Propranolol is a type of beta-blocker medication that works by blocking the effects of epinephrine (adrenaline) on the body.
It’s often used to treat tremors, chest pain, high blood pressure, heart rhythm disorders, and other heart or circulatory disorders.
Beta-blockers are an FDA approved medication; however, prescribing them for performance anxiety is considered off-label. Doctors are able to prescribe medications for off-label uses, and many have been prescribing beta-blockers to help with performance anxiety for decades.
How can beta-blockers help with performance anxiety?
Though performance anxiety is generally considered to be a mental condition, there’s actually a strong connection to our physical bodies as well.
By blocking adrenaline from affecting the body, beta-blockers prevent many of the common physical symptoms that many of us experience when we’re under a lot of stress, like:
- Racing heart
- Shaky hands
- Trembly voice
- Sweaty palms
- Shallow breathing
Beta-blockers do not help ease any underlying psychological symptoms of anxiety. But getting these uncomfortable and distracting physical symptoms out of the way can help you feel calmer and more confident during big moments.
According to Yale Professor of Cardiology Dr. Robert Attaran: “[Beta-blockers] will not eliminate the feeling of anxiety and fear, but they will reduce some of its symptoms. This can prevent a negative feedback loop in some performers, who will feel even more nervous if they notice they have a tremor, for example”.
Though beta-blockers have helped many people ease the symptoms of performance anxiety, they may not be effective for anyone. Some people may need additional or alternative options to resolve their conditions.
Additionally, while beta-blockers are generally safe, they aren’t right for everyone. People with certain conditions or who are taking certain medications should not take them. Be sure to consult with a doctor before trying them.
How should you use beta-blockers for performance anxiety?
When being used for performance anxiety, beta-blockers should be used on an as-needed basis. They don’t need to be and should not be taken every day.
Generally, our doctors recommend taking one 10mg tablet of propranolol one hour prior to your performance, presentation, meeting, interview, etc.
Your doctor has included a personalized treatment plan that includes recommendations, instructions, as well as benefits and any potential risks.
Be sure to read through this treatment plan completely to understand any recommendations tailored specifically to your needs, including the exact dosage your doctor has recommended for you.
Get started with an online consultation now and connect with one of our board-certified doctors to learn if propranolol is right for you.
Reviewed by Dr. Alex Dimitriu
Dr. Alex Dimitriu is a Stanford-trained physician with dual board certification in psychiatry and sleep medicine. The included content is not intended to replace medical advice. Always be sure to discuss any prescription medications with your doctor.