Does Propranolol Help Anxiety? Side Effects, Dosage & Warnings

Propranolol for Anxiety Does it Really Help Anxiety?: Anxiety is a word that has become an integral part of our daily lives. From teens to the elderly, most people face anxiety problems at some point in their lives or the other. The cause can differ from person to person, but the result is quite similar – life becomes hell and the person can barely continue with their normal lives. As such, treating anxiety and its various symptoms is very important if one has to lead a quality life. Amongst the various drugs available in the market to treat anxiety and its symptoms, propranolol is quite popular. Though the drug isn’t quite useful in case of general anxiety disorders, it can yield excellent results in patients with stage fright or performance anxiety.

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What is Propranolol?

Propranolol was developed by Sir James Black in the 1960s and this invention won him the Nobel Prize. Propranolol is usually sold under its brand name Inderal, though the generic form of the drug is also available. Propranolol is a beta-blocker which, when administered, inhibits the activity of the adrenergic receptors present in the body. By preventing the stimulation of the receptors, propranolol, like other beta blockers help in reducing the cardiac response to stimuli. This helps in lowering the rate of heartbeats as well as blood pressure, both of which allow the heart to beat at a much-relaxed pace.

When administered to patients with performance anxiety, propranolol can help minimize the symptoms that occur. However, it doesn’t treat the actual issue.

Who Should Take Propranolol for Anxiety?

Propranolol is usually recommended to people who suffer from anxiety disorders to help relieve the symptoms. Studies on propranolol have shown that the drug can effectively alleviate symptoms like uncontrolled trembling, blushing or shaking, increased heartbeat, fear of talking in front of a mass of people, muscle tension, sweating, and other symptoms associated with anxiety. However, it must be understood that the administration of propranolol to relieve anxiety symptoms would be effective only in case of performance anxiety and stage fright. The effect of propranolol in alleviating symptoms of other types of anxiety disorders is very low or even nil. Propranolol is only a temporary solution to the symptoms and cannot be considered as a treatment of the actual psychological condition.

Apart from treatment of anxiety symptoms, the drug is also prescribed to patients suffering from various diseases or ailments of the heart, respiratory disorders, aggressive behavior, phobia, etc. Irrespective of the condition for which propranolol needs to be taken, a doctor’s prescription is necessary before you start a course of the drug.

Who Should Stay Away from Propranolol?

Though propranolol has been proven effective in treating symptoms of anxiety, it is to be understood that the medication isn’t suitable for all people. Given below is a list of conditions that may be contraindicated if propranolol is administered:

Since propranolol is known to reduce heartbeats, taking the medication isn’t safe for people suffering from cardiac ailments, especially Bradycardia, angina, etc. Sudden discontinuation may also lead to heart attack.
People with low BP issues must also stay away from propranolol as the medicine can significantly lower BP levels and cause serious issues.
People with a history of respiratory problems are also advised not to take propranolol for anxiety. Beta-blockers may worsen conditions of COPD, asthma, bronchospastic lung disease, etc.
Diabetic patients should also say no to propranolol or consume it with utmost caution as it can lower blood glucose levels considerably.
Propranolol is known to cause blurriness in vision and hence, is not recommended for people with sight issues or willing to take a glaucoma test.
People with renal or kidney problems, too, need to be very careful if they want to take propranolol.
Patients with pheochromocytoma shouldn’t take propranolol as it may cause a sudden spike in hypertension.
Patients suffering from myasthenia gravis aren’t also prescribed propranolol.
If a person has a known allergic reaction to beta blockers, administration of propranolol should be totally avoided as it may cause anaphylactic reactions.
A section of physicians and doctors also believe that administering beta blockers like propranolol to patients with cocaine toxicity may have contradictory results.
Pregnant women aren’t also advised to take propranolol unless absolutely necessary. This is mainly because animal studies of the drug showed adverse effects on fetal development.
Breastfeeding mothers should consult with their doctor before taking propranolol as the drug is excreted into breast milk.

Side Effects of Propranolol

Even for a person who is not undergoing any of the conditions mentioned above, propranolol may cause a number of adverse effects when administered. These side-effects vary in the degree of their severity and vary from person to person. However, most symptoms occur when the medicine is taken in high doses or several times at short intervals.

Mild Side Effects of Propranolol may include:

Dry mouth
Irritability
Restlessness
Sleep problems and weird dreams
Diarrhea
Confusion
Lethargy
Very low pulse
Short-term memory loss
Numbness in the feet or hands

Most of these symptoms also appear in the initial phases of the medication administration and usually disappear after a few uses. However, if the effects are causing constant discomfort, it would be prudent to consult a doctor.

Moderate Side Effects of Propranolol:

Propranolol may also cause symptoms that can be a bit more severe than those mentioned above and would require medical attention. Some such symptoms are as below:

Irregular heartbeat
Troubled breathing
Allergic reactions
Swelling of the face or the throat area
Blistering of the skin
Skin itching and peeling
Development of lumps on the skin

Your doctor will be able to find a cause of the side-effects and advise you on whether you should continue the medication or not or possibly suggest a solution for the allergic reactions.

Severe Side Effects of Propranolol:

Complications may also arise in patients being administered propranolol on a regular basis. These complications are extremely serious and may prove dangerous unless treated by a doctor. Such effects include:

Blood in the stool and urine
Bloody nose
Abdominal pain
Manic symptoms
Blurry vision
Tightness in the chest

Interactions of Propranolol with Other Medications

Not only are people suffering from certain conditions advised against the administration of propranolol, doctors also prohibit the use of propranolol amongst people taking certain drugs. This is because beta blockers like propranolol are known to have negative interactions with certain drugs, thereby neutralizing their benefits or causing additive reactions that may prove harmful to the patients. Common drugs that are known to have interactions with propranolol are as follows:

Epinephrine
Verapamil
Salbutamol
Clenbuterol
Formoterol
Levosalbutamol
Salmeterol
Ergot alkaloids
Clonidine
NSAIDs
Isoprenaline (isoproterenol)
Cimetidine
Quinidine
Fluvoxamine
Lidocaine
Rifampicin
Phenobarbital
Albuterol
Bupropion
Fingolimod

Patients taking any of these drugs should mention this to their doctors before undergoing a treatment with propranolol.

Precautions to be Taken

If you are taking propranolol for anxiety, it must be done under strict rules and guidelines of your doctor.
Alcohol mustn’t be consumed when you are on propranolol. Alcohol is seen to cause dizziness and lightheadedness when taken while on propranolol.
Multivitamins, too, have a detrimental effect on the benefits of propranolol. So, they must be discontinued or taken with a fair amount of gap in between the consumption of the two.
Those who use the drug on a daily basis should never give it up abruptly. If you have to stop, consult a doctor and he will suggest the best way to do so.
Never self-prescribe propranolol as a wrong use may prove serious or even fatal.

Propranolol Overdose Problems

Propranolol dosage usually lies between 40 mg – 320 mg and usually decided by the doctor taking into consideration the ailment or symptoms that need to be treated, the severity of the problems, and different other factors. It must be remembered that propranolol must be taken strictly according to the doctor recommended doses and no deviation should be made.

Overdosing on propranolol may lead to fainting, weakness, irregular heartbeat, seizures, cardiogenic shock, ventricular arrhythmias, bradycardic PEA, etc. All of these conditions need an immediate check-up and treatment without which things may take a serious turn.

Propranolol for Anxiety – How Long Does it Last

The beginning of sense of ‘propranolol’ medicine is between 1 -2 hours, and will last for between 5 to 10 – hours. Tiredness and physical weakness are normal side effect that must go away within a short duration .but you should also inform to your medical professional about side effects that you are feelings.

Conclusion

Propranolol is significantly useful in treating anxiety and a list of other ailments. What makes the drug much more popular is that it doesn’t cause sedation or addiction. It can be discontinued without any issue at all. However, discontinuation shouldn’t be abrupt and must be done following the doctor’s orders. Though available as OTC, propranolol must never be taken without a proper expert prescription.