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Propranolol is an FDA approved medication that acts as a beta blocker. It is used mainly to treat heart conditions, such as:
However, it is also proven effective in the treatment of anxiety and anxiety disorders.
Beta blockers work to temporarily stop or reduce the body’s “fight-or-flight” responses by blocking the effects of the hormone epinephrine, also known as adrenaline. This causes your heart rate to slow, which creates low blood pressure and mitigates the physical symptoms of anxiety (racing heart, shortness of breath) caused by a rapid heart rate.
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Common side effects of propranolol are typically mild and include:
While propranolol is not a physically addictive medication, patients may become accustomed to the generally relaxed feeling that propranolol provides, especially for anxiety treatment. It is safe to take propranolol for an extended period as serious side effects have not been reported in individuals who have taken it for several years.
Propranolol is relatively fast-acting, though not as immediate as some other medications commonly used for treating panic attacks, such as Xanax. It generally takes between 30 minutes and one hour to experience the effects of propranolol.
These effects are most pronounced for about 4-hours after dosage but can occur for up to 12 hours.
There is no standardized duration for taking propranolol to treat performance anxiety or other forms of social anxiety. Patients can take it once to deal with an anxiety-inducing event or take it daily for several months.
Propranolol should be taken about an hour before to feel the desired effects. The dosage should also not exceed the amount recommended by the patient’s doctor or any health care professional qualified to give medical advice.
Propranolol works to slow a racing heart rate and help with shortness of breath. Treatment of these physical effects causes patients to feel calmer and more relaxed.
The usual dose of propranolol to treat anxiety is 40mg once per day. This can typically be increased to 40mg up to 3 times a day, or even up to 80mg per dose. All dosage depends on the severity of symptoms, bodyweight, and individual response to treatment.
It usually takes between 30 minutes and one hour to experience the effects of propranolol. These effects can last for up to twelve hours. Speak with a healthcare professional to determine the appropriate next dose or other treatment options if you are currently taking beta-blockers for anxiety treatment.
Propranolol has not been shown to impair cognitive function or cause any mental health-related side effects. In one study, this medication led to improved cognitive functioning in 16% of participants and worsened functioning in 17%, with no significant impact on the rest.
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Steenen, Serge A et al. “Propranolol for the treatment of anxiety disorders: Systematic review and meta-analysis.” Journal of psychopharmacology (Oxford, England) vol. 30,2 (2016): 128-39. doi:10.1177/0269881115612236
Jorstad-Stein EC, et al. "Social Phobia: An Update on Treatment," Psychiatric Clinics of North America (Sept. 2009): Vol. 32, No. 3, pp. 641–63.
Stein MB, et al. "Social Anxiety Disorder," Lancet (March 29, 2008): Vol. 371, No. 9618, pp. 1115–25.