From the FDA Drug Label
Metoprolol is a beta 1-selective (cardioselective) adrenergic receptor blocker. The mechanism of the antihypertensive effects of beta-blocking agents has not been fully elucidated However, several possible mechanisms have been proposed: (1) competitive antagonism of catecholamines at peripheral (especially cardiac) adrenergic neuron sites, leading to decreased cardiac output; (2) a central effect leading to reduced sympathetic outflow to the periphery; and (3) suppression of renin activity
The answer to whether metoprolol lowers stress is not directly addressed in the provided drug labels. However, beta blockers like metoprolol can reduce the physical symptoms of stress and anxiety by blocking the effects of epinephrine (also known as adrenaline) and lowering blood pressure.
- Key points:
- Metoprolol is a beta 1-selective adrenergic receptor blocker.
- It can reduce heart rate and cardiac output.
- The mechanism of antihypertensive effects is not fully elucidated but may include central effects leading to reduced sympathetic outflow.
- Metoprolol may help reduce physical symptoms of stress and anxiety by blocking epinephrine effects 1, 1. However, the FDA drug label does not directly answer the question of whether metoprolol lowers stress.
From the Research
Effects of Metoprolol on Stress
- Metoprolol has been shown to reduce the response to mental stress in patients with essential tremor, with the ability to blunt the tremorgenic response to mental stress associated with serum concentrations of the drug 2.
- However, in a study on normal persons and patients with hypertension, metoprolol only influenced the heart rate in mental stress and did not affect vigilance, suggesting a limited effect of metoprolol in psychological stress reaction 3.
- Metoprolol has been compared to methyldopa in the long-term management of hypertension, with results showing that metoprolol reduced the proportional increase in systolic and diastolic pressure in response to a standardized stress situation, but not methyldopa 4.
- In a study on patients with postinfarction treatment with metoprolol, the drug was found to reduce heart rate responses to mental stress, with some blockade persisting one week after withdrawal, but no rebound increase in cardiovascular reactivity to mental stress was found 5.
- The acute effects of metoprolol on blood pressure and heart rate have also been studied, with results showing that the antihypertensive effect of metoprolol was significant from the 4th hour after administration, but the variation in systolic and diastolic blood pressure did not correlate with the plasma metoprolol level 6.
Mechanism of Action
- The mechanism of action of metoprolol in reducing stress is thought to be related to its beta-adrenergic blocking properties, which reduce the effects of adrenaline and noradrenaline on the heart and blood vessels 2, 3, 5.
- The ability of metoprolol to blunt the response to mental stress is associated with serum concentrations of the drug, suggesting that the effect is dose-dependent 2.
- The time courses of metoprolol serum concentrations were similar to the time course of metoprolol's ability to blunt the response to mental stress, suggesting that the effect is related to the pharmacokinetics of the drug 2.