Beta blockers are a class of drugs primarily used to improve heart rhythm. They act on beta receptors, which are found inside of the heart muscle, and they seem to play a beneficial role in relieving hypertension.
Some individuals with anxiety have used beta-blockers off label as a treatment for their panic disorder. Off label means that beta blockers are not approved for this use, but used anyway. In this article, we'll explore the use of beta blockers for panic attacks and anxiety, and explain why they are probably not a good idea.
Stop Panic Attacks Without Medication
You don't need medication to control panic attacks. You can stop panic attacks from occurring with the right coping, relaxation, and stress reduction strategies. Find out more by taking my free 7 minute anxiety test, now.
Medication - A Last Resort
All anxiety medications need to be a last resort, especially for something like panic attacks. It's not that they're inherently bad. There are some medications that have fewer side effects than others. The problem is that if you take the medication without learning how to cope with anxiety, you're going to need to continue to stay on that medication forever, otherwise your anxiety may not only come back - it may come back even stronger, because you won't have any practice fighting your anxiety.
If you do decide to use a medication, make sure you always - always - use a non-medicine treatment as well. Take my anxiety test to learn more.
Beta Blockers - An Unusual Anxiety Treatment
Beta blockers may be considered an off label "anxiolytic" (anti-anxiety drug), but the reality is that doctors appear to have no idea how it works.
That should be a fairly clear warning sign as to why beta blockers should not be your first choice when it comes to your anxiety treatment. Scientists have no idea why beta blockers appear to reduce anxiety.
It's likely that by keeping the heart muscle from overacting, the body simply doesn't activate fight or flight mode the same way. Perhaps it translates the heart's "calm" nature as a sign that it shouldn't trigger anxiety symptoms. There is some evidence that those that have more control of their body have less anxiety.
Do Beta Blockers Work?
According to available research evidence, beta blockers do have some effect on panic attacks and panic disorder, but the effect is weaker than it is with other anxiety medications.
Normally a panic attack is both a physical and a psychological reaction. Panic attacks cause extreme anxiety and a feeling of doom, and then symptoms arise as a result of that anxiety (like rapid heartbeat, chest pains, etc.) which cause more anxiety until the entire thing peaks (the height of a panic attack) and slowly subsides.
If beta blockers have any benefit, it's that they prevent the physical symptoms from becoming as severe. Presumably if your heartbeat doesn't speed up as quickly and you experience fewer panic symptoms, your anxiety will not overwhelm you to such a degree. You may still have the panic attack, but the symptoms might be weaker.
Beta Blockers Creating Panic Attacks
In some cases, beta blockers could potentially increase your risk of panic attacks as well. Beta blockers do have side effects, and some of these side effects - like hypotension - can create their own physical symptoms that may trigger panic attacks in those that are sensitive to physical changes. Since beta blockers can cause lightheadedness, dizziness, fatigue, insomnia, and even abnormal vision, there are several common panic attack triggers that occur as a response to using beta blockers.
Whether these will increase your rate of panic attacks is based on a case by case basis, but there is a risk that using beta blockers will have no effect or a negative effect on anxiety.
What Are Beta Blockers Good For?
Beta blockers may be useful for those that have panic attacks as a result of some type of heart problem that triggers rapid and irregular heartbeat. For example, some people find that they suffer from mitral valve prolapse, which is known to trigger rapid heartbeat and ultimately panic attacks in some people.
It's possible that they may have a benefit for those with severe heart symptoms or heart anxiety, but nevertheless they're not the ideal medication. Always listen to your doctor, but note that beta blockers do have many downsides.
How to Get the Most From Your Beta Blockers
If your doctor does prescribe beta blockers for your anxiety, the most important thing you can do is make sure that you partner it with some type of non-medicinal treatment, so that no matter what you do not need to stay on the medication forever or depend on the medication forever.
Take my free 7 minute anxiety test to find out more. The test will examine your symptoms to help you understand the best way to cure your anxiety.
Hayes, Peggy E., and S. Charles Schulz. Beta-blockers in anxiety disorders. Journal of affective disorders 13.2 (1987): 119-130.
Neftel, Klaus A., et al. Stage fright in musicians: a model illustrating the effect of beta blockers. Psychosomatic medicine 44.5 (1982): 461-469.
Lader, Malcolm. Beta-adrenoceptor antagonists in neuropsychiatry: an update. The Journal of clinical psychiatry 49.6 (1988): 213.
Author: Micah Abraham, BSc Psychology, last updated Sep 28, 2017.