What is the appropriate dose of propranolol (propranolol hydrochloride) for a 17-year-old with performance anxiety, specifically for public speaking?

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Last updated: May 19, 2025View editorial policy

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From the Research

For a 17-year-old experiencing public speaking anxiety, propranolol can be prescribed at a dose of 40 mg taken 30-60 minutes before the anxiety-provoking event, as indicated by the most recent study 1. This dose is based on the study that investigated the use of propranolol in reducing public speaking anxiety, which found that 40 mg of propranolol was used in the treatment group 1. Typically, starting with a lower dose and adjusting based on response and side effects is a common approach, but the study 1 specifically used 40 mg. It is essential to note that this medication should only be used occasionally for specific anxiety-provoking situations, not daily. Before taking propranolol, the young adult should consult with a healthcare provider as this medication requires a prescription and proper medical evaluation. Propranolol works by blocking beta-adrenergic receptors, reducing physical symptoms of anxiety like rapid heartbeat, trembling, and sweating. Potential side effects include fatigue, dizziness, and lowered blood pressure. This medication is contraindicated in individuals with certain conditions including asthma, certain heart conditions, and diabetes. While propranolol can help manage the physical symptoms of anxiety, it should ideally be used alongside non-pharmacological approaches such as cognitive behavioral therapy and public speaking practice, as suggested by studies 2, 3, 4, 5. Some key points to consider when using propranolol for public speaking anxiety include:

  • The importance of proper medical evaluation before starting the medication
  • The need for occasional use only, rather than daily
  • The potential for side effects and contraindications
  • The benefits of combining propranolol with non-pharmacological approaches for optimal results.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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