Beta Blockers: Types, What They Do & Side Effects

Stress: It’s one of the most unavoidable things in life — and the hardest to manage. While you might be most familiar with the panic, fear, tension and insomnia that typically characterize it, other effects of stress can be seriously dangerous to your health.

When you’re in a stressful or tense situation, your body has a natural fight-or-flight nervous system response that causes your heart to beat faster than normal — something that can increase your risk of heart disease and other problems down the line. 

Enter beta blockers. This Swiss army knife medication can be a stressed body’s worst enemy — or saving grace, depending on how you look at it.

Beta blockers are a class of medications that prevents the stress hormones contributing to your body’s fight-or-flight response from affecting your heart. They’re used to treat various medical conditions. 

If you’ve been prescribed a beta blocker, you probably have lots of questions — one of them may even be, “But I’m not stressed?” 

Below, we’ll explain what beta blockers do, what they’re used for, the side effects and indications to be aware of, and how to know if they’re right for you.

Let’s get the science-y stuff out of the way right now. Beta blockers (also known as beta-adrenergic blocking agents or beta antagonists) are medications that block the effects of hormones like adrenaline and noradrenaline — primarily on your heart.

These medications actually started their career in heart health as management tools for cardiovascular disorders. We’re talking high blood pressure, irregular heartbeat (atrial fibrillation) and high risk of heart attack — all of which can contribute to excessive stress on the heart.

Today, however, beta blockers like propranolol are used for the management of anxiety disorders, anxiety symptoms and other stress-based conditions, along with hyperthyroidism, tremors and certain diseases like glaucoma.

Here’s the thing about those hormones we mentioned: Adrenaline and noradrenaline are used by your body to activate your fight-or-flight mechanism, which is designed to protect you in a dangerous situation.

Normally, being in a stressful situation causes your body to secrete increasing levels of stress hormones, including adrenaline, resulting in a noticeably faster heartbeat. You might also notice your hands getting shaky and sweaty or your voice becoming unsteady and faint.

How beta blockers work to solve these problems is surprisingly simple: Instead of a fast heartbeat, your heart will beat at a normal pace, limiting the physical effects of adrenaline on your body.

By reducing the amount of stress on the heart, beta blockers can make heart attacks and other major health issues less likely — which is why they’re frequently prescribed to people with these conditions.

Some of the most widely used beta blockers include:

• Acebutolol

• Atenolol

• Bisoprolol

• Carteolol

• Esmolol

• Metoprolol

• Nadolol

• Nebivolol

• Propranolol

• Carvedilol

• Labetalol

Keep reading to learn about the different types of beta blockers.

Selective vs. Nonselective Beta Blockers

There are two main types of beta blocker medications: selective beta blockers and nonselective beta blockers. Most beta blockers target the heart specifically, while others can also target the lungs and blood vessels.

Selective beta blockers are designed specifically to block β1 receptors, which are primarily located in the heart. Since the action of these beta blockers is more specific, they’re usually safe to use if you have diabetes.

Common selective beta blockers include acebutolol, atenolol, bisoprolol, betaxolol, bevantolol, celiprolol, metoprolol, esmolol and nebivolol.

Since selective beta blockers only affect receptors concentrated in the heart tissue, they aren’t a popular treatment option for anxiety.

However, nonselective beta blockers block the β1, β2 and β3 receptors (t-t-triple the receptors!). This means they also affect the veins, liver, pancreas and other parts of the body.

Common nonselective beta blockers include alprenolol, carteolol, oxprenolol, propranolol and sotalol. Nonselective beta blockers can be used to treat some physical effects of anxiety (in addition to still being good for heart conditions).

Beta blockers can be employed for numerous uses — antihypertensive agents, anxiolytics and heart disease management among them.

We’ve already mentioned this a few times, but the thing is, most medications only treat a few specific types of disease — beta blockers are kind of an everywoman in the medication world.

Seriously, look at the list. You might be prescribed a beta blocker for the treatment of:

• Cardiovascular disease

• Angina (chest pain)

• Myocardial infarction

• Congestive heart failure

• Portal hypertension

• Glaucoma

• Migraine prophylaxis

• Cardiac arrhythmias

• Coronary artery disease

• Hyperthyroidism

• Essential tremor

• Aortic dissection

• Tachycardia

• Hypertension

We’ll get into the side effects of beta blockers below.

Unfortunately, just because these things kick ass at bullying your beta receptors into submission doesn’t mean they’re free of side effects. 

The good news is that the vast majority of people who use beta blockers don’t experience side effects. Beta blockers are safe and very effective, with a low risk of side effects when used according to your healthcare provider’s instructions.

If you do experience adverse effects, the most common side effects of beta blockers tend to be:

• Fatigue

• Weight gain

• Cold feet and cold hands due to circulation changes

• Nausea

• Dizziness and lightheadedness

• Slow heartbeat

• Higher cholesterol and triglyceride levels

• Asthma attacks

• Cramps

• Depression

• Hypoglycemia

• Low blood pressure

• Bradycardia

• Erectile dysfunction in men

Keep scrolling for critical info about potential drug interactions.

Most of the side effects of beta blockers are fairly mild and uncommon. But when these medications interact with other medications, it can cause potentially severe, serious side effects — making those drug interactions the most important risks to avoid.

Keep in mind, beta blockers alter heart rhythms. So when you mix them with other medications, your life is potentially on the line. 

Serious areas of risk include:

• Interactions with other heart medications. Since they both affect your heart, calcium channel blockers, ace inhibitors and other medications that lower blood pressure shouldn’t be mixed with beta blockers without the direction of a healthcare professional.

• Effects on exercise. If you’re a frequent exerciser, you may need to adjust your routine. After taking a beta blocker, your maximum heart rate will be lower than normal, so you may have less stamina while exercising, especially with cardiovascular exercises such as running, cycling, walking or rowing.

• Consumption of high-sodium foods. You also need to be careful with your food — and particularly, your sodium intake. Eating foods high in sodium can raise your blood pressure and put extra pressure on your heart. If you’re prescribed a beta blocker for heart issues, avoid high-sodium foods.

• Consumption of high-potassium foods. Beta blockers affect your body’s ability to process potassium, so you’re probably gonna want to cut down on your six-bananas-a-day habit.

• Diabetes risks. This risk doesn’t apply to all beta blockers, but you should make sure to tell your healthcare provider if you have diabetes before taking one. Nonselective beta blockers specifically are not considered safe to use if you have diabetes.

Beta blockers are some of the most widely used medications in the world, prescribed for heart conditions, anxiety and more. Safe, easy to use and effective, they provide fast and noticeable results that make them ideal for preventing chronic anxiety and panic attacks.

Whether they’re right for you is another question. Here’s what to keep in mind:

• Beta blockers were primarily created to assist in the management of various heart conditions.

• By blocking the effects of stress hormones like adrenaline on your heart, beta blockers can block the physical effects of anxiety on your body, such as sweating, rapid heartbeat or dizziness.

• Many doctors consider the use of beta blockers for anxiety as an effective management strategy. That means you might see benefits if you suffer from performance anxiety, situational anxiety or even depression.

• When using beta blockers for anxiety, it’s important to understand they don’t treat the psychological causes of anxiety. Instead, they just make it easier for you to handle the physical reaction your body might have to feelings of anxiety.

Trying to manage your anxiety? Beta blockers might be part of the solution. 

Along with beta blockers for anxiety or other medications for stress, you might want to consider therapy.

Our mental health services include online psychiatry and online therapy — both are effective, long-term strategies for managing anxiety and other mental health issues.