Propranolol — a type of beta blocker — has not been shown to be an effective treatment for anxiety.
The conclusions come from a recent review of the research.
Propranolol works by blocking the action of adrenaline.
The drug is mostly used to treat high blood pressure, but is now sometimes prescribed for anxiety.
Actors, public speakers and musicians in general are known to take them to cope with stage fright.
One study from the 1980s found that 27% of orchestra musicians admitted to taking beta blockers before performances to help their nerves (Fishbein et al., 1987).
Does propranolol for anxiety work?
In general, the evidence for its use in the treatment of anxiety disorders is poor.
The reason being that it only affects the physical symptoms for a short period.
It does not affect the psychological symptoms of anxiety.
In other words: it stops your heart beating fast, but does not reduce the rush of anxious thoughts through your brain.
People who regularly use beta blockers like propranolol for anxiety can find they become reliant on them.
The research on propranolol for anxiety
Propranolol for anxiety is often prescribed ‘off-label’, despite little evidence of its long-term effectiveness.
A recent review of the research concluded that there were few studies of its effectiveness and little evidence it helped in treating anxiety disorders.
The study’s authors concluded that:
“…the quality of evidence for the efficacy of propranolol at present is insufficient to support the routine use of propranolol in the treatment of any of the anxiety disorders.”
Research that has been done has tested propranolol for anxiety against benzodiazepines and placebos.
“…no statistical difference between the effects of propranolol and benzodiazepines on anxiety and panic attack frequency.
In addition, four […] trials failed to show solid evidence on the therapeutic effect of propranolol in patients with dental phobia, animal-type specific phobia, and social phobia.
No RCTs were available on the effects of propranolol in the treatment of any of other anxiety disorders (e.g. generalised anxiety disorder, obsessive–compulsive disorder (OCD), separation anxiety disorder, or selective mutism.”
The study was published in the Journal of Psychopharmacology (Steenen et al., 2016).
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