From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Propranolol is not recommended for performance anxiety due to the lack of robust evidence supporting its effectiveness, as shown in the most recent study from 2025 1. The use of propranolol for performance anxiety has been a topic of debate, with some studies suggesting its potential benefits in reducing physical symptoms of anxiety. However, the most recent and highest quality study from 2025 1 found no evidence to support the use of beta-blockers, including propranolol, in the treatment of anxiety disorders.
Key Points to Consider
- The recommended dosage of propranolol for performance anxiety is not established due to the lack of evidence, but previous studies have used dosages ranging from 10-40 mg, taken approximately 1 hour before the anxiety-provoking event 2.
- The effects of propranolol can last for 4-6 hours, but this can vary between individuals, and its use may be associated with common adverse effects such as fatigue, dizziness, and light-headedness 2.
- Propranolol works by blocking beta-adrenergic receptors, preventing adrenaline from binding to these receptors and thereby reducing physical symptoms of anxiety, but it does not directly affect psychological anxiety 3.
- Patients should be aware that propranolol is contraindicated in those with asthma, certain heart conditions, and diabetes, and it is essential to start with the lowest effective dose to minimize side effects 2.
Clinical Implications
- The lack of evidence supporting the use of propranolol for performance anxiety suggests that alternative treatments, such as cognitive-behavioral therapy or other anxiolytic medications, may be more effective and safer options.
- Clinicians should exercise caution when prescribing propranolol for performance anxiety and carefully weigh the potential benefits and risks, considering the individual patient's medical history and condition.
- Further research is needed to fully understand the effects of propranolol on performance anxiety and to establish evidence-based guidelines for its use in this context.