From the Guidelines
Metoprolol can be used for anxiety, particularly for symptom relief in panic disorder, as evidenced by its use in combination with other treatments like cognitive behavior therapy and/or selective serotonin reuptake inhibitors and/or a benzodiazepine 1. While metoprolol, a beta-blocker, is not typically the first-line treatment for anxiety disorders, it can help manage physical symptoms of anxiety such as rapid heartbeat, trembling, and sweating. It works by blocking the effects of adrenaline, which can reduce heart rate and blood pressure. Some key points to consider when using metoprolol for anxiety include:
- Metoprolol is most commonly prescribed for cardiovascular conditions like hypertension, angina, and heart failure.
- For anxiety-related situations, propranolol (another beta-blocker) is more commonly used, particularly for performance anxiety or situational anxiety.
- The use of beta-blockers like metoprolol for anxiety is supported by recent studies, such as the 2022 study published in Hypertension, which discusses the use of beta-blockers for psychiatric comorbidities including panic disorder 1.
- First-line treatments for chronic anxiety disorders typically include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), buspirone, or benzodiazepines, along with cognitive-behavioral therapy.
- If you're experiencing anxiety symptoms, it's essential to consult with a healthcare provider who can determine the most appropriate treatment based on your specific symptoms, medical history, and overall health status.
From the Research
Metoprolol for Anxiety
- Metoprolol is a beta-blocker that has been used to treat various conditions, including anxiety disorders.
- However, according to a systematic review and meta-analysis published in the Journal of Affective Disorders 2, there is no evidence to support the use of beta-blockers, including metoprolol, for the treatment of anxiety disorders in adults.
- The study found that beta-blockers were not effective in reducing anxiety symptoms in patients with social phobia or panic disorder with/without agoraphobia.
- The lack of evidence for the effectiveness of beta-blockers in treating anxiety disorders is concerning, given the increasing prescription of these medications for anxiety.
Alternative Treatments for Anxiety
- Selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) are commonly used to treat anxiety disorders, and have been shown to be effective in reducing symptoms of anxiety, obsessive-compulsive, and stress-related disorders 3, 4.
- A 3-level network meta-analysis published in PLoS Medicine found that all SSRIs and SNRIs were effective for multiple symptom domains, and in patients from all included diagnostic categories 4.
- However, the use of SSRIs and SNRIs for anxiety disorders should be guided by clinical practice considerations, including the risk of tachyphylaxis and discontinuation syndrome, and the need for periodic monitoring to reassess the risk-benefit ratio of remaining on the medication 3.