What Is Propranolol? Propranolol For Anxiety & Other Conditions

Scott McDougallMPharmDirector & Registered Manager

Reviewed on: 28 Aug 2022

Situational anxiety (also known as performance anxiety, social anxiety, or social phobia) is a common mental health condition that causes an intense fear of certain social situations. It can also produce distressing physical symptoms such as a rapid heart rate or sweating — but using medicines such as beta blockers for anxiety can help alleviate these physical symptoms.

It’s normal to feel nervous or anxious before a high-pressure situation where you have to perform, of course, whether you’re giving a presentation or just answering interview questions. But if the intensity is such that you’re overwhelmed and can’t perform as well as you could (or even proceed at all), anxiety treatments like Propranolol can help.

In this guide, we’ll be looking at Propranolol in more detail, covering things including uses of Propranolol and how you can find the correct Propranolol dosage. Most vitally, we’ll answer the most common questions asked about it, including “How does Propranolol work?” and “How quickly does Propranolol work for anxiety?”, giving you the knowledge you need.

What is Propranolol used for?

Propranolol is used to treat various health conditions, including cardiovascular diseases. It’s a beta-blocker, which is a type of medicine that can manage heart rhythms.

Due to this, Propranolol can be used to relieve the physical effects and signs of anxiety (particularly social or performance anxiety), slowing a racing heartbeat and reducing sweating and trembling. This is one of the main uses of Propranolol.

There are a few different forms of Propranolol (you can take it in a tablet, a capsule, or a liquid), and it’s offered in varying dosages: your doctor or pharmacist can prescribe a dosage that suits the condition you’re treating.

Propranolol uses

Propranolol has a wide range of health uses covering both physical and mental issues. Here are some of the conditions Propranolol is used to treat and alleviate the symptoms of:

Anxiety
Panic disorder
Migraine
High blood pressure (hypertension)
Heart rhythm disorder (fast or irregular heartbeats)
Chest pain caused by angina
Overactive thyroid gland
Infantile hemangioma

This list isn’t exhaustive; Propranolol can also be used to treat other conditions and disorders that we have not mentioned above. It’s also used as a preventative measure in some cases. It can reduce the risk of suffering a heart attack or stroke, for instance.

The Propranolol dosage you should take will depend on why you need it in the first place. Your doctor or pharmacist will be able to help you with the correct dosage.

Anxiety

As we’ve mentioned above, one of the uses of Propranolol (in its 10mg tablet form) is to relieve the physical symptoms of social and situational anxiety.

Propranolol 10mg tablets will help to reduce physical anxiety symptoms including:

Sweating
Flushing
Fast heartbeat
Fast breathing (hyperventilating)
Shaking or trembling

Propranolol will not treat the psychological symptoms of anxiety, such as feeling tense, nervous, worried or feeling a sense of dread. However, these psychological symptoms are often reduced by the reduced physical symptoms from propranolol.

Migraines

Propranolol can also be taken regularly to reduce the number of migraine attacks experienced by migraine sufferers. It is the most commonly used drug of choice for migraine prevention. It is worth noting that Propranolol doesn’t reduce the severity or duration of migraines.

How does Propranolol work?

Propranolol works by slowing your heart rate and affecting your blood vessels, making it easier for your heart to pump blood around your body.

If you are feeling particularly anxious, worried or stressed about an upcoming event (such as an interview, exam or presentation at work), then you may experience anxiety symptoms such as a racing heart, sweating and flushing. By slowing down your heart rate, Propranolol can tackle the physical symptoms of anxiety and help you to feel calmer.

Propranolol also inhibits the effects of the stress hormone noradrenaline, which further combats these physical anxiety symptoms.

Propranolol doesn’t treat the mental symptoms of anxiety such as worry, a sense of dread or a foggy mind, but lots of people find that easing their physical symptoms with medication can also help to alleviate mental symptoms, making them less aware of how nervous they are.

Propranolol is a type of beta-blocker. Beta-blockers are medical treatments that were initially developed to treat heart problems but are now also used to help with anxiety and migraines.

Propranolol dosage

Propranolol comes in various different dosages, with each featuring a distinct concentration of the active ingredient. The dosage in a given tablet, capsule or liquid serving can range from 10mg to 160mg.

The right Propranolol dosage for anxiety will vary from person to person; if you find that 10mg is not alleviating your anxiety symptoms, you can increase your dosage to as many as four 10mg tablets before an event. You can also take this Propranolol dose for anxiety up to three times a day.

Stronger doses of Propranolol are available to decrease the frequency of regular migraines.

The typical Propranolol dosage for migraines is 40mg once or twice a day, but this can be increased to as much as 240mg daily if migraines worsen or continue.

It’s important that you do not exceed the recommended Propranolol dosage prescribed by your doctor or pharmacist for your condition. Doing so could result in unpleasant side effects, or worse, an overdose which would cause light-headedness, blurred vision and even fainting (these things stem from major reductions in heart rate and blood pressure). It could even result in severe heart problems.

If you miss a dose, take the missed tablet as soon as possible. If you can’t take that missed tablet before it’s nearly time for the following dose, though, you should forget about it and resume your regular routine. Never double your dose to make up for a missed tablet.

How quickly does Propranolol work for anxiety?

Propranolol can work very quickly to help relieve situational anxiety symptoms. It can help to reduce peripheral symptoms such as sweating, tension and tachycardia in as little as half an hour and on some occasions, 20 minutes.

If you have a stressful situation, event or performance that you’re worried and anxious about — such as a presentation at work, an interview or an exam — then you usually need to take Propranolol about 30 to 60 minutes before.

For some people, it may take a little longer to feel the effects of Propranolol — perhaps a few hours — so it’s a good idea to test it out first, rather than using it for the first time before a situation you’re worried about.

How long does Propranolol last?

Propranolol generally lasts between three to four hours. For most people, Propranolol can provide around four hours of symptom relief.

During this time, Propranolol helps with the physical symptoms of anxiety, such as flushing, increased heart rate, shaking, and sweating. As noted, while it doesn’t alleviate the mental symptoms of anxiety (such as worry, mental fog, or mental blankness), becoming less aware of the obvious physical symptoms can lead to those mental symptoms improving.

The half-life of a medicine is the time it takes for the amount of it in your body to be reduced by half, and Propranolol has a half-life of around three to six hours. In all likelihood, it will take around one to two days for a dose to be completely out of your body, with some potential Propranolol side effects lasting that long (or even lingering longer).

Best time to take Propranolol for anxiety

The best time to take Propranolol propranolol for anxiety is dependent on a few factors.

If you are using Propranolol to combat performance anxiety, take your normal dosage (which will be between 10mg-40mg), about half an hour before the situation or event that you are worried about begins.

If you are using Propranolol for more general social anxiety during the day, then you can take it at regular intervals throughout the day. Start by taking one 10mg tablet three times per day. If you feel it is necessary, you can increase the dose to four tablets, but it’s a good idea to speak to your doctor about this.

Propranolol can be taken either with or without food, so you don’t need to worry about planning to take it around your mealtimes.

Is Propranolol good for anxiety?

Propranolol is widely acknowledged to be an effective treatment for anxiety and is generally considered safe to take for a long time. There don't seem to be any lasting harmful effects if you take it for several months or even years.

There are some cases in which it isn’t advisable to use Propranolol, though, such as if you’re pregnant, have certain medical conditions, or are already taking other types of medication.

You should also avoid mixing Propranolol and alcohol. This is because Propranolol and alcohol both serve to reduce blood pressure. As a result, you could end up with dangerously low blood pressure, leading you to experience dizziness, lightheadedness, headaches, and a range of other symptoms.

As is the case with all medicines, there are some possible side effects to be aware of. With that said, side effects are rare and normally mild; many users experience only minor side effects or no side effects at all.

These are some of the most common side effects associated with taking propranolol:

Problems sleeping
Nightmares
Cold hands
Tiredness
Dizziness
Cold feet

If you stop taking the medication suddenly, you could experience these withdrawal symptoms:

An irregular heartbeat
Chest pain
Sweating
Shaking

It should also be noted that Propranolol isn’t generally recommended for patients with peripheral vascular disease. This is because it’s been reported that beta-blockers can worsen the symptoms of intermittent claudication.

You should consult your doctor if you experience any side effects when taking Propranolol.

Summary

Propranolol is a type of prescription-only medicine called a beta-blocker. It’s used to treat anxiety and a range of other health conditions including heart problems and migraines.

Propranolol comes in different strengths: the dosage you should take will depend on the health condition you are treating.

Low doses of Propranolol can be used to help treat performance or situational anxiety by reducing physical symptoms including flushing, shaking, sweating, and an elevated heart rate. Propranolol can work very quickly to relieve these symptoms (taking effect in between 30 and 60 minutes) and can last for around three to four hours.