Beta blockers are a class of medication that prevents adrenaline from affecting your heart, effectively relaxing it and your blood vessels. This keeps the heart from racing and can lower your blood pressure. Clinical pharmacist Curtis Alexander, PharmD, who works in a neurology clinic, cites a few reasons for beta blockers’ recent rise in popularity, including fewer side effects than other anti-anxiety meds, less risk of dependence, and lower price point. Here’s what you need to know.
Beta Blockers and Anxiety
Because beta blockers are typically prescribed to manage irregular heart rhythms and treat high blood pressure when other drugs haven’t worked, it’s easy to understand how they could help manage anxiety symptoms. “For many people, beta blockers do a really good job of blocking the physical symptoms of anxiety like a racing heart, sweating, or tremors,” says psychiatrist Sarah Gupta, MD. “And a lot of the time, just dialing down the physical symptoms can be enough to get anxiety under control.” Gupta notes that while beta blockers aren’t approved by the FDA for anxiety, they’re often used “off-label,” especially in situations where the individual can anticipate feeling anxious like performance anxiety, stage fright, or facing certain social settings. To determine the best medication fit for his patients, psychiatrist Alex Dimitriu, MD, groups symptoms of anxiety into two categories. “I always ask my patients if they feel anxiety more in the mind—rumination, catastrophic thoughts, worry—or the body—racing heart, tight chest, shortness of breath, tremor,” Dimitriu says. “More globally it should be recognized that either beta blockers or other medication such as Xanax or Klonopin are patches. If someone needs a patch too often, it might be better to take something that works all the time, usually SSRIs.” While beta blockers won’t treat the psychological symptoms of anxiety, for short-term and situational anxiety they can be a solid option. In these scenarios, the drug can be useful for people who want an as-needed medication to treat their symptoms, whereas benzodiazepines like Xanax or Ativan are more commonly considered rescue medications for anxiety that are associated with greater risks and potential side effects. This could be another reason behind the choice in beta blockers. And a review of research published in 2016 even found that using propanolol, a type of beta blocker, in the short term had similar effects to benzodiazepines in treating anxiety. “It’s nice to have an option for people who don’t want to try anxiety medications that may lead to dependence,” Alexander says.
Understanding the Risks
It’s important to keep in mind that beta blockers don’t come without their own risks. Taking a beta blocker can result in low blood pressure and a slow heartbeat, so they’re not recommended for individuals with heart problems. They’ve also been known to worsen asthma symptoms or even trigger attacks, and they can make exercise much more difficult, Dimitriu notes. Some other common side effects include fatigue, cold hands or feet, and weight gain. Less common side effects include shortness of breath, depression, and difficulty sleeping. People with diabetes that take beta blockers are also recommended to regularly check their blood sugar, as this medication can prohibit the signs of low blood sugar, like a rapid heart beat.
