Anxiety affects 19.1% of the adult population, if not more, and anti-anxiety drugs are some of the most widely prescribed psychoactive drugs in the world.
They’re also some of the most addictive, particularly in the case of benzodiazepines such as Xanax and Valium.
But while benzodiazepines are a well-known type of anti-anxiety drug, they’re not the only potential treatment. There are five types of drugs primarily used to treat anxiety:
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs)
- Beta blockers
At Kick, we prescribe beta blockers to treat performance anxiety. Beta blockers have a significantly lower risk of addiction and typically fewer side effects than benzodiazepines. They’re also well-tolerated by most patients.
Beta Blockers: Safer, non-addictive anti-anxiety medications
On label, beta blockers are approved by the FDA for the treatment of cardiovascular diseases and hypertension. Off-label, they’re used to treat the physical symptoms of a wide variety of anxiety disorders.
For anxiety treatment, beta blockers:
- Are fast acting, typically kicking in within an hour of ingestion.
- Work well for acute short term anxiety.
- Can help lower blood pressure and heart rate, relieving physical symptoms.
- May be an alternative for people who experience adverse side effects when they take other anti-anxiety medications.
- May reduce tremors, boosting the confidence of people anxious about public speaking and other performances.
A 2016 meta analysis “...found no statistically significant differences between the efficacy of propranolol [beta blocker] and benzodiazepines regarding the short-term treatment of panic disorder with or without agoraphobia.”
How beta blockers help with anxiety
Beta blockers are taken “as needed” to treat the symptoms of anxiety. As such, they’re not a long-term solution, and should always be used in conjunction with a treatment plan created by a mental health practitioner.
“Beta-blockers work to dampen down the body's 'fight-or-flight' response,” Dr. Jack Owens at the Center for Adult Behavioural Health explains. “Often, when people think of anxiety or a panic attack, it's accompanied by a racing heart, sweating, or shaking. Beta-blockers can work by lessening those symptoms.”
Our hearts have three different types of beta receptors that receive messages from stress-related chemicals like norepinephrine and epinephrine (adrenaline). Beta-blockers do as their name suggests — they block the adrenaline from binding to those receptors.
By reducing the amount of adrenaline reaching the heart, beta-blockers slow the rate and intensity of the heartbeat.
The physiological symptoms of anxiety are numerous. The list can be extensive and includes:
- Increased heart rate
- Heart palpitations
- Shortness of breath (or rapid breathing)
- Chest pain
- Dry mouth
Reducing these physical symptoms of anxiety can often lead to a reduction in mental anxiety as well, creating a significant improvement in overall symptoms.
For qualified patients, our doctors will prescribe either propranolol or atenolol, depending on your personal circumstances.
Propranolol is a non-selective beta blocker, which is a medication that works by blocking beta receptors in many areas of your body. It’s one of the oldest and most widely used beta blockers.
Non-selective beta blockers are more generalized than selective beta blockers. They block beta 1 and beta 2 receptors in the heart, lungs, kidneys, and smooth muscle, among other places. By blocking these receptors, they reduce the effects of epinephrine and norepinephrine on your cardiovascular system. In turn, this leads to reduced heart rate, respiratory rate, sweat, and tremors.
Compared to benzodiazepines, beta blockers can be just as effective for treating anxiety and with far lower addiction risk. A 2016 meta analysis of the effects of propranolol for anxiety found “no statistically significant differences between the efficacy of propranolol and benzodiazepines regarding the short-term treatment of panic disorder with or without agoraphobia.”
Atenolol is a selective beta blocker. These drugs block epinephrine from binding to beta receptors (Beta-1) that almost exclusively affect the heart.
This reduces the effects that adrenaline has on the heart. Selective beta blockers allow the heart to relax and reduce some of the physical effects of anxiety, such as increased heart rate and shaking.
Atenolol has been studied with a wide variety of anxiety disorders, including social anxiety and performance anxiety. While results have varied between studies, some studies have suggested it may be a better option to treat anxiety than even Propranolol. Nearly all studies have demonstrated or replicated an at least moderate improvement in anxiety symptoms.
Because of its selective nature, atenolol is often a preferential choice for patients with respiratory obstructions (e.g., asthma or COPD) over non-selective beta blockers.
How these medications make you feel
For most patients, reducing the physical symptoms of anxiety is enough to offer a sense of calm and focus. As with any medication, how this drug impacts you will vary from person to person.
If you’ve never taken beta blockers before, it’s advised that you take your first dose the day before your big event to acclimate to the feeling of the medication.
Beyond that, beta blocker side effects are rare, though some may experience tiredness and dizziness after the first few doses.
Common side effects of using beta blockers for anxiety
Most people tolerate beta-blockers well, experiencing few adverse effects.
Some possible side effects include:
- Insomnia: Beta-blockers reduce your body’s natural production of melatonin, which can lead to insomnia or other changes in your sleep patterns.
- Fatigue or dizziness: Reducing your heart rate and blood pressure can make you feel tired.
- Nausea or constipation: Taking beta blockers with food is recommended to avoid gastrointestinal side effects (if present).
- Sexual/erectile dysfunction:Like other drugs that lower blood pressure, beta-blockers can lead to temporary sexual dysfunction, including reduced arousal and libido.
Discuss any concerns or questions you have about side effects with your physician or pharmacist. While internet articles can provide generalized advice, only a medical professional with access to your medical history will be able to provide specific guidance.
At Kick, you can skip the appointment and get ongoing medical support for your performance anxiety. Private message your doctor at any time with questions or concerns. Learn more about our doctors here.
Frequently asked questions
Which anxiety medication is not addictive?
Benzodiazepines are the most well-known anti-anxiety medication, but also among the most addictive. Less addictive anti-anxiety medications include beta blockers, buspirone, SSRIs, and SNRIs.
At Kick, we use the beta blockers propranolol and atenolol to treat performance anxiety. These drugs are well-tolerated by most people and have a long history of use.
Beyond that, some other popular options include:
- SSRIs (selective serotonin reuptake inhibitors)
- Fluoxetine (Prozac®)
- Escitalopram (Lexapro®)
- Citalopram (Celexa®)
- Paroxetine (Paxil®)
- Sertraline (Zoloft®)
- SNRIs (Serotonin and norepinephrine reuptake inhibitors)
- Venlafaxine (Effexor®)
- Duloxetine (Cymbalta®)
- Vistaril® (Hydroxyzine)
- Buspar® (Buspirone)
What is the best long term anti-anxiety drug?
Benzodiazepines are not intended for long term use. SSRIs, SNRIs, Buspar, and beta blockers are all safer to tolerate long-term. Ultimately, the best long-term treatment for you will depend on your unique needs.
Our doctors are available to determine if you’re eligible for beta blockers as an anti-anxiety treatment. Start your risk-free confidence visit today. If you don’t qualify, you won’t be charged.
What is the best non-addictive anti-anxiety medication?
Beta blockers are a highly effective anti-anxiety treatment with little to no addiction potential. As with all medications, there is no universally best treatment, but some are better tolerated than others.
At Kick, we prescribe propranolol and atenolol for performance anxiety.