Beta Blockers for Anxiety?

October 28, 2009 7:06 AM

Looking for information and anecdotes about your experience and knowledge of beta blockers for anxiety.

I was diagnosed ages ago with Generalized Anxiey Disorder, which I am usually able to handle with exercise and CBT techniques, but not always. I recently went to the GP for a short-term (less than a month) prescription to deal with some intense anxiety-inducing circumstances in my life- I was expecting a few weeks worth of low-dosage Xanax, which is what I got from my doctor in the US a few years ago in similar circumstances - but I now live in the UK and apparently Xanax is not available on the NHS. I wasn't really comfortable with the diazepam (aka valium) the GP offered to prescribe, nor was I comfortable with his second offer of anti-depressants (I don't remember which ones). So he suggested a beta blocker, specifically one 80 mg sustained-release propranolol caplet per day. I filled the prescription this morning but i haven't taken one yet

I'd really like to hear other people's experiences of beta-blockers for anxiety - does it work, and if so, how? I've read that it's long been a well-known secret among performers to curb stage fright, but my anxiety doesn't feel like panic or active fear - it just feels like a kind of constant, low-grade dread with intense spikes when I have to deal directly with my current unpleasant circumstances. Will the beta blocker help with this? Will it make me feel spacey or disconnected or narcotised, like the xanax sometimes did?

I'm also interested in the side effects - including reactions to alcohol. Google says I probably should avoid it, but I can't find any specific effect that it will have - i.e., does it cause an additional, unpleasant effect, or does alcohol just cause the beta blocker not to work as well? The GP didn't mention this contraindiction at all - he just told me that I might have cold hands and feet and vivid dreams.

Finally, as I don't want to take this indefinitely, what will happen when I stop taking it? I know I need to step down the dose and not quit all at once, but will I have a rebound effect with my anxiety where it's more intense for a period of time?

Sorry for all the mini-questions within this larger question, if you can only speak to a small part of what I've asked, please answer anyway - I'm pretty desperate for information!

posted by Wroksie to health & fitness (5 comments total)

I don't have answers to all of your questions, but I have a history of anxiety, and have used atenolol for public speaking and interviews. I did not notice any sedative effects, as with xanax or other benzodiazapenes. On the other hand, I didn't notice any anxiety either. Oddly, I just felt calm and confident, and ended up giving one of the best interviews ever, with dry palms and no fidgeting.

've probably only taken it 2-3 times. Hope this helps.
posted by reverend cuttle at 8:10 AM on October 28, 2009

All beta blockers really do is suppress the effects of adrenaline and noradrenaline (which cause fight-or-flight response). I don't have anxiety problems but I've taken a few beta blockers in the past and found they do have a physical calming effect, probably to the point of making one a little bit sleepy or slightly fatigued. However it should cause no psychological effects, and I am skeptical about the vivid dreams. Since you have the doctor's blessing I say go for it.

Beta blockers are the only type of medication I'm aware of that directly mediate adrenaline, and there is no OTC or herbal drug I know of that does this. Other substances that revolve around anxiety, including alcohol, SSRIs, valium, kava, melatonin, and the smorgasbord of anxiety meds, largely work on the GABA or serotonergic receptors. By doing that they cause a psychoactive effect and then from there the brain decides what to do about triggering fight-or-flight responses, anxiety, and so forth. Beta blockers, on the other hand, directly suppress that response across the board.

For anxiety personally I think beta blockers are extremely safe if your health and blood pressure are monitored by your doctor. If those check out good then I think the only side effect that might be a problem is fatigue. Also since they aren't psychoactive they won't help at all with any root causes of the anxiety; it's more of a reactionary treatment.
posted by crapmatic at 8:14 AM on October 28, 2009

I tried propanalol for my anxiety (generalized anxiety disorder mixed with other psych diagnosis) since I'm loathe to take any medication. The propanalol made me extremely fatigued due to my already low blood pressure being lowered even more-it was a struggle to make it through the day physically. I also didn't notice any appreciable difference in my anxiety, but that could have been because I was so fixated on how tired I felt. I've read that beta blockers seem to work better controlling anxiety if taken every once in a while for specific events (like reverend cuttle's job interview) rather than every day to control more generalized anxiety.
posted by hollygoheavy at 8:49 AM on October 28, 2009

You don't mention marijuana, but if you start taking a beta blocker, you will have to stop smoking.
posted by sickinthehead at 8:56 AM on October 28, 2009

This question may have some answers that will help.
posted by dogmom at 7:00 PM on October 28, 2009