Beta Blockers For Anxiety: Supporting Mental Health And Managing Symptoms
Beta blockers (also known as beta-adrenergic blocking agents) are typically prescribed off-label to help people manage the physical side effects that anxiety can cause. In some cases, they are used to treat anxiety symptoms alone, but much more frequently, they are used in combination with other treatments.
Before talking to your doctor about beta blockers, it may be helpful to learn more about these special medications and their effects. While beta blockers do not “cure” the psychological symptoms of mental illness, they may help some people cope with anxiety so it does not impair daily functioning.
There are several types of anxiety, and beta blockers may not be appropriate for all of them. However, even with generalized anxiety disorder (GAD), it can be possible to use beta blockers in combination with other medications and treatments to manage physical symptoms.
Beta blockers for anxiety: Understanding symptoms, side effects, and mental health treatment options
Understanding what type of anxiety you are experiencing, how beta-blockers work, and the treatment options available may 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
Beta blockers may be prescribed for various types of anxiety, including performance anxiety. Performance anxiety may occur for entertainers or those being asked to perform a certain task, such as a presentation at work or a public speech. Beta blockers may benefit some people with this form of anxiety, as they can alleviate the physical symptoms and improve functioning without clouding the mind, as some other anti-anxiety medications might do.
Social anxiety is another condition for which doctors may prescribe beta blockers. Some people do not have anxiety at any time, other than when they are faced with certain social situations. Beta blockers can be an option for situational anxiety.
The most common anxiety disorders are panic disorder and general anxiety disorder (GAD). Panic disorder might not be effectively treated by beta blockers because anxiety can arise quickly and unexpectedly, and the medication may not have time to offer immediate relief. Some people might benefit from beta blockers for GAD. However, they are often paired with other forms of treatment, such as psychotherapy. Beta blockers may not be prescribed for everyone, given their impacts on the heart and other health conditions. Talk to your doctor before deciding whether these medications are right for you.
The BetterHelp platform is not intended to provide any information regarding which drugs, medications, or medical treatments may be appropriate for you. The content provides generalized information that is not specific to one individual. You should not take any action without consulting a qualified medical professional.
Physical symptoms of anxiety
Beta blockers may not fully alleviate the emotional effects of anxiety. If you take beta blockers, you may continue to have symptoms like apprehensiveness, worry, or fear. Beta blockers often target the physical symptoms of anxiety.
How beta blockers target physical symptoms of anxiety
Physical symptoms of anxiety might include a racing heart, shortness of breath, dizziness, nausea, numbness, tingling in the hands and feet, trembling or shaking, and, in some severe cases, diarrhea or frequent urination. These physical symptoms are the result of increases in adrenaline and noradrenaline. Beta blockers can reduce these symptoms, which may lessen anxiety.
How do beta blockers work?
Beta blockers work by blocking the release of adrenaline (epinephrine) and noradrenaline. These medications block epinephrine and cause the heart to pump blood with less force through the blood vessels, making them effective in reducing high blood pressure. These medications can cause a sensation of slowing down or being calmer.
Medications may not work right away. Beta blockers are often prescribed in pill form and can take one to two hours to cause physical effects. In some cases, these medications are taken on a schedule to consistently prevent adrenaline production, maintain a low heart rate, and maintain a “calm” physical feeling. Other times, they may be taken shortly before a provoking situation, such as a presentation or interview.
Evidence supporting beta blockers
Several studies have been conducted on the effectiveness of beta blockers in treating anxiety symptoms. A recent meta-analysis 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 predominate.
Other studies have sought to understand what types of anxiety and situations beta blockers are most effective in supporting. Researchers found that these medications are most effective for anxiety that has a recent onset and is not characterized by a recognized anxiety disorder.
A potential advantage of beta blockers is that they may have fewer side effects as some other anti-anxiety medications. However, there are still some side effects to consider:
- Fatigue
- Cold hands or feet
- Headache
- Dizziness or lightheadedness
- Shortness of breath
- Vomiting, diarrhea, stomach pain, or constipation
These side effects could be mild, or you may not have them at all, as different individuals can have different responses to medications. If you experience moderate or severe side effects, talk to your doctor and avoid stopping your medication without consultation.
If you have any of the following side effects, contact a doctor immediately.
- Very slow or irregular heart rhythms
- Chest pain
- Low blood sugar
- Swelling or fluid retention
Some people with asthma may also experience more frequent asthma attacks when on beta blockers. In general, non-selective beta blockers should not be used in patients who have asthma. However, cardio-selective beta blockers may be used in patients with whom the benefits of treatment outweigh the risks of adverse effects on asthma. If you have an asthma attack, contact your physician immediately.
Beta blockers have also been known to cause depression in people who are at increased risk, such as those who have a family history of mental illness. If you have both depression and anxiety, beta-blockers may worsen depressive symptoms. If you have a history of depression, discuss your symptoms with your doctor to determine if a beta blocker is right for you.
When to avoid beta blockers for low blood pressure
Those with low blood sugar levels or low blood pressure may also be advised to avoid taking beta blockers. If you have one of these conditions, talk to your doctor about other medications that may be more appropriate options, based on your medical history.
Everybody responds differently to different medications, so a thorough discussion with a doctor with relevant experience can be helpful before deciding on a treatment for your symptoms. If a medication causes negative effects, you can mention it immediately to your doctor, and they may prescribe a different option. Some people may choose not to take medication or have reasons they cannot do so. Other treatment options, like therapy, may also be helpful.
Who should avoid beta blockers?
Some people may not benefit from taking beta blockers for anxiety. If you have a history of depression or asthma, discuss this factor with your doctor before taking them. In addition, make your doctor aware if you have low blood sugar or a slow heartbeat. Beta blockers may make these conditions worse and could be dangerous. A doctor may monitor your condition to ensure you don’t have dangerously low blood pressure.
Types of beta blockers
Many beta blockers are available to be prescribed by a doctor for anxiety. However, not all have been tested or have shown promise in the treatment of anxiety. All beta blockers also come in a generic form, which may save individuals money at the pharmacy.
Only a healthcare provider can prescribe beta blockers. Stopping a medication suddenly may lead to serious side effects. In addition, if you’re breastfeeding, propranolol may have side effects.
Beta blockers and blood pressure: Important considerations for use
It’s recommended that you speak with a doctor if you breastfeed. Also, drinking alcohol while taking propranolol may lead to lower blood pressure, so it’s recommended that you not drink alcohol while taking beta blockers. If you are afraid to stop drinking alcohol abruptly, a healthcare provider may be able to prescribe medication to help you safely stop.
If you are struggling with substance use, contact the SAMHSA National Helpline at 1-800-662-HELP (4357) to receive support and resources. Support is available 24/7.
Getting help with anxiety disorders
If you have anxiety that is severe or situational and you’re seeking support in addressing your symptoms, it may be beneficial to contact a therapist. Multiple modalities may be available, including cognitive-behavioral therapy, which is often used in conjunction with other treatments. A therapist can help you examine your feelings and determine the best course of action. They may refer you to a doctor if they believe beta-blockers or another medication may help you in the treatment of your anxiety.
How online therapy supports mental health and addresses anxiety symptoms
In some cases, anxiety symptoms can be a barrier to seeking in-person care. Symptoms like fatigue and social withdrawal may cause individuals to avoid going out in public, even for therapy appointments. If you relate, you may find online therapy more feasible. This type of internet-based treatment for anxiety can be reached 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
What are the best beta blockers for anxiety?
The most commonly prescribed beta blockers include propranolol, metoprolol, and atenolol. Among these, propranolol is often preferred due to its effectiveness in reducing anxiety symptoms like a rapid heartbeat, trembling, and sweating, especially in specific situations such as stage fright or public speaking.
Studies, including at least one meta-analysis, have shown propranolol treatment to be particularly effective for performance-related anxiety disorders, though its role in treating generalized anxiety disorder or panic disorder may be more limited. In these cases, beta blockers are used as part of a broader treatment plan, which may include antidepressants, therapy, or other medications. They don’t address the underlying psychological causes of chronic anxiety, but they may offer relief for somatic symptoms.
For this reason, beta blockers aren’t usually a first-line treatment for all types of anxiety disorders, but they can be effective in managing short-term physical reactions tied to stress. Keep in mind that different patients respond differently to other selected drugs, and the best choice depends on the type of anxiety disorder, coexisting health conditions, and overall risks.
What is the 3 3 3 rule for anxiety?
The 3-3-3 rule is a simple grounding technique used by many patients with anxiety disorders to help manage anxiety symptoms in the moment. It’s especially helpful during episodes of panic disorder or other anxiety-related situations when stress overwhelms the body.
This short-term strategy involves three steps:
- Look around and name three things you can see
- Listen and name three sounds you can hear
- Move three parts of your body
It’s not a cure for mental disorders, but it can be a useful tool to improve health and emotional awareness during moments of intense discomfort. Though not a replacement for treatment with drugs like propranolol, benzodiazepines, or antidepressants, this technique is supported by evidence as helping manage immediate distress. In contrast, longer-term research-based treatments work to address the root of the problem.
For many, grounding exercises like this are part of a broader effectiveness strategy in managing anxiety disorders. It may not replace medication, but it’s a low-risk coping method that supports patients’ overall health.
What is the best anxiety medicine with the least side effects?
There’s no one-size-fits-all answer, but many patients respond well to SSRIs and beta blockers, depending on the type of anxiety disorders they experience. Propranolol is often used for short-term relief of physical anxiety-related symptoms in panic disorder. It may be favored when fewer other side effects are desired.
A meta-analysis has shown that propranolol is effective for certain anxiety disorders. While not all drugs are equally tolerated, some antidepressants may also be considered when long-term effectiveness is a priority and health risks are minimal.
The best medication depends on the patient's overall health, existing mental disorders, and how they respond to the dose.
Do beta blockers make you feel calmer?
Yes, especially propranolol, can make patients feel calmer by reducing symptoms linked with panic disorder and other anxiety states. These drugs work by blocking the effects of adrenaline, making the body feel more at ease. This calming effect is why beta blockers are sometimes used for social anxiety disorder or post-traumatic stress disorder.
While they don't treat the emotional side of anxiety like antidepressants or benzodiazepines, beta blockers may be effective for patients whose main symptoms are physical. Some research and meta-analysis provide evidence that beta blockers can help, although comparative efficacy with other treatments is still being explored.
A systematic review or double-blind placebo-controlled trials are often used in medical science to evaluate how well these drugs work. One such review found that while beta blockers may not be ideal for long-term routine use, they can offer short-term relief, with fewer risks than other options.
If you’re considering either beta blockers or other beta blockers, always talk with a healthcare provider about the potential risks.
What are three negatives of beta blockers?
- Health risks - Beta blockers like propranolol can cause risks such as low heart rate, fatigue, and dizziness. Some people may also experience worsened asthma. This is a concern for people with certain health issues.
- Limited emotional support - While beta blockers may help with physical symptoms of panic disorder, they don’t address the emotional side. Medical science and systematic review data, including a large meta-analysis, show that antidepressants or benzodiazepines might be better for overall anxiety relief.
- Not ideal for everyone - In some double-blind, placebo-controlled studies, beta blockers have shown limited benefits. One study even found they may not help patients with other conditions.
While beta blockers are helpful in some cases, the evidence suggests there are better long-term options for some patients, especially those with complex health needs.
Why is propranolol a high-risk med?
Propranolol is considered a high-risk medication because it can cause serious effects on the heart and blood pressure. Medical science research, including systematic review data and meta-analysis, shows that it may not be safe for everyone, especially those with asthma or panic disorder.
In some double-blind studies with a control group, evidence from data extraction and the present review suggests that propranolol can help with anxiety, but the risks may outweigh the benefits in some cases. Studies also show it may not be safe for routine use, especially for longer than two weeks. Because of these findings, experts suggest using propranolol carefully and only when necessary.
Is Xanax a beta blocker?
No, Xanax isn’t a beta blocker. It belongs to a class of drugs called benzodiazepines, which are used to treat anxiety disorders, including panic disorder. According to medical science and findings from systematic review and meta-analysis, Xanax may offer quick relief for anxiety symptoms. However, evidence also shows it can lead to dependence, especially with long-term use beyond two weeks.
What is the best medicine for stress and anxiety?
It depends on individual needs and the specific diagnosis outlined in resources like the Diagnostic and Statistical Manual of Mental Disorders. There’s strong evidence that supports the effectiveness of SSRIs as first-line treatment. Experts suggest medications like sertraline, escitalopram, and paroxetine for many anxiety-related conditions. While there’s no particular reference that identifies a single “best” medication, research guided by statistical manuals and preferred reporting items helps doctors make informed decisions.
What is a natural beta blocker for anxiety?
Natural options like L-theanine, magnesium, and omega-3 fatty acids may mimic some effects of beta blockers by promoting relaxation and reducing anxiety symptoms without medication.
Why do I feel weird after taking propranolol?
You might feel lightheaded, tired, or detached due to propranolol slowing your heart rate and lowering blood pressure, common effects that impact your body’s response to stress.
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