Everyone’s talking about beta blockers for anxiety. Here’s what experts want you to know before taking them

What are beta blockers, and how do they work for anxiety?

Beta blockers were originally developed to treat a range of disorders involving the heart and the circulatory system, like high blood pressure and irregular heart rhythms. They fall into two categories:

• Selective beta blockers: Only target specific receptors in the heart
• Non-selective beta blockers: Bind to receptors more broadly throughout the body

Over time, these medications have also become a common off-label option for anxiety, particularly non-selective ones like propranolol, explains Kate Hanselman, a board-certified psychiatric nurse practitioner at Thriveworks. That means they’re not officially FDA-approved for treating anxiety, but providers can still prescribe them if they believe it’s appropriate for your symptoms.

So why would a heart medication work for anxiety? Beta blockers block the effects of adrenaline in your body, Hanselman says. Adrenaline is what drives your fight-or-flight response, so when it’s dialed down, your heart rate slows, your hands shake less, and you’re less likely to feel that full-body surge of panic. In practice, she explains, that means they’re usually taken as needed, about 30 to 60 minutes before a stressful situation, to tone down the physical stress response in the moment. The effects typically last a few hours (around three to six), keeping symptoms in check while you get through it.

While beta blockers only address the physical—not psychological—side of anxiety, controlling those bodily symptoms can make a big difference. That’s because those physical symptoms often create an anxious feedback loop: “Your body essentially sends inappropriate signals to your brain that there’s something wrong, and it makes you more anxious,” Hanselman explains. “So if we can put a lid on that feedback loop, you’ll be more equipped to handle the cognitive anxiety.”

Just keep in mind, beta blockers don’t tackle the underlying or external causes of anxiety, points out Hallie Kritsas, a licensed mental health counselor at Thriveworks. “That thing that caused you to go into fight-or-flight is still going to be there—we can’t erase that with medication,” she says. “But if our anxiety is at a 10 and a beta blocker can help get us down to maybe a five or a six, that can be a helpful part of treatment.”

What the research says about beta blockers and anxiety

There isn’t much high-quality research on beta blockers for anxiety, and what we do have is a mixed bag. A 2025 systematic review and meta-analysis in the Journal of Affective Disorders found that many studies on the subject are small, old, or missing data, which makes it hard to draw strong conclusions about how well these medications work for anxiety.

That said, the research mostly echoes what the experts say: While beta blockers aren’t a cure-all for anxiety, they can help in certain situations. For instance, a 1984 study in the American Heart Journal looked at a small group of music students and found that nadolol (a non-selective beta blocker) helped with anxiety-induced shakiness and a racing heart during a performance. A 1983 study in the British Journal of Psychiatry found that propranolol reduced both self-reported and observer-rated anxiety in 16 people involved in a public speaking experiment. And a small 2000 study in the Journal of Clinical Psychopharmacology found that using a beta blocker (pindolol) along with an antidepressant (fluoxetine) was more effective for treatment-resistant panic disorder than using the antidepressant alone.

“It can be a tool at our disposal that works really nicely in conjunction with other tools,” Hanselman says.

How to know if a beta blocker is right for your anxiety

Beta blockers aren’t a fit for everyone, and they aren’t considered the most effective first-line treatment for anxiety, Hanselman says. Managing persistent anxiety that interferes with your day-to-day life typically includes a mix of long-acting medication (like SSRIs and SNRIs) and therapy (like cognitive behavioral therapy and exposure therapy).

That said, here are a few situations when beta blockers may be a fit for your anxiety:

1. Other treatments aren’t fully managing your symptoms

Sometimes you need to supplement the go-to approach above with a fast-acting medication too, Hanselman says. That can be especially helpful when you’re waiting for another med like an SSRI to kick in, which can take weeks or months. Fast-acting medications like beta blockers could also help with anxiety symptoms that spike in specific situations (like a stressful event) despite being otherwise managed with your daily medication. It can also be a solid supplement to exposure therapy, Hanselman says, making it possible for people to take the first baby steps toward facing a fear.

2. Your anxiety only spikes in specific situations

Maybe you don’t deal with persistent, life-impacting anxiety on a daily basis, but certain situations (like public speaking or high-stakes social events) send your anxiety into overdrive. According to Hanselman, it’s not unusual for a provider to prescribe beta blockers for one-off or occasional situational anxiety, say for a performance or presentation.

3. Your anxiety is very physical

“Some people just have an especially somatic experience of anxiety,” Hanselman says. “They come to me and say, ‘My mouth gets bone dry, I turn bright red, my heart beats like crazy,’ and that can become a big problem.” When those symptoms start interfering with day-to-day life, or make you avoid things like speaking up in meetings or going to events, a beta blocker can help take the edge off.

On the other hand, if you deal mostly with mental symptoms like constant worrying, rumination, or catastrophizing, a beta blocker probably won’t be that helpful, Hanselman says.

4. Other fast-acting anxiety medications aren’t a fit for you

There are other fast-acting medications that are actually FDA-approved for anxiety, like Lorazepam (a benzodiazepine). Providers often prescribe these for short-term relief during acute spikes, but they can leave people feeling “drowsy, loopy, or altered,” Hanselman points out. “You might prefer beta blockers because they aren’t as physically impairing or psychoactive as benzos can be.”

Also, because benzodiazepines can be habit-forming, they aren’t a fit for anyone who may be at risk for developing a dependence, like someone with a history of substance abuse. Beta blockers, on the other hand, aren’t a controlled substance and don’t carry the same risk of habit-formation or misuse, Hanselman says. (But like any medication, they’re dangerous to take in large quantities, she adds—an overdose could lead to a dangerously low heart rate, heart block, and even heart failure.)

5. You don’t have a health condition that would make it unsafe for you to use a beta blocker

Remember, these meds directly affect your cardiovascular system, so they’re generally not recommended if you have certain medical conditions like asthma or low blood pressure. You also have to be careful when taking it if you have diabetes, says the Mayo Clinic, since beta blockers can make it harder to catch signs of low blood sugar, like a rapid heartbeat.

At the end of the day, there are no formal guidelines when it comes to off-label use like this. That’s why it’s important to have a healthcare provider assess your health history and a mental health provider consider your unique symptoms when deciding what’s best for you.

What are the side effects of beta blockers for anxiety?

Like any medication, beta blockers can come with side effects. According to the Mayo Clinic, that might include dizziness, fatigue, dry mouth, cold hands and feet, and feeling lightheaded. Some people report trouble sleeping or vivid dreams and nightmares. Less commonly, they can cause shortness of breath or mood changes like depression. And because they affect your heart and blood pressure, they’re not something you want to start, stop, or experiment with on your own without consulting a healthcare provider.

Hanselman often suggests patients try a beta blocker for the first time in a low-stakes setting, like a quiet afternoon at home, so they know what to expect. If you don’t like how it makes you feel, you and your provider can adjust the plan or try something else, she says.

Could relying on beta blockers get in the way of real coping skills?

That’s not something providers typically worry about, especially considering beta-blockers aren’t habit-forming.

After all, anxiety isn’t always something you can just breathe or ground your way through. “If you’ve never experienced that level of physiological arousal—your whole body going into overdrive—it’s really hard to describe how debilitating it can be,” Hanselman says. In moments like that, it can feel nearly impossible to access other coping skills. And when those tools don’t work, people often assume they’re the problem, Hanselman adds, which impacts their willingness to try others in the future.

In that way, Hanselman argues beta blockers are usually more of a help than a hindrance. Under the guidance of a responsible provider, beta blockers can make coping tools more accessible without replacing them.

There’s also no real concern about dependence or needing to take them for the long haul. “I think people are afraid that they won’t be pushed to get better,” Hanselman says. “But it’s not a crutch; it’s a treatment.” Some people find they need beta blockers less as they build confidence and strengthen other coping skills. Others keep them in their rotation for certain situations—and that’s OK too.

When to talk to a provider about beta blockers and what to ask

If you had any moments of “that’s so me” or “that sounds so helpful” when reading this article, it might be worth bringing up beta blockers with a provider. You can start with a primary care doctor, psychiatrist, or a nurse practitioner.

If your anxiety feels bigger than a few specific situations, Kritsas recommends looping in a therapist to build out a broader anxiety treatment plan too. But if it really is situational—say, a one-off presentation or a recurring high-stakes event—some providers are perfectly comfortable prescribing a low, as-needed dose.

Frequently asked questions (FAQs)

Is propranolol FDA-approved for anxiety?

No, propranolol and similar beta blockers are not FDA-approved for anxiety in the U.S., only for treating certain heart and blood pressure conditions. That said, it’s still commonly used off-label for anxiety, which means providers can prescribe it when they believe it’s appropriate.

Can you take beta blockers for anxiety every day?

When used to treat anxiety, beta blockers are typically prescribed for short-term or as-needed use. But depending on your situation, your doctor might suggest you take them more frequently or explore a different treatment plan for anxiety. The right approach depends on your symptoms, your health history, and what you’re trying to get relief from—so it’s something to figure out with a provider, not on your own.

Are beta blockers better than SSRIs or benzodiazepines for anxiety?

The “better” or “best” treatment really depends on the person. When treating anxiety, your provider will work with you to find the most appropriate treatment option depending on your symptoms, health history, and goals. In general, beta blockers are fast-acting medications that target the physical symptoms of anxiety, like a racing heart, shaking, and sweating. Benzodiazepines are also fast-acting medications that work to reduce anxiety by slowing down the central nervous system, though they can be habit-forming. Selective serotonin reuptake inhibitors (SSRIs) are long-acting medications that are taken daily to treat anxiety disorders.

Can beta blockers make anxiety worse?

Beta blockers aren’t known to make anxiety worse, and in many cases, they can actually help you get better at managing it in different ways. Experts also say concerns about them negatively affecting your coping skills are often overstated. When used appropriately, they don’t replace coping skills, they just make those skills easier to access.

That said, side effects can include things like dizziness, fatigue, dry mouth, or lightheadedness, all of which can feel an awful lot like the anxiety you’re trying to treat. That’s why it’s important to take beta blockers under a provider’s guidance and pay attention to how your body responds. You can decide from there whether it’s helping or hurting.

Do beta blockers help with anxiety or just the physical symptoms?

Beta blockers help with anxiety by targeting the physical symptoms. When your heart is racing, your hands are shaking, and your body feels on edge, your brain often interprets that as danger, which can ramp up anxiety even more. By calming that physical response, beta blockers can interrupt that feedback loop and lower how anxious you feel overall.