimes, beta-blockers for anxiety are used alone, but much more frequently, they are used in combination with other treatments.

Before talking to your doctor about beta-blockers for anxiety, it is important to understand all you can about these special medications. While beta-blockers do not alleviate the psychological symptoms of anxiety, they can help you cope with your anxiety so that it doesn't stop you from functioning.

There are many different types of anxiety, and beta-blockers are not appropriate for all of them. However, even with general anxiety disorder, or GAD, it is possible to use beta-blockers in combination with other medications and treatments to manage physical symptoms.

Understanding what type of anxiety you are experiencing, how beta-blockers work, and what options you have can help you be prepared for well-informed conversations with your doctor. Arming yourself with information may be the first logical step in addressing the treatment of your anxiety.

Types of anxiety

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Anxiety is treatable
The most common type of anxiety for which beta-blockers are prescribed is performance anxiety. This refers to anxiety that entertainers feel or anxiety from the need to perform a certain task like a presentation at work or a public speech. Beta-blockers are a good choice for this type of anxiety because they can alleviate the physical symptoms and allow you to function without clouding your mind, as many anti-anxiety medications might do.

Social anxiety is another type of anxiety that beta-blockers are sometimes prescribed to treat. Many people do not have anxiety at any time other than when they are faced with certain social situations. Beta-blockers are a good treatment option when anxiety is situational.

There are other types of situational anxiety as well. You might experience anxiety when you go to the dentist or doctor, for instance. You might have anxiety when you are faced with an important review at work, or an examination if you are in educational studies.

There are also additional anxiety disorders. The most common are panic disorder and general anxiety disorder. Panic disorder is not effectively treated by beta-blockers because the anxiety comes on so quickly and unexpectedly that there is no time for the beta-blockers to work. Some patients might benefit from beta-blockers for general anxiety disorder, but frequently they are paired with other types of treatment.

Physical symptoms of anxiety

It is important to understand that beta-blockers for anxiety do not treat the emotional effects of anxiety. If you take beta-blockers, you may still feel apprehensive, worry excessively, or feel fearful, for example. Beta-blockers for anxiety only treat the physical symptoms of anxiety.

There are many different physical symptoms of anxiety that may present themselves, such as increased heart rate, shortness of breath, dizziness, nausea, numbness, tingling in the hands and feet, trembling or shaking, and in some severe cases, even diarrhea or frequent urination. These physical symptoms are the result of increases in adrenaline and noradrenaline. This is what beta-blockers prevent.

How do beta blockers work?

Beta-blockers work by blocking the beta receptors that produce adrenaline and noradrenaline. By blocking these receptors, less adrenaline is produced, which can give you a general sense of well-being and reduce the physical symptoms of anxiety. In other words, beta-blockers prevent adrenaline so that your body doesn’t go into a stressed or anxious state.

Beta-blockers for anxiety do not work right away. Beta-blockers are usually in pill form and can take one to two hours before you will start feeling the effects. Sometimes, beta-blockers are taken on a schedule to consistently prevent adrenaline production, maintain a low heart rate, and keep that calm physical feeling, while other times they are taken shortly before an anxiety-provoking situation.

Evidence of beta-blockers for anxiety

There have been a lot of studies conducted as to the effectiveness of beta-blockers for anxiety. Studies (such as this meta-analysis) have found that beta-blockers are effective in the treatment of anxiety when compared to placebo and anti-anxiety medications. The studies found that they are most helpful when physical symptoms of anxiety predominate.

Other studies (including this systematic review) have sought to understand what types of anxiety and situations for which beta-blockers are most effective. They have found that they are most effective for anxiety characterized by moderate physical symptoms and anxiety that has had a recent onset and is not characterized by a recognized anxiety disorder.

Beta-blocker side effects

One of the biggest advantages of beta-blockers is that they do not have as many side effects, and they are not addictive. While the potential side effects of beta-blockers are much less severe than the side effects of most anti-anxiety medications, there are still some side effects about which to be aware of. 

Some of the common side effects of beta-blockers are:

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  • Fatigue
  • Cold hands or feet
  • Headache
  • Dizziness or lightheadedness
  • Shortness of breath
  • Vomiting, diarrhea, or constipation

These side effects could be mild, or you may not have them at all. However, these mild side effects are not cause for concern, and you do not need to worry or stop taking the medication if you have them. However, there are a few rare side effects that could be more problematic.

If you have any of these side effects, you should contact your doctor immediately.

  • Very slow or irregular heartbeat
  • Low blood sugar
  • Swelling or fluid retention

Also, some people with asthma may experience more frequent asthma attacks when on beta-blockers. If you have asthma, you should be aware of this, and report to your doctor immediately if it happens.

Another thing that you need to be aware of is that beta-blockers have been known to cause depression in people who have a predisposition to it. If you have both depression and anxiety, beta-blockers may not be right for you. If you have a history of depression, it is important to discuss this with your doctor before deciding to take beta-blockers for anxiety.

Because of these serious side effects, anyone who already has low blood sugar or low blood pressure should avoid taking beta-blockers. If you have one of these conditions, then talk to your doctor about other drugs that can help with the physical and psychological aspects of your anxiety. You should also discuss your medical history with them in case other prescriptions cause side effects or an allergic reaction. Everybody responds differently to beta-blockers, so a thorough discussion with a doctor with relevant experience is essential before deciding on a treatment for your anxiety.

Who should not take beta-blockers for anxiety

Some people should not take beta-blockers for anxiety. If you have a history of depression or asthma, you should discuss this with your doctor before taking beta blockers. You should also make your doctor aware if you have low blood sugar or a slow heartbeat. Beta-blockers can make these conditions worse and may be dangerous.

Beta-blockers list

There are many beta-blockers available, but only a few are regularly prescribed for anxiety. Not all beta-blockers have been tested or have shown promise in the treatment of anxiety. The most common beta-blockers for anxiety are:

  • Propranolol
  • Sotalol
  • Oxprenolol
  • Atenolol

All of these beta-blockers come in a generic form, which can save you money at the pharmacy.

Getting help

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Anxiety is treatable

If you have anxiety that is severe or situational and you need help addressing your symptoms, it may be beneficial to contact a therapist. The sooner you get help for your anxiety, the better you will feel. There are a lot of treatments available, including cognitive behavioral therapy, which is often used in conjunction with other treatments. A therapist provides an invaluable service and can help you examine your feelings of anxiety and determine the best course of action. They can refer you to a doctor if they feel that beta-blockers may help you in the treatment of your anxiety.

Having anxiety can make seeking professional help difficult, though. Symptoms like fatigue and social withdrawal may cause you to avoid going out in public, even for therapy appointments. If this sounds familiar, then you may find online therapy more feasible. This type of internet-based treatment for anxiety can be accessed from the comfort of your home. And you can make appointments at a time that’s convenient for you. 

Researchers have found that online therapy is associated with positive outcomes for individuals with anxiety. In a recent study, college students experiencing symptoms of anxiety were separated into two groups: one received traditional therapy and one underwent an online intervention. Both experienced positive outcomes, and there were no significant differences in results. 

Takeaway

While beta-blockers may be a good complement to anxiety treatment, they’re not for everyone. And they may not get to the root of your anxiety. Therapy with a licensed mental health professional like those at BetterHelp can help you devise a long-term strategy for managing anxiety symptoms.

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