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Beta Blockers and Anxiety - What to Know

Micah Abraham, BSc
Beta Blockers and Anxiety - What to Know

You and your doctor or psychiatrist will work together to discover the best possible medication to treat your anxiety symptoms. One type of drug that they may recommend is known as a “Beta Blocker.” Beta blockers are not specifically an anti-anxiety drug. Rather, they are a class of drugs prescribed for a host of issues. While they may be used to treat heart disease, glaucoma, and hypertension, many doctors prescribe beta blockers for anxiety - especially those with severe anxiety and anxiety attacks.

Many people have reported using beta blockers with some success. But there are many risks associated with this class of drug, and in some cases, it's possible that beta blockers will increase your anxiety, rather than help it. Below, we’ll explore the effects of beta blockers and the relationship between anxiety and these medications. 

Do Beta Blockers Work?

In theory, beta blockers may help reduce anxiety. But they don't reduce anxiety for everyone, and they can't cure anxiety altogether. Beta blockers are taken “as needed.” to reduce anxiety in the moment, but the anxiety will still come back if not properly managed.

If you're willing to commit to medication, then you're willing to commit to something better and safer, and thus it is highly recommended that - no matter your success with beta blockers - you consider a supplementary non-medicinal treatment to learn how to manage your stress and anxiety. 

How Beta Blockers Work

Beta-blockers are a class of drugs. They target what's known as a "beta receptor" that is found on many cells in the sympathetic nervous system, including the heart, kidneys, muscles, and airways. During times of stress, these areas of the body are "excited" by epinephrine.

In those with heart disease, as well as other health issues, beta blockers reduce the effects of adrenaline on the sympathetic nervous system in order to prevent second heart attacks and other disorders that are exacerbated by stress.

There are many types of beta blockers. Two of the most commonly prescribed for anxiety are Propranolol and Atenolol. Other beta blockers may only affect areas that are not ideal for reducing anxiety or may cause too many side effects.

Beta Blockers Are Not Approved for Anxiety Reduction

Maybe the most important reason to avoid beta blockers is that they're not technically approved for anxiolytic (anti-anxiety) use. Doctors prescribe these medicines "off-label" - meaning that they aren't approved for use but are used anyway.

Off-label use is not uncommon for medications - not even medications for anxiety. What makes beta-blockers unique is that not only are they used off-label but doctors aren't even sure why beta blockers reduce anxiety. Their mechanism is only partially known. Beta blockers lower heart rate and reduce norepinephrine, which can spike when a person has anxiety. This then controls the symptoms of anxiety. What is not entirely clear is whether or not beta blockers control any mental symptoms of anxiety. Doctors and patients sometimes find that people taking beta blockers seem to experience reduced anxiety, but it is not clear if any emotional symptoms are due to the beta blockers themselves, or just a reaction to weaker physical symptoms. 

Medicine as a Treatment

Medicine, in general, should not be used to treat anxiety by itself in the long term. Rather, it needs to be combined with other treatments that do not depend on medicine. Medicine can only dull anxiety or relieve symptoms, not cure it, and in most cases it can cause the brain to become dependent on the medicine and rely on it during times of stress.

For those living with anxiety, this can be a tremendous problem. Anxiety itself indicates that you may already be struggling to cope with stress. If you also depend on this medication - or any medication - without combining it other forms of therapy, you may find it more difficult to cope with anxiety after you stop taking the medication.

Side Effects of Beta Blockers

Yet the main reason to avoid beta blockers is the side effects. What's unique about beta blockers is that no one knows how they'll affect any given person. Everyone responds to beta blockers differently. So while some may find temporary relief from their anxiety, others may find their anxiety to be much worse, while others may see no effect.

The most common side effects of beta blockers for anxiety include:

In rare cases, heart disease may become a problem for those taking beta blockers.

How Beta Blockers Increase Anxiety

Some people tolerate beta blockers well, and find that they're successful for reducing anxiety symptoms. Others may find that the side effects increase their anxiety overall.

Those with panic attacks are especially prone to this anxiety increase, because many of the side effects of beta blockers act as triggers for anxiety attacks and increase stress.

Furthermore, the nightmares, sleep disorders, shortness of breath, hallucinations, and general ill feeling can increase anxiety in certain patients, leading to significant disturbances in coping ability.

Beta blockers have their place as an anxiety treatment, but beta blockers also have several dangers that make them a risky choice for regular use. Always consult a doctor before taking any beta blocker, and make sure that you keep your doctor informed of any side effects.

Alternative Treatments to Beta Blockers

All medications have their risks, and as mentioned above, medications in general are not an ideal form of treatment. Still, other medications may be more successful for reducing anxiety than beta blockers. Some people prefer medicines like busparone, while others may benefit from benzodiazepines like Valium.

Still, the best way to treat anxiety is to use a non-medicinal treatment that won't cause dependency or side effects.

Article Resources
  1. Hayes, Peggy E., and S. Charles Schulz. Beta-blockers in anxiety disorders. Journal of affective disorders 13.2 (1987): 119-130.
  2. Silvestri, Antonello, et al. Report of erectile dysfunction after therapy with beta-blockers is related to patient knowledge of side effects and is reversed by placebo. European heart journal 24.21 (2003): 1928-1932. 
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