From the Guidelines
Metoprolol is effective in treating specific types of anxiety, such as performance anxiety and panic disorder, but it is not a first-line treatment for anxiety disorders. While metoprolol can help reduce physical symptoms of anxiety like rapid heartbeat, trembling, and sweating by blocking the effects of adrenaline, it doesn't address the psychological components of anxiety 1. According to a 2022 study published in Hypertension, beta-blockers like metoprolol are commonly prescribed for symptom relief in panic disorder, combined with cognitive behavior therapy and/or a selective serotonin reuptake inhibitor and/or a benzodiazepine 1.
Some key points to consider when using metoprolol for anxiety include:
- Metoprolol is primarily FDA-approved for treating high blood pressure, angina, and heart failure
- For anxiety disorders, selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), or benzodiazepines are typically more effective as they target the neurochemical imbalances associated with anxiety
- Beta-blockers like metoprolol are sometimes used off-label for specific anxiety situations such as performance anxiety or social phobia, typically at doses of 25-100 mg taken 30-60 minutes before an anxiety-provoking event
- Metoprolol can cause side effects including fatigue, dizziness, and can be dangerous for people with certain conditions like asthma or diabetes
It's essential to consult with a healthcare provider who can recommend appropriate treatment options based on your specific symptoms and medical history, as metoprolol should only be used under medical supervision 1.
From the Research
Effectiveness of Metoprolol in Treating Anxiety
- Metoprolol, a beta-blocker, has been studied for its potential in treating anxiety disorders, with mixed results 2, 3, 4, 5, 6.
- Early studies suggested that beta-blockers, such as propranolol, may be effective in treating anxiety disorders with prominent somatic or autonomic symptoms, but not extreme in degree 2, 3.
- A more recent systematic review and meta-analysis found no evidence for a beneficial effect of beta-blockers compared with either placebo or benzodiazepines in patients with social phobia or panic disorder 4.
- A preliminary investigation on the effects of atenolol, another beta-blocker, suggested that it may be well-tolerated and effective among persons with anxiety disorders, with 86% of patients reporting a positive effect 5.
- A study on metoprolol treatment in chronic heart failure patients with neuropsychiatric disorders found that metoprolol afforded anxiolytic benefits independent of heart rate reduction, but worsened depressive and high burnout symptoms 6.
Key Findings
- Beta-blockers may be effective in treating anxiety disorders with prominent somatic or autonomic symptoms, but not extreme in degree 2, 3.
- Metoprolol may have anxiolytic benefits independent of heart rate reduction, but its use should be cautious in patients with concurrent depressive illness 6.
- More rigorously controlled empirical studies are needed to further substantiate the claim that beta-blockers, including metoprolol, are effective in treating anxiety disorders 4, 5.