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Whether you’re a science nerd or not, you have to admit that one of the most interesting things about modern medicine is how many unexpected benefits of medications have been found.
You might be surprised to hear that many erectile dysfunction drugs today actually started as experiments in cardiovascular medicine. And then there are the lesser-known new developments, like the use of beta blockers for anxiety.
Managing your anxiety with a blood pressure medication is certainly an interesting concept, but as you probably suspect, there are certain risks associated with using beta blockers for something other than their intended purpose. And if that’s made you wonder whether it’s safe to use beta blockers to treat anxiety, you’re asking the right questions.Â
Our job is to answer them, and we’re here to do just that. But before we can give you the tools to decide whether beta blockers are the right treatment for your anxiety, we have to cover some important facts about how these medications work.
So here’s how the anti-anxiety (and blood pressure) medication called beta blockers do what they do.
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As we mentioned initially, beta blockers (also known as beta-adrenergic blocking agents) are a cardiovascular medication — one specifically designed to treat high blood pressure.Â
Beta blockers bind to the same receptors in your nervous system where epinephrine (also known as adrenaline) and norepinephrine (the levels of which are often associated with mood disorders) come to make their connections.
This prevents adrenaline from causing your heart to beat faster, which can then prevent heart failure and other unwanted effects.Â
These medications are FDA-approved to treat a variety of cardiovascular conditions, including:
Glaucoma
Migraines (as a preventive medicine)
Congestive heart failure
Cardiac arrhythmias
Coronary artery disease
Myocardial infarction
Hyperthyroidism
Tremors
Aortic dissection
Tachycardia (rapid heartbeat)
Hypertension
But these medications have a second, off-label use related to adrenaline. By reducing adrenaline’s ability to affect your heart, they can also prevent certain symptoms of anxiety (like a racing heart) from occurring.
We mentioned that beta blockers are an off-label anxiety treatment, and we absolutely need to clarify that beta blockers are not FDA-approved for the treatment of anxiety disorders.
That doesn’t mean that they’re used against medical advice — just that the FDA has not formally approved their regular use by medical professionals to treat anxiety-related disorders.
Beta blockers don’t work like other anxiety medications, which might affect neurotransmitters like serotonin or work as sedatives. Instead, beta blockers are known for their effects on your sympathetic nervous system itself.
The easiest way to look at it is this: When anxiety triggers adrenaline production, it’s basically making a call to your body to tell it to react. Beta blockers occupy that same phone line and prevent your body from having those physical symptoms of anxiety.
Mental health medications can vary widely in how long they take to work, with some antidepressants taking days or weeks to hit their full effectiveness. In contrast, the benefits of beta blockers are almost immediate.
Beta blockers are quickly absorbed, and unless they’re sustained-release formulas, most will reach peak absorption within one to four hours.
The effects of these medications can range substantially though — some may take just minutes to begin showing their effects, while others may take hours.
Depending on your particular medication, you may receive different instructions for how and when to take it. A healthcare professional can help you understand your medication better if you begin taking beta blockers for anxiety.
Right out of the gate, beta blockers offer many benefits for people with anxiety. While they’re by no means a treatment for the mental symptoms of anxiety, they can really help the rest of your body avoid the stress and fatigue associated with intense anxiety responses and panic attacks.
The sympathetic nervous system is basically the part of your nervous system that responds to danger and threats of danger. It could also be considered your “fight or flight” system.Â
Because of this, there’s a specific use case for beta blockers that’s often referenced — public performance or speech. One beta blocker in particular, propranolol, is prescribed for stage fright.
Beta blockers can:
Improve public speaking and stage performance
Reduce tremors
Slow your heart rate
Reduce sweating
Lessen muscle tension
By lessening those symptoms of anxiety, beta blockers can help give you more agency over your body’s behavior, even if you may be anxious in a particular situation.
There are dangers to the use and misuse of beta blockers, and while they’re generally considered safe, any medication (and any type of beta blocker) that affects blood flow can carry risks.
Because beta receptors are all over your body, these medications can have undesirable effects on unintended systems. Fatigue, nausea, constipation and sexual dysfunction are commonly reported adverse effects of beta blocker use.
Side effects of beta blocker use include
Increases in blood sugar
Shaky hands
Cold hands and feet
Slow heart rate
Irregular heart rhythm
Chest pain
Furthermore, beta blockers can exacerbate a number of conditions, including:
Raynaud syndrome
Asthma
Hypoglycemia
Blood pressure issues, for people with on blood pressure medications
There’s also the risk of beta blocker overdose to consider. Beta blockers can cause potentially fatal heart problems when taken in excess.
A healthcare provider might also walk you through other ways of treating and managing anxiety disorders, including therapy, lifestyle changes and other medications.
Various forms of psychotherapy are recommended for the treatment of anxiety, but we like to highlight cognitive behavioral therapy, or CBT.
CBT is a practical form of therapy that teaches people with anxiety to recognize the telltale signs of unhealthy or irrational anxious thoughts, and learn to reject those thoughts. Over time, learning this skill can help reduce your instances and symptoms of anxiety (even the weird ones).
In addition to beta blockers, medications like benzodiazepines, selective serotonin reuptake inhibitors and other great medications for anxiety can help with the management of generalized anxiety disorder. It may take time to find the right dosage with these anti-anxiety medications, and unlike beta blockers, they may take days or weeks to show their full benefits.
Alcohol, caffeine, drugs and tobacco can all negatively affect people with anxiety disorders like generalized anxiety disorder.
So, if you’re experiencing anxiety, you may find benefits in cutting back on these substances. Likewise, prioritizing sleep, exercise and a healthy diet can reduce your symptoms and/or risk of anxiety. So take care of that body and the brain inside it at the same time.
Beta blockers may be a great anxiety medication for your individual needs. However there are some specific risks of taking them that you may feel are important to avoid. These are things that a healthcare professional can walk you through.
Getting the support of a healthcare professional is crucial when dealing with medical conditions and mental health conditions from anxiety to heart problems.
While they may seem like different conditions on the outside, we’re pretty sure you get the picture that all the parts of our bodies are connected in unexpected ways. If you didn’t before, you do now.
Either way, getting your symptoms assessed can help you find the best treatment option for your individual needs. Whether that’s therapy, medication, changes to your habits or all of the above, you’ll get the best guidance when you talk one on one.Â
If you’re ready to have that talk, talk to us. We talk back — our mental health resources connect you with healthcare professionals to assess your anxiety and help you design management solutions. And our online therapy platform is a great place to talk to therapists conveniently, from wherever you are.Â
A video chat is far less scary than a trip out of your home, which means you have one less excuse to avoid talking about solutions now.
Kate Hagerty is a board-certified Family Nurse Practitioner with over a decade of healthcare experience. She has worked in critical care, community health, and as a retail health provider.
She received her undergraduate degree in nursing from the University of Delaware and her master's degree from Thomas Jefferson University. You can find Katelyn on Doximity for more information.