A Guide to Beta-Blockers for Anxiety

Medically Reviewed By Ami Patel PharmD, BCPS
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Beta-blockers are medications doctors often prescribe to treat anxiety. This medication may be most effective in managing short-term anxiety. This article explains the use of beta-blockers for anxiety, including the types of beta-blockers and how they work. It also covers how to take the medication, its benefits, common side effects, and the possible risks of taking beta-blockers for anxiety.

What are beta-blockers?

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Beta-blockers, also known as beta-adrenergic blocking agents, are medications commonly used to treat heart conditions, such as high blood pressure or an irregular heartbeat.

Doctors also recommend beta-blockers to help relieve the physical effects of short-term anxiety, such as situational or performance-related anxiety. They are not recommended for long-term anxiety.

Doctors can prescribe beta-blockers for “off-label” use with anxiety. “Off-label” means it is a medication prescribed for reasons not approved by the Food and Drug Administration (FDA).

This is a legal and common practice. Talk with your doctor to find out if beta-blockers may be helpful for off-label use with your anxiety symptoms.

Learn about anxiety.

Types of beta-blockers

There are several types of beta-blockers, each with its own characteristics. Two common beta-blockers prescribed for anxiety are propranolol (Inderal or Angilol), and atenolol (Tenormin). Other common beta-blockers may not typically be prescribed for anxiety, but include:

  • metoprolol (Betaloc or Lopresor)
  • bisoprolol (Cardicor or Emcor)
  • carvedilol (Coreg)
  • labetalol (Trandate)
  • acebutolol (Sectral)
  • bisoprolol (Zebeta)
  • nadolol (Corgard)

How do beta-blockers work?

Beta-blockers work by relaxing your blood vessels and slowing your heart rate. They do this by blocking the action of stress-related hormones like adrenaline. This helps improve blood flow and decrease blood pressure, which relieves stress on the heart.

How do beta-blockers help anxiety?

During an anxiety or panic attack episode, the body goes into fight, flight, or freeze response. Beta-blockers help control this response and lessen physical symptoms of anxiety, such as:

As your physical symptoms lessen, you may feel less anxious during stressful situations.

A 2016 review of research on propranolol for anxiety found that the beta-blocker medication had similar effects to benzodiazepines. These are medications also used to treat anxiety and panic disorder.

Read more about the physical symptoms of anxiety.

How do you take beta-blockers for anxiety?

Beta-blockers typically come in tablet form, but they are also available in capsule or liquid form. There are two types of medication:

  • standard release – releases the medication into your body quickly and lasts for a shorter period, so you may need to take it several times a day depending on your dose and the anxiety-provoking situation
  • extended-release – releases the medication slowly and lasts longer in the body, so you do not have to take it as often

Talk with your doctor about the most effective dose for you and your symptoms. Take your medication as prescribed to minimize side effects.

Beta-blockers do not typically upset your stomach, so you can take your medication with or without food.

Beta-blockers may be taken approximately 1 hour before an anxiety-provoking situation. Discuss with your doctor what is right for you based on your medication and situation.

Other tips for starting beta-blockers for anxiety:

  • Swallow extended-release tablets whole. Do not crush, chew or split tablets.
  • If you miss a dose, take it as soon as you remember unless it is closer to the time of your next dose. In this case, skip the missed dose and take your next dose as usual. Never take two doses at the same time.
  • You can use a pillbox, alarm clock, calendar, or cellphone alert to help you remember to take your medication. A family member or friend can also help by checking in or reminding you to take your dose.

If you take too much

The amount of beta-blockers that can lead to overdose varies from person to person. Taking too much of this medication can:

  • slow your heart rate
  • make it difficult to breathe
  • cause dizziness or trembling

If you take more than your prescribed dose, contact your doctor or go to the emergency room right away.

What are possible side effects of beta-blockers?

Beta-blockers are generally well-tolerated. Most people have either no or very mild side effects that lessen over time.

Possible side effects include: 

Tell your doctor about any side effects that are bothersome or last more than a few days. Your doctor may change your dosage or recommend another medication.

What are potential risks of taking beta-blockers?

In rare cases, beta-blockers can cause serious side effects. Contact your doctor right away if you experience any of the following.

Who should not take beta-blockers

While beta-blockers are generally safe, some people should not take them. These include people with:

Summary

Beta-blockers are medications that can help relieve symptoms of short-term anxiety. They reduce your body’s physical reactions to anxiety, such as a racing heart, sweating, or shaking.

There are several types of beta-blockers. Beta-blockers are not FDA-approved for anxiety, but your doctor can prescribe them for off-label use to help treat your symptoms.

Side effects of beta-blockers are typically mild and include fatigue, dizziness, or lightheadedness. In rare cases, serious side effects may also occur. These include shortness of breath, wheezing, and chest pain. Talk with your doctor about the benefits and risks of beta-blockers.

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Medical Reviewer: Ami Patel PharmD, BCPS
Last Review Date: 2023 Jan 9
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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