Propranolol

Propranolol, commonly sold under the brand name Inderal, belongs to a class of medications called beta blockers. Although typically used to treat heart conditions such as high blood pressure, heart failure, and an irregular heartbeat, beta blockers also can help with anxiety symptoms.

As a beta blocker, propranolol works by relaxing blood vessels and blocking the effects of adrenaline. It prevents adrenaline from connecting with your heart’s beta receptors, which lowers your blood pressure and causes your heart to beat more slowly and less forcefully.

Its main benefit, if you have anxiety, is to help you manage physical symptoms of anxiety. You will need additional therapy or medication to address the psychological causes of your anxiety.

Propranolol is best known for treating high blood pressure, irregular heartbeats, and tremors. It may be prescribed after a heart attack to reduce strain on the heart. It’s also used to prevent chest pain, migraine headaches, and physical symptoms of anxiety.

At Brightside, we use propranolol to treat short-term anxiety symptoms. The goal is to help you manage physical reactions to stress, such as dizziness, excessive sweating, fast heart rate, and shaky voice and hands.

Our psychiatric providers specialize in personalizing treatment for each person. We give you personal attention and expert advice you can count on and explain all your options. By using our expertise, we’ll work with you to find the medication that’s just right. It’s important to us that you understand how medications work and what to expect so that your treatment is worry-free.

At Brightside, we evaluate your symptoms and recommend medication that is tailored to your unique needs.

 Propranolol can help with the physical symptoms of anxiety, including: 

• Dizziness
• Fast heart rate
• Shaky voice and hands
• Sweating

Brightside providers have an in-depth knowledge of the strengths and drawbacks of each medication. You’ll get all the information you need to make an informed choice about your treatment.

We understand you want to make sure propranolol will work for you. How well you respond to this particular medication for anxiety may depend on your age, sex, genetic makeup, family history, symptoms, and other medications you’re taking.

At Brightside, we’re experts at finding a medication that helps you function at your highest level. We use our advanced Brightfinder technology to learn about you and discover which medications and treatment approaches will work best for you, drawing from a wealth of research. We combine leading-edge technology and our providers’ experience to develop a treatment tailored to your exact needs.

Together, you and your provider will develop a plan to improve how you feel as quickly as possible. Know that your provider may need to adjust your dosage to ensure you get optimal results with the fewest side effects. Your Brightside provider will make sure you’re well-informed and supported every step of your treatment journey.

We know that mental health concerns often can’t wait, so if you need to meet with a provider to discuss a new or existing medication, we offer telehealth services and provider consultations that can be scheduled within 48 hours.

It’s natural to wonder how long you’ll need to continue taking the medication. With propranolol, your provider may prescribe a regular dose of the medication or recommend that you take it just before stressful events. Propranolol is generally not prescribed for long-term treatment of anxiety.

The amount of time you need to take propranolol will depend on your diagnosis and specific symptoms.

How long you need to take propranolol will depend on your symptoms and diagnosis.

How well propranolol works for you may depend on whether anxiety causes physical effects in your body, such as dizziness, shaking, sweating, and fast heart rate.

Propranolol is likely to be most effective for you if you have performance anxiety in situations such as making a presentation at work or performing before a crowd. One study cites its effectiveness in these cases. You’ll generally take propranolol one hour before the stressful event and fully feel the effects of it in one to two hours. It decreases your heart rate, which can make you feel more relaxed.

In some cases, your provider may recommend that you take propranolol daily.

To get the best results with your medication, it’s important to consistently measure progress during treatment. This is known as Measurement Based Care, and it’s the approach we use at Brightside. It’s common to adjust the dose and/or medication when starting treatment for anxiety until you find just the right fit.

Some people are concerned that taking a medication for anxiety will change who they are. Propranolol will not change your personality, but it will make you feel better and more relaxed. But remember, it doesn’t happen overnight. Keep taking your medication as prescribed, and talk to your provider if you have any questions or concerns.

Propranolol is a safe medication, but it’s important to talk with your Brightside provider about potential side effects of this treatment. Most of these effects are mild and go away as you get used to your medication. If you take propranolol only occasionally, it is uncommon to have side effects.

Some of the most common side effects of beta blockers like propranolol include:

• Cold hands and feet
• Dizziness or lightheadedness
• Depression
• Fatigue
• Headache
• Shortness of breath
• Vomiting, diarrhea, or constipation

In rare cases, serious side effects can occur. If you experience any of the following, call your provider right away or call 911 if you feel your symptoms are life-threatening: 

• Blue fingers/toes
• Easy bruising or bleeding
• Decreased sexual ability
• Fainting
• Heart failure symptoms, such as shortness of breath, swelling of ankles and feet, unusual tiredness, or sudden weight gain
• Increased thirst/urination
• Mood changes
• Numbness or tingling in your arms or legs
• Signs of infection, such as fever
• Swollen or aching joints 
• Very slow heartbeat.

You are advised not to take propranolol if you have chronic lung disease, asthma, diabetes, certain heart diseases, or severe depression. At Brightside, your health and safety are our highest priorities. We make sure you get individual attention and guidance to help you feel your best.

If you are taking propranolol daily and decide you want to stop taking it, do not stop abruptly. Stopping suddenly has been reported to cause worsening of angina (chest pain) and even heart attack in some cases.

Talk to your Brightside provider, who will help guide you to reduce the dose gradually and avoid withdrawal symptoms.

If you’re pregnant or plan to become pregnant, please talk to your health care provider before making any medication changes.

There are no well-controlled, conclusive studies on pregnant women taking propranolol. There have been some reports of newborns whose mothers took propranolol during pregnancy being born with abnormalities or problems such as bradycardia (abnormally slow heart), low blood sugar, and/or respiratory depression.1 You and your provider will have to decide if the potential benefits justify the potential risks to the baby.

If you’re taking propranolol while nursing, small amounts of this medication will be in your breast milk, so caution should be used. Talk to your provider so you can develop a plan together to manage your symptoms and feed your baby safely.

Propranolol is not a controlled substance, and it’s not addictive like some other medications used to treat anxiety. However, it can cause withdrawal symptoms if stopped suddenly.

If you have concerns about taking propranolol or want to change your dosage, please talk to your Brightside providers first. They can help you avoid withdrawal symptoms.