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Terms & Conditions

Anxiety Aid - Propranolol

Propranolol - Patient Information

What is Propranolol?

Propranolol is a ​Beta-blocker medication. This is a class of medication that helps control your body’s fight-or-flight response and reduce its effects on your heart. Many people take beta-blockers to treat heart-related conditions, such as:

  • high blood pressure
  • heart failure
  • an irregular heartbeat

Doctors can also prescribe beta-blockers for off-label use like for help managing performance anxiety symptoms. Examples of situations when Propranolol can be used include the following:

  • General social anxiety
  • Performances and auditions
  • Presentations at work
  • Public speaking
  • Interviews
  • Networking events
  • Dating or personal conversations

Read on to learn more about how beta-blockers impact performance anxiety, and whether they could work for you.

How do beta-blockers work?

Beta-blockers are also called beta-adrenergic blocking agents. They prevent adrenaline — a stress-related hormone — from making contact with your heart’s beta receptors. This prevents adrenaline from making your heart pump harder or faster.

In addition to relaxing your heart, some beta-blockers also relax your blood vessels, which can help to reduce blood pressure.

There are many beta-blockers available, but some of the more common ones include:

  • acebutolol (brand name Sectral®)
  • bisoprolol (brand name Zebeta®)
  • carvedilol (brand name Coreg®)
  • atenolol (brand name Tenormin®)
  • metoprolol (brand name Lopressor®)

The beta-blocker that is prescribed by ​doctors​ through the hims & hers platforms is called Propranolol ​. This is sometimes sold under the brand name Inderal®.

All beta-blockers used to treat anxiety are prescribed off-label. Propranolol is a beta-blocker that is sometimes prescribed off-label to help with performance anxiety.

OFF-LABEL DRUG USE ​Off-label drug use is when a drug is used to treat a condition that hasn't been explicitly approved by the FDA for that drug. Sometimes drugs approved by the FDA for certain conditions are found to be effective treatment options for non-FDA approved conditions. Since the FDA does not regulate the practice of medicine, a physician may prescribe a drug for an "off-label use" if they determine that it is appropriate for a particular patient's condition.

How can beta-blockers help performance anxiety?

Beta-blockers won’t treat the underlying psychological causes of performance anxiety, but they can help you manage some of your physical symptoms, such as:

  • a fast heart rate
  • shaky voice and hands
  • sweating
  • dizziness

By decreasing your body’s physical reactions to stress, you may feel less anxious during stressful times.

Beta-blockers work best for managing short-term anxiety about specific events, rather than long-term anxiety. For example, you can take a beta-blocker before giving a public speech if that’s something that makes you feel anxious.

People respond differently to medications, especially when it comes to treating mental health issues like anxiety. What works for one person may not work at all for someone else. You may also need additional treatment options for your anxiety while taking beta-blockers. For instance, since beta-blockers only help to treat the physical symptoms of performance anxiety, you may need another treatment or treatments to help with the psychological aspects of anxiety.

How do I take beta-blockers for performance anxiety?

Propranolol comes in a pill form. The amount you should take depends on both the type of beta-blocker and your medical history. Never take more than what your doctor prescribes. You’ll likely notice results the first time you take beta-blockers for performance anxiety, but they can take an hour or two to reach their full effect. During this time, you’ll feel your heart rate decrease, which might make you feel more relaxed.

For appropriate patients, ​doctors through the hims & hers platform​ typically recommend a single Propranolol 20mg tablet, a low dose, to be taken approximately 30-60 minutes prior to the stressful event. If prescribed, you will be provided a total of 4, 6, 8, 10, or 12 pills per month, based on the doctor’s medical evaluation. Do not take more than 2 tablets in a 24 hour period.

What are the possible side effects?

Beta-blockers can cause some side effects, especially when you first start taking them. These side effects are more common if you take Beta-blockers every day. You should only take a Beta-blocker “as needed” for performance anxiety, unless your doctor says otherwise. You should NOT take propranolol on a daily basis when using it for performance anxiety.

Possible side effects include:

  • dizziness or lightheadedness
  • fatigue
  • cold hands and feet
  • headache
  • depression
  • shortness of breath
  • vomiting, diarrhea, or constipation

Consult your doctor right away or go to the emergency room if you experience any more serious side effects, including:

  • very slow or irregular heartbeat
  • low blood sugar
  • an asthma attack
  • swelling and fluid retention, along with weight gain

If you notice mild side effects, don’t stop taking the beta-blocker without talking to your doctor first. If you take beta-blockers regularly, you may have serious withdrawal symptoms if you suddenly stop.

For some people, the side effects of beta-blockers may actually cause anxiety symptoms. You should follow up with your doctor as soon as possible if you feel like taking beta-blockers is increasing your anxiety.

Who shouldn’t take beta-blockers?

While beta-blockers are generally safe, certain people shouldn’t take them. Before taking beta-blockers, make sure to tell your doctor if you have one or more of the following conditions:

  • Anaphylactic reaction/Anaphylaxis (severe)
  • Bradycardia (slow heartbeat), Heart block/heart rhythm disorder, Sick sinus syndrome (type of abnormal heart rhythm), Tachycardia (fast heartbeat)
  • Angina (severe chest pain)
  • Asthma or Bronchospasm
  • Recent heart attack
  • Glaucoma
  • Muscle problems (eg, myopathy, myotonia or myasthenia gravis)
  • Wolff-Parkinson-White syndrome (rare heart condition)
  • Heart failure
  • Tremors due to Parkinson's disease
  • Hypotension (low blood pressure)
  • Pheochromocytoma (an adrenal problem)
  • Diabetes
  • Hypoglycemia (low blood sugar)
  • Hyperthyroidism (overactive thyroid)
  • Kidney disease
  • Liver disease
  • Lung disease (eg, chronic bronchitis, emphysema, COPD)
  • Blood circulation problems (e.g., Raynaud's disease)

If you have any of these conditions or symptoms, you may still be able to take beta-blockers, but you’ll need to work with your doctor to evaluate the risks and benefits.

Beta-blockers can also interact with other medications used to treat many heart conditions and antidepressants, so make sure you keep your doctor up to date about any medications, supplements, or vitamins you take.

If you are not sure about taking propranolol with another medication be sure to discuss this with your doctor.

Allergies

Tell your doctor if you have ever had a​ny unusual or allergic reaction to this medicine or any other medicines. Also tell your doctor​ if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Use in pregnancy

Pregnancy CategoryExplanation
All TrimestersCAnimal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

To learn more about Propranolol we recommend accessing the ​Prescribers Digital Reference (PDR).

The bottom line

Beta-blockers can be helpful in managing symptoms for some people with performance or situational anxiety. Propranolol has been shown as a viable treatment option to treat short-term anxiety symptoms, especially those that occur before a stressful event. However, it isn’t recommended that beta-blockers be used as a long-term treatment for anxiety.

If you’re interested in trying beta-blockers for managing your performance anxiety we recommend an online consultation with a doctor through our platform. They can advise on the best treatment plan for you to help manage your specific symptoms.