What is a good dose of propanolol (as needed) for someone without hypertension (HTN) taking it for anxiety and stage fright?

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Last updated: June 17, 2025View editorial policy

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From the Guidelines

For anxiety and stage fright in individuals without hypertension, a good dose of propranolol is typically 10-40 mg taken 30-60 minutes before an anxiety-provoking event, with a common starting dose of 10-20 mg, as evidenced by 1. This dose range is based on the medication's ability to block beta-adrenergic receptors, reducing physical symptoms of anxiety like rapid heartbeat, trembling, and sweating without causing sedation. Some key points to consider when taking propranolol for anxiety and stage fright include:

  • Trying the medication before an important event to gauge your response
  • Potential side effects, such as fatigue, dizziness, or cold extremities
  • Cautious use if you have asthma, diabetes, or certain heart conditions
  • Consulting with a healthcare provider to determine the appropriate dose based on your specific health profile and needs, as they can assess the potential risks and benefits of propranolol use, as outlined in 1 and 1. It's also important to note that propranolol should be used as needed, rather than as a regular daily medication, to minimize potential side effects and maximize its effectiveness in managing anxiety and stage fright.

From the Research

Propranolol Dosage for Anxiety and Stage Fright

  • The dosage of propranolol for anxiety and stage fright can vary, but average therapeutic doses range from 20 to 40 mg, taken once to three times a day 2.
  • Propranolol may be effective in treating anxiety disorders, especially those characterized by somatic symptoms related to increased adrenergic tone, moderate intensity, and recent onset 2.
  • For stage fright, propranolol has been shown to be effective in reducing symptoms, with a dose of 100 mg taken 6.5 hours before performing 3.
  • However, the efficacy of propranolol in treating anxiety disorders, including stage fright, may depend on the individual and the specific circumstances, and more research is needed to fully understand its effects 4, 5.

Comparison with Other Beta-Blockers

  • Atenolol, another beta-blocker, has been shown to be effective in treating anxiety-related disorders, with 86% of patients reporting a positive effect and 90% denying adverse effects or finding them tolerable 6.
  • Atenolol may be more effective and better tolerated than propranolol, but more research is needed to confirm this 6.
  • The choice of beta-blocker and dosage may depend on the individual and the specific circumstances, and should be made in consultation with a healthcare professional 2, 4, 5, 6, 3.

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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