Are Beta Blockers Effective For Anxiety?

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.

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

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, medication, or medical treatment 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.

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 a different response 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. 

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 pressures. 

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. 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 (800) 662-4357 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.

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.