Drugs Q & A

How Effective Is Propranolol For Anxiety?

What does it mean to have anxiety?

According to the American Psychological Association (APA) anxiety is “an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure. Knowing the difference between normal feelings of anxiety and an anxiety disorder requiring medical attention can help a person identify and treat the condition.

The duration or severity of an anxious feeling can sometimes be out of proportion to the original trigger, or stressor. Physical symptoms, such as increased blood pressure and nausea, may also develop. These responses move beyond anxiety into an anxiety disorder.

The APA describes a person with anxiety disorder as “having recurring intrusive thoughts or concerns.” Once anxiety reaches the stage of a disorder, it can interfere with daily function.

While a number of different diagnoses constitute anxiety disorders, the symptoms of a generalized anxiety disorder (GAD) will often include the following:

•          restlessness, and a feeling of being “on-edge”

•          uncontrollable feelings of worry

•          increased irritability

•          concentration difficulties

•          sleep difficulties, such as problems in falling or staying asleep

While these symptoms might be normal to experience in daily life, people with GAD will experience them to persistent or extreme levels. GAD may present as vague, unsettling worry or more severe anxiety that disrupts day-to-day living.

What is Propranolol?

Propranolol is a medication used to treat high blood pressure, irregular heart rhythms, pheochromocytoma (tumor on a small gland near the kidneys), certain types of tremor, and hypertrophic subaortic stenosis (a heart muscle disease). It is also used to prevent angina (chest pain), migraine headaches, and to improve survival after a heart attack.

How Propranolol works

Propranolol belongs to a class of drugs called beta blockers. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Propranolol is a non-selective beta receptor blocking agent. This means it works similarly on the heart, lungs, and other areas of the body.

The way that this drug works to lower blood pressure is not clearly understood. It reduces the workload of the heart and blocks the release of a substance called renin from the kidneys.

Propranolol generally lasts between three to four hours. For most people, Propranolol can provide around four hours of symptom relief. The beta-blocking properties help to control heart rhythm, delay the start of chest pain, prevent migraines, and reduce tremors. It isn’t fully understood how this drug works to treat these problems.

Does Propranolol Work For Anxiety?

Yes, propranolol can help with the physical symptoms of anxiety, such as flushing, increased heart rate, shaking, and sweating. Research has shown that propranolol works best as a short-term treatment for specific types of anxiety, such as performance anxiety, social anxiety, and specific phobias. Propranolol isn’t beneficial for treating other types of anxiety, such as generalized anxiety disorder.

However, a Journal of Psychopharmacology study published in 2016 which evaluated the use of propranolol for anxiety concluded, that the quality of evidence for the efficacy of propranolol is insufficient to support the routine use of propranolol in the treatment of any of the anxiety disorders.

How quickly will propranolol work for anxiety?

Propranolol is relatively fast-acting, though not as immediate as some other medications commonly used for treating anxiety like 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. If you stop taking propranolol, it will take about 1 to 2 days for it to be completely out of your body but the side effects can last for up to 1 week.

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