From the Guidelines
Beta blockers are a viable treatment option for managing anxiety, particularly for panic disorder and performance anxiety, as they can provide symptom relief by blocking the physical effects of adrenaline. According to a 2022 study published in Hypertension 1, beta-blockers are commonly prescribed for symptom relief in panic disorder, often in combination with cognitive behavior therapy and/or selective serotonin reuptake inhibitors and/or a benzodiazepine. Some key points to consider when using beta blockers for anxiety include:
- They can help alleviate physical symptoms such as rapid heartbeat, trembling, and sweating, which can contribute to the anxiety cycle
- They are particularly effective for performance anxiety or situational anxiety rather than generalized anxiety disorder
- Common beta blockers used for anxiety include propranolol and metoprolol, with dosages ranging from 10-40mg and 25-100mg, respectively
- Potential side effects may include fatigue, cold hands/feet, and dizziness, and they should be used cautiously in people with asthma, diabetes, or certain heart conditions
- Unlike benzodiazepines, beta blockers are not addictive and don't impair cognitive function, making them suitable for situations requiring mental clarity. It's essential to weigh the benefits and risks of beta blockers for anxiety management, considering the individual's medical comorbidities and the specific anxiety disorder being treated, as noted in the 2022 study 1.
From the FDA Drug Label
The mechanism of the anti-migraine effect of propranolol has not been established. Beta-adrenergic receptors have been demonstrated in the pial vessels of the brain.
The FDA drug label does not answer the question.
From the Research
Mechanism of Action
- Beta blockers manage anxiety by blocking peripheral adrenergic beta-receptors, which helps to alleviate symptoms such as tremor and palpitations 2
- The primary action of beta blockers is to block the physical symptoms of anxiety, rather than the psychological symptoms 2
Efficacy in Anxiety Disorders
- Beta blockers have been shown to be effective in treating anxiety disorders with prominent somatic or autonomic symptoms, but not extreme in degree 2
- Propranolol and oxprenolol are the most clearly established beta blockers in terms of efficacy for anxiety 3
- However, other studies have found that beta blockers are not effective in treating generalized anxiety disorder or panic disorder 4, 5
Specific Anxiety Disorders
- Beta blockers may be effective in treating social phobia or performance anxiety, particularly when physical symptoms are prominent 2
- However, there is no evidence to support the use of beta blockers in treating panic disorder with or without agoraphobia 5
- Beta blockers may provide symptomatic relief in some patients with residual somatic complaints, such as palpitations and tachycardia, when combined with other treatments 4
Comparison to Other Treatments
- Beta blockers are considered a viable alternative to benzodiazepines, which can be addictive 3, 2
- However, beta blockers may not be as effective as benzodiazepines in treating anxiety disorders, and may have a slower onset of action 2, 5
- Antidepressants may also be considered as a first-line treatment for anxiety disorders, particularly if beta blockers are not effective 3