Most of us have experienced performance anxiety at least once.
Speaking up in a meeting to deliver an opposing opinion you know you'll get pushed back on. Promising to deliver a killer best man's speech, even though public speaking is secretly your biggest fear.
The realization that a roomful of people is waiting to watch us speak or perform can be flat-out alarming.
Rapid heartbeat, sweaty palms, rushed breathing, flushed cheeks - the list of physical symptoms that scream out to everyone around us that we're scared is endless.
Many people assume that it takes a major intervention to relieve performance anxiety during these crucial situations.
For instance, it's not all that rare to see someone sneaking in a shot of whisky before they pick up the mic. In some cases, people will even turn to anxiety medications, like Xanax, to help them keep their cool.
The problem with these "treatment options", however, is that they come with side effects that blur your concentration and make it even more impossible to focus on the delivery of your content.
Beta-blockers, on the other hand, offer short-term relief without having to sacrifice your clarity and focus.
In fact, many are surprised to learn that the typical Propranolol dosage for anxiety is actually quite low, with most doctors recommending taking a small dose of 10–20 mg one hour before a pivotal moment like a presentation, job interview, or crucial exam.
This is a fraction of the normal dosage recommended for other conditions beta-blockers are used for like migraines, high blood pressure, and heart conditions.
How Does Propranolol Work For Anxiety?
When your body goes into fight-or-flight mode as a response to stress, norepinephrine (what you probably know as adrenaline) kicks in. It sends your heart rate through the roof, makes your breathing short and shallow, and, in some of us, produces upsetting amounts of sweat.
Unfortunately, as humans, our bodies have not yet adjusted to our modern environment.
Our physical response to stress is the same, whether we’re nervous about presenting to a room full of people or facing down a hungry lion.
The physical processes designed to keep us alive and uneaten in the animal world are obstacles in a human world that rewards crisp, relaxed performances.
A high heart rate can further elevate anxiety, resulting in a negative spiral. Shallow breathing or trembling can spoil a performance, regardless of how practiced a speaker or performer is.
When you take your Propranolol dose for anxiety, however, it blocks adrenaline from impacting the way your body feels.
That helps prevent many of the physical responses to stress like high heart rate, labored breathing, and excessive sweating. The elimination of those physical symptoms helps calm many people as they prepare to perform at their peak.
How Do I Know The Right Dosage For Me?
Like we mentioned above, doctors tend to prescribe 10-20 mg of Propranolol as an off-label prescription to be taken an hour before a big moment. This micro-dose, taken only when needed, is usually enough to achieve the relief from performance anxiety that beta-blocker prescriptions provide.
However, it’s important to give your doctor a full medical history as well as an updated list of any medications and supplements you’re taking to help figure out the right dosage for you.
As with any medication, the exact dosage will vary based on your height, weight, body composition, and a variety of other factors.
Though beta-blocker medications can cause some common side effects, taking the correct dosage recommended by your doctor can help minimize or eliminate them altogether.
Be sure to read through your treatment plan to make sure you're following full instructions from your doctor.
Though Propranolol is largely considered to be a safe medication, it simply isn't the right solution for everyone. You can complete an online visit with a board-certified doctor to discuss your performance anxiety and understand if a beta-blocker prescription 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.