Beta-Blockers

Beta-Blockers are beta-adrenergic blocking agents, commonly used in the treatment of high blood pressure (hypertension). They are also used to prevent a second heart attack, relieve chest pain (angina), stop migraines, and tremors. Beta-blockers work by “blocking” the effects of stress hormones, such as adrenaline, and easing the workload of the heart.

When stress hormones are activated, beta-receptors cause the heart rate to slow and heart muscle contractions to decrease. Beta-receptors are structures that exist on nerve cell membranes of the sympathetic nervous system and affect its activities, such as heart rate. Beta-blockers bind with the beta-receptors and prevent stress hormones from entering the receptors and triggering the stress reaction. It is because of this effect on stress hormones that the “fight or flight” reaction does not kick in, so the symptoms of anxiety, such as racing heart and sweating, do not manifest themselves. Common beta-blockers include:

  • Inderal-LA (propranolol)

  • Lopressor (metoprolol)

  • Betapace (sotalol)

  • Normodyne (labetalol)

  • Trandate (labetalol)

  • Sectral (acebutolol)

Beta-blockers are often prescribed for people who have social phobia, because it reduces the more noticeable signs of anxiety, such as shaking, trembling, and blushing. Individuals who experience performance anxiety, such as public speakers and performers, also use these. Beta-blockers have been called “the underground drug” for musicians, because it helps to stop the symptoms of performance anxiety, which include thought blocking and loss of concentration. Beta-blockers do not in any way influence the emotional component of anxiety—they only have a physiological effect and can usually stop the “fight or flight” reaction from starting. Though, if anxiety is high enough, beta-blockers may not be able to reduce the symptoms enough to feel relief. Beta-blockers are not addicting and begin to work within a few hours after swallowing and come in either tablet or liquid form.

Side Effects of Beta-Blockers

Beta-blockers have side effects especially within the first few weeks of treatment. You may not experience any symptoms but if you do they may include: fatigue, cold extremities, upset stomach, sleep disturbances/nightmares, dizziness/feeling lightheaded and faint, wheezing/chest feels tight, and skin rashes.

Fact

Since beta-blockers act quickly, they can be taken on an as needed basis for anxiety. It is recommended that 20 to 40 milligrams of a beta-blocker, such as propranolol (Inderal), is taken one hour before the stressful situation. If your anxiety is very high, and the beta-blocker will not give you enough relief, then you can usually safely combine it with a benzodiazepine, such as alprazolam (Xanax). Remember, you must check with your doctor before combining medications.

If taken occasionally, beta-blockers usually have no side effects. Even if taken daily, they are not associated with weight gain or sexual problems, but males taking higher doses have reported difficulties in achieving erection. If you are taking beta-blockers on a daily basis for more than a month, and you want to stop, it is best to stop gradually. Though you will not experience withdrawal symptoms, you may have a very high spike in blood pressure. Another caution is the use of alcohol, which can only exacerbate the effects of sedation, and also lower blood pressure.

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