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Propranolol may be helpful for certain types of anxiety, fears, and phobias. Learn more about its benefits, risks, and whether it’s the right anxiety medication for you or a loved one.
Propranolol is a beta blocker, a type of medication that affects the heart and circulatory system. Since propranolol can lower your heart rate and blood pressure, it’s most commonly used to treat cardiovascular disease such as angina, high blood pressure, and irregular heart rate. However, propranolol can also be prescribed for anxiety “off-label,” which means that anxiety is not the condition it was officially approved for, but your doctor thinks it may be effective for you.
Propranolol may help manage your physical symptoms of anxiety, such as a racing heart, shortness of breath, chest tightness, headaches, shaking, and sweating. For this reason, it’s most commonly used for situational anxiety such as performance anxiety (stage fright), social anxiety, and certain phobias.
As well as being sold under the generic names propranolol, propranolol HCl, and propranolol hydrochloride, you may see brand names in the U.S. such as:
These medications may come in the form of immediate-release tablets, extended release capsules, or oral liquid solutions. For in-the-moment anxiety relief, your doctor is most likely to recommend immediate-release tablets.
Some research suggests there isn’t sufficient evidence to support the effectiveness of beta blockers in treating anxiety. It’s also important to remember that propranolol is not a cure for anxiety and may not be suitable for everyone. By learning more about how it works and then consulting with a psychiatrist or family doctor, you can decide if propranolol is the right treatment for you.
When used to treat anxiety, propranolol works by blocking the effects of the stress hormones involved in the fight-or-flight response, such as adrenaline and norepinephrine, that cause your heart to pound, palms to sweat, mouth to dry up, and muscles to shake.
The drug can work quickly, making it ideal for in-the-moment relief. For this reason, propranolol is most commonly used for situational anxiety, where you become anxious or experience a panic attack during specific events, such as a job interview, delivering a work presentation, or meeting lots of new people at a party. Beta blockers such as propranolol have long been used by performers as an effective way to counter stage fright.
Since propranolol addresses only the physical symptoms of anxiety and not the emotional symptoms or the underlying causes, it may not be suitable for all types of anxiety disorders. For example, your doctor may not recommend it for ongoing chronic worry, feelings of apprehension or dread, and intrusive thoughts associated with generalized anxiety disorder (GAD).
Propranolol works differently to other anti-anxiety medications, including benzodiazepines like Xanax (alprazolam). While propranolol addresses your physical symptoms of anxiety, Xanax targets receptors in your brain to calm and relax your nervous system. Benzodiazepines like Xanax are controlled substances, though, and are rarely prescribed online. Propranolol doesn’t have the same potential for abuse so many top online psychiatry platforms are able to prescribe it for anxiety.
If you’re an adult with situational anxiety, your doctor may suggest an immediate release propranolol dose of 10 to 40mg. Since propranolol is fast-acting, you can take the medication 30 to 60 minutes before an anxiety-inducing event such as giving a speech or facing your fear of flying.
Extended release capsules don’t work as quickly since they’re designed to release the medication over a longer period. If your doctor recommends a daily dose of propranolol, they’ll likely start you on one 40mg dose once a day, depending on your age, weight, and medical history. If necessary, that may be increased up to three doses per day.
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Take Assessment HelpGuide is a user-supported nonprofit. We earn a commission if you sign up for Talkspace’s services after clicking through from this site. Learn more Learn moreUncommon but serious side effects can occur with propranolol. These include bradycardia (slow heartbeat), hypotension (low blood pressure), even heart failure. If you experience any severe symptoms such as an allergic reaction, shortness of breath, chest tightness, severe dizziness, or worsening mood it’s important to report them to your prescriber right away.
More common side effects can include:
Propranolol isn’t right for everyone. It’s usually only prescribed for anxiety in adults, not children. The medication slows the heart, relaxes blood vessels, and causes the airways to constrict. It may also impact blood sugar levels and cause or worsen depression. Therefore, doctors may recommend you don’t use propranolol for anxiety if you have any of the following:
Propranolol may also interact with certain blood pressure and heart medications, epinephrine, NSAIDs, and Warfarin.
Your doctor will most likely prescribe propranolol for you to use before specific events that trigger an anxiety response. It may take some experimenting to find the lowest, most effective dose and the best timing to take the medication. Your prescriber may also recommend other anxiety treatments that can help manage your symptoms, such as therapy, lifestyle changes, and breathing exercises.
When using propranolol you’ll also want to talk to your doctor about your alcohol and tobacco use. Alcohol may increase the amount of propranolol in your body, while smoking may decrease its effectiveness.
Propranolol isn’t your only option to treat anxiety. Other types of anxiety medication include benzodiazepines (typically prescribed for short-term use), Wellbutrin (bupropion), BuSpar (buspirone), and antidepressants such as SSRIs and SNRIs which may be better suited for longer-term use.
Therapy has proven very effective in treating anxiety. The most common forms of therapy for anxiety are cognitive behavioral therapy (CBT) and exposure therapy. For many people with anxiety, online therapy can be just as effective as traditional, in-person therapy. We reviewed the best online therapy platforms to help you find a service that fits your schedule and needs.
Finally, there are plenty of ways to help yourself when you start to feel anxious. Mindfulness, controlling your breathing, and reframing negative thoughts are strategies that can help you manage anxiety in the moment without having to rely on medication.
Last updated or reviewed on November 6, 2025Learn about common side effects, risks, and taking medication responsibly
Cognitive behavioral therapy, exposure therapy, and other options
Lexapro (escitalopram) is an FDA-approved medication for long-term anxiety treatment. Learn more about how this medication works and its side effects.
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