Beta-Blockers for Anxiety?

Today we’re going to take a look at a class of medicines that are sometimes used off-label to treat anxiety, called Beta Blockers. Beta-blockers, also known as beta-antagonists, beta-adrenergic blocking agents, and beta-adrenergic antagonists, are FDA approved to treat high blood pressure and heart problems. Though they are not FDA approved to treat anxiety, many doctors will prescribe them off-label to treat the symptoms of situational anxiety and panic, due to their effectiveness at lowering the heart rate and creating a sense of calm.

As we’ve covered in previous articles, our bodies use a chemical signaling system using receptors and neurotransmitters in order to control various processes and functions. One type of these receptors is called adrenergic receptors, which are activated by the neurotransmitter epinephrine, also known as adrenaline.

When a stressful or anxiety-provoking situation like boarding a plane with a fear of flying, or giving a speech with a fear of public speaking triggers the body to release high levels of adrenaline- This can result in rapid heartbeat, high blood pressure, increased anxiety, panic, excessive sweating, and heart palpitations. Beta-blockers are able to prevent this response by blocking the action of adrenaline on the nervous system, and as a result, the heart slows, the body relaxes, and pressure in the brain, heart and the rest of the body is greatly decreased.

Due to their ability to work quickly and effectively, many doctors prefer to prescribe beta-blockers off-label to treat anxiety. Not only do they work faster than common SSRIs that are used to treat anxiety, but they are also equally as effective as benzodiazepines without the many risks associated with them.

Unlike antidepressants which are taken daily, beta-blockers are typically taken on a short-term or as-needed basis. Once ingested, these medications usually reach peak levels within an hour, and their calming effects can last for several hours longer. Therefore, most doctors recommend taking them as needed, typically before an anxiety-producing situation, like a medical procedure, or a public speaking event.

Though beta-blockers are effective as an as-needed medication to relieve anxiety symptoms, they are not without their side effects and risks.

Common side effects are:

  • Dizziness
  • Lightheadedness
  • Tiredness
  • Decreased sex drive
  • Nausea
  • Stomach pain
  • Diarrhea
  • Constipation

Less common, but sometimes very serious side effects can also occur. These include:

  • Hallucinations
  • Cold hands or feet
  • Muscle weakness
  • Muscle cramps
  • Shortness of breath
  • Memory loss
  • Fluid retention
  • Blood sugar changes
  • Insomnia and nightmares
  • Allergic reaction
  • Vomiting
  • Shakiness
  • Weight gain
  • Skin rash
  • Mood Changes

Though there are several beta-blockers on the market today, when it comes to anxiety, most healthcare providers will usually start with a low dose of the medication propranolol or atenolol.

It’s important to note that though beta-blockers can be helpful, they do not treat the root of the anxiety itself. In order to do that, it is recommended that pharmacological therapy be combined with other treatments such as therapy, to help address the underlying causes of anxiety.

If you are interested in finding out if beta-blockers could be a helpful addition to your treatment plan, please call and schedule an appointment today. Our highly skilled mental health practitioners are happy to discuss this potential option and determine if it could benefit you. 

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