From the Research
Propranolol is typically prescribed at 10-40 mg taken as needed, 30-60 minutes before an anticipated anxiety-provoking situation, with a maximum of 40 mg per dose and not exceeding 120-160 mg per day, for the treatment of anxiety disorders, particularly situational or performance anxiety 1. The medication works by blocking beta-adrenergic receptors, reducing physical symptoms of anxiety like rapid heartbeat, trembling, and sweating without causing sedation or cognitive impairment. Some key points to consider when prescribing propranolol for anxiety disorders include:
- The onset of action is relatively quick (within 30-60 minutes) and effects last 3-6 hours 1.
- Patients should be aware that propranolol may cause side effects including fatigue, dizziness, and cold extremities, and is contraindicated in certain conditions like asthma, certain heart conditions, and diabetes.
- It's essential to start at a lower dose (10 mg) to assess individual response and tolerance before increasing if needed.
- The quality of evidence for the efficacy of propranolol in treating anxiety disorders is insufficient to support its routine use, according to a systematic review and meta-analysis 1.
- Other medications, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), may be more effective for certain types of anxiety disorders, such as generalized anxiety disorder 2.