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16 min read

The calming powers of Propranolol for anxiety relief

Written by Klarity Editorial Team

Published: Apr 24, 2024

Medically Reviewed by Dr. Zoe Russell

Table of contents

Finding peace while struggling with the symptoms of anxiety is challenging, pushing you to search for solutions. During your search for anxiety treatment options, you likely came across Propranolol for anxiety. Propranolol is a medication primarily used to treat conditions such as high blood pressure. In recent years, the medical community has recognized the efficacy of Propranolol for anxiety treatment. 

In this blog post, we cover how Propranolol works in the body, who should take it for anxiety, the warnings and side effects you should know about before taking it, and more. We also answer your questions about what to do if you forget to take your dosage or what the best time to take it is. 

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How Propranolol treats anxiety

Propranolol, initially developed for cardiovascular conditions, has gained notability for its effectiveness in treating anxiety. It addresses physical symptoms, such as rapid heart rate and sweating. Propanol is a beta-blocker. It works by blocking the effects of adrenaline, a key part of the body’s fight or flight response. 

Blocking the effects of adrenaline makes Propranolol a good option if you’re facing situational anxiety, like public speaking. It temporarily relieves the physical symptoms of anxiety. In addition to its use for situational anxiety, Propranolol is considered for broader anxiety management under specific circumstances. Although it’s not the main treatment for generalized anxiety disorder, its advantages for quickly relieving physical symptoms are evident.

How does Propranolol for anxiety work?

Propranolol is a beta blocker, a type of medicine that helps to control things like heart rate and blood pressure. It functions by blocking the effects of adrenaline on certain receptors in the body. This helps reduce the physical symptoms associated with anxiety disorders, such as a racing heart, trembling, and sweating. 

Propranolol primarily targets the beta-1 receptors, which are part of your body’s cells that help regulate things like heart rate and blood pressure, but it may also affect beta-2 receptors in other parts of the body that help relax your airways and blood vessels. 

How quickly does Propranolol work?

How quickly Propranolol starts to work can vary from person to person. Generally, it starts to take effect within 30 minutes to an hour. However, keep in mind that your responses may differ due to factors. such as metabolism and dosage. 

Follow your healthcare provider’s instructions and give the medication sufficient time to work. And don’t make adjustments to your dosage without talking with your provider.

How long do effects from Propranolol last?

The duration of Propranolol’s effects can also vary based on several factors, including dosage, individual metabolism, and the specific formulation of Propranolol prescribed to you. Typically, the effects of a single dose of Propranolol last for around 4 to 6 hours. If you’re prescribed the sustained-release formulation, the effects can last 8 to 11 hours.

Best time to take Propranolol for anxiety

The best time to take Propranolol depends on your individual needs and lifestyle. Some people may find it beneficial to take Propranolol on an “as-needed” basis. This means you don’t need to take it every day. Instead, you can take it before anticipated anxiety-provoking situations, such as public speaking or important events. This allows the medication to take effect before your anxiety symptoms show up.

Other people need to take it every day, as advised by their healthcare provider, to manage persistent symptoms of general anxiety. 

Discussing the best time to take Propranolol with your healthcare provider is crucial, as they can assess your specific situation and provide personalized recommendations. They may consider factors such as the timing of your anxiety symptoms, the dosage prescribed, and any other medications or conditions you may have.

Who should take Propranolol?

Propranolol is a suitable treatment option for individuals who experience physical anxiety symptoms and are seeking relief. It’s important to note that Propranolol isn’t suitable for everyone, and determining whether Propranolol is the right medication for you should be done in consultation with a qualified licensed healthcare professional. 

Propranolol may be recommended for you if you:

  1. Experience situational or performance anxiety: If you frequently face anxiety-inducing situations, such as public speaking, social interactions, or performances, Propranolol may help alleviate the physical symptoms associated with these situations. It can provide a sense of calm and reduce the physiological response to anxiety triggers.
  1. Have generalized anxiety disorder (GAD) or panic disorder: In cases of generalized anxiety disorder or panic disorder, Propranolol may be prescribed as part of your comprehensive treatment plan. It can be particularly helpful in managing the physical symptoms of anxiety, such as a racing heart, trembling, and sweating, which can contribute to the overall distress experienced with these conditions.
  1. Have cardiovascular conditions: Propranolol is primarily used to treat cardiovascular conditions, such as high blood pressure, irregular heart rhythms, and angina. If you have both anxiety symptoms and a cardiovascular condition, your healthcare provider may consider Propranolol as a suitable option to address both issues simultaneously.

Propranolol dosage

The amount of Propranolol you’re prescribed can vary depending on the specific condition being treated, your response, and healthcare provider’s recommendations. Following your healthcare provider’s instructions and not adjusting the dosage on your own is important if they prescribe you Propranolol.

Here are some general considerations regarding Propranolol dosage:

  • Initial dosage: Typically, the initial dosage of Propranolol for anxiety is low. This is so your provider can assess individual response and minimize potential side effects. Your healthcare provider may gradually increase the dosage based on your specific needs and how well you tolerate the medication.
  • Maintenance dosage: Once the optimal dosage is determined, you’ll be prescribed a maintenance dosage to manage your anxiety symptoms effectively. The maintenance dosage may vary depending on the severity of your symptoms and your individual response to the medication.
  • Sustained-release dosage: In some cases, your healthcare provider may prescribe a sustained-release dosage of Propranolol. These formulations (in 80 milligrams and 160 milligrams tablets) release the medication gradually over a longer period, allowing for extended effects and potentially reducing the frequency of dosing.

What if you forget to take a dose?

If you accidentally miss a dose of Propranolol, take it as soon as you remember. However, if it’s close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Don’t take a double dose to make up for the missed dose, because doubling your dose may increase the risk of side effects.

What if you take too much Propranolol?

If you accidentally take more Propranolol than prescribed, it’s important to seek immediate medical attention. An overdose of Propranolol can have serious consequences and may require emergency treatment. 

Symptoms of an overdose may include severe dizziness, slow heart rate, difficulty breathing, fainting, or confusion. Contact your local poison control center or emergency services right away if you suspect you’ve overdosed.

Remember, it’s essential to adhere to your prescribed dosage and communicate with your healthcare provider if you have any concerns or questions regarding Propranolol dosing. They can provide specific guidance based on your individual needs and monitor your progress throughout the treatment.

Propranolol side effects

Like any medication, Propranolol may cause certain side effects. It’s important to be aware of potential side effects and discuss them with your healthcare provider. While not everyone experiences side effects, some common ones associated with Propranolol include:

  • Fatigue and dizziness: Propranolol can cause a feeling of tiredness or dizziness, particularly when starting the medication or adjusting the dosage. It’s advisable to avoid activities that require alertness until you know how Propranolol affects you.
  • Gastrointestinal issues: You may experience gastrointestinal discomfort, such as nausea, vomiting, diarrhea, or stomach cramps. These symptoms are typically mild and transient.
  • Cold hands and feet: Propranolol may lead to reduced blood flow to the extremities, resulting in cold hands and feet. This is usually temporary and not a cause for concern, but if you experience prolonged or severe coldness, it’s important to inform your healthcare provider.
  • Changes in sleep patterns: Propranolol can occasionally cause sleep disturbances, such as insomnia or vivid dreams. If sleep issues persist or significantly impact your daily life, consult your healthcare provider for further guidance.

It’s important to note that these aren’t the only possible side effects of Propranolol. Individual responses may vary, and other side effects may occur. If you experience any unusual or bothersome symptoms while taking Propranolol, promptly inform your healthcare provider.

Warnings for Propranolol

When taking any type of prescribed medication, it’s important to be aware of specific warnings and considerations to ensure its safe and effective use. Propranolol carries important warnings, and there are factors to keep in mind, such as the boxed warning regarding discontinuation and considerations during pregnancy and breastfeeding.

Understanding and discussing these aspects with your healthcare provider is crucial for informed decision-making, maximizing the benefits of Propranolol, and minimizing potential risks.

Boxed warning

Propranolol comes with a boxed warning, which is the strongest warning issued by the U.S. Food and Drug Administration (FDA). This warning highlights the potential risks associated with sudden discontinuation of Propranolol. 

It’s essential to follow your healthcare provider’s instructions for gradually tapering off propanolol if needed. Abruptly stopping Propranolol can lead to withdrawal symptoms and a rebound effect, causing an increase in heart rate, blood pressure, or even chest pain in individuals with cardiovascular conditions. To ensure your safety, always consult your healthcare provider before making any changes to your Propranolol dosage or treatment plan.

Pregnancy and breastfeeding

If you’re pregnant, planning to become pregnant, or currently breastfeeding,it’s important to discuss the potential risks and benefits of Propranolol with your healthcare provider. Propranolol may have certain implications during pregnancy or while breastfeeding. 

While limited studies suggest that Propranolol is generally considered safe during pregnancy, it’s important to have a discussion with your healthcare provider to weigh the potential benefits for you and the potential risks for your baby. Similarly, if you’re breastfeeding, it’s important to discuss the use of Propranolol with your provider to assess any potential risks to your infant and determine the best course of action.

Medication contraindications

Propranolol may interact with other medications, soit’s vital to inform your healthcare provider about all the medications, supplements, or herbal products you’re currently taking. 

Certain medications, such as monoamine oxidase inhibitors (MAOIs), antipsychotics, and calcium channel blockers, may interact with Propranolol and lead to adverse effects.

Additionally, the combination of Propranolol and certain medications may increase or decrease the effectiveness of either medication. Tell your healthcare provider about all the medications you take — they can evaluate potential interactions and adjust your treatment plan accordingly to ensure your safety and optimize the efficacy of your medications.

Medical considerations

Prior to starting Propranolol, it’s important to inform your healthcare provider about any pre-existing medical conditions you have. This includes conditions such as asthma, diabetes, liver or kidney disease, heart failure, or any other heart-related conditions.

Certain medical conditions may warrant specific monitoring to ensure its safe use. By providing a comprehensive medical history, you let your healthcare provider make informed decisions regarding the suitability of Propranolol for your individual circumstances and make any necessary adjustments to your treatment plan.

Remember, the information provided here offers a general overview of the warnings and considerations associated with Propranolol. Your healthcare provider is best positioned to provide guidance and address any concerns you may have to ensure the safe and effective use of Propranolol for anxiety.

Propranolol FAQs

What else does Propranolol treat?

While Propranolol is primarily known for its use in treating cardiovascular conditions and managing physical anxiety symptoms, it can be used to address other medical conditions as well. Propranolol has been found to be effective in treating migraines, essential tremors (involuntary shaking of the hands), and certain types of tremors associated with Parkinson’s disease. 

Additionally, it may be prescribed to manage symptoms of thyroid storm, a severe condition caused by an overactive thyroid gland. It’s important to point out that the use of Propranolol for these conditions should be under the guidance and supervision of a healthcare professional.

Does Propranolol cause depression?

Propranolol is primarily a beta blocker medication and isn’t typically associated with causing depression as a direct side effect. However, individual responses to medications can vary, and some people may experience changes in mood or emotional well-being while taking Propranolol. 

If you notice any concerning changes in your mood or experience symptoms of depression, it’s important to discuss them with your healthcare provider. They can evaluate your symptoms and determine the most appropriate course of action, which may include adjusting your medication, dosage, or exploring additional treatment options if necessary.

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National Health Service. “Propranolol.” Nov. 18, 2021.

The Independent Pharmacy. “What Is Propranolol? Propranolol For Anxiety & Other Conditions.” Scott McDougall. Aug. 28, 2022.

MedicalNewsToday. “Propranolol for anxiety: How quickly it works, the best time to take it, and how long the effects last.” Jenna Fletcher. September 29, 2022.

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