Atenolol for Anxiety – What You Need to Know

Last Updated: September 14, 2021

Atenolol, commonly sold under the brand name Tenormin, is a commonly prescribed pharmaceutical beta-blocker. Beta blockers (beta-adrenergic blocking agents) are traditionally prescribed to help with heart conditions, angina, arrhythmia, etc. Many professional musicians use beta-blockers like Atenolol off-script to help with their stage fright and performance anxiety, as beta blockers essentially help the user steady their heart rate and block the release of adrenaline into the bloodstream. Here we look at what Atenolol is exactly, examine it’s effectiveness against anxiety symptoms, and see if Atenolol is effective for anxiety.

Social anxiety, performance anxiety and similar issues have the potential to ruin a person’s life. At the very least, these afflictions make living a fulfilled, happy life much more difficult than it needs to be.

These issues are nothing new. Many accomplished performers still experience stage fright every time they get on the stage or in front of a camera. The list of people suffering in private from bouts of anxiety related to meetings, interviews, social gatherings and dates, is longer than you could imagine.

Some people take a class of drugs called beta-blockers to deal with social anxiety or stage fright. There are a number of different beta-blockers that show potential as a treatment for anxiety, one of which is Atenolol.

In this article we’ll discuss how Atenolol works to treat the symptoms of anxiety, and its effectiveness at doing so. We’ll also touch on any dosage information, side-effects, or interactions you need to know, and finally, share some natural beta-blocker alternatives.

What Are Beta-Blockers?

Atenolol is part of a class of drugs known as beta-blockers. Beta-blockers are a prescription medication used to treat heart conditions.

Beta-blockers (also known as beta-adrenergic blocking agents) effectively slow down the heart and reduce blood pressure. They work by suppressing or blocking the effects of epinephrine, or adrenaline, the stress hormone associated with the body’s “fight or flight” response.

The conditions beta-blockers are prescribed to treat include angina, arrhythmia, heart failure, migraines and hypertension (high blood pressure). By blocking the release of adrenaline, they help to regulate heart rate and blood pressure, thus providing relief for the aforementioned conditions [1][2].

How do Beta-Blockers Work for Anxiety?

Beta-blockers are also taken at times to treat anxiety. These cases are usually off-script (meaning for a reason other than what is prescribed or approved). Though sometimes a doctor may prescribe beta-blockers to use for anxiety.

When we experience anxiety, particularly social anxiety and performance anxiety (aka stage fright), it often comes with an elevated stress response. This stress response triggers a release of adrenaline, which is released into the bloodstream, causing an increase in heart rate and blood pressure, as well as symptoms like rapid breathing, sweating, nausea and trembling [3].

Beta-blockers suppress adrenaline, and thus help suppress the physiological symptoms of social and performance anxiety. So while they don’t directly treat anxiety, they may help reduce the severity of how we experience bouts of anxiety or panic attacks.

What is Atenolol?

Atenolol is one of several commonly prescribed pharmaceutical beta-blockers. It is also known by its brand name, Tenormin.

Like other beta-blockers (such as Propranolol and Metoprolol), Atenolol is used primarily for heart conditions, such as hypertension, angina and recovery from heart attacks.

Recommended dosage for Atenolol

Atenolol is most commonly taken in tablet form, recommended with or without food. Tablets come in 25mg, 50mg and 100mg [3]. It can also be administered via IV infusion, however this would only be in a hospital setting.

Recommended dosage varies from 25mg to 100mg, depending on what condition it’s being used to treat. An initial dose of 50mg is recommended for angina and hypertension, and may be increased to 100mg per day for hypertension, or 200mg for angina [4].

When taking Atenolol for anxiety, the recommended dose is 50mg to 100mg per day as a single dose [5].

Before deciding to take Atenolol for anxiety, it’s important to check with your doctor to ensure the intended dosage is safe, and will not cause issues with any other medication or health issues you may have.

Does Atenolol have any side effects?

Most people will experience only minor side effects when taking Atenolol, or none at all.

In general, beta-blockers like Atenolol are safe. However, that doesn’t mean that side effects are impossible. And there may be rare cases in which some people experience more serious side effects.

Some common side effects [4][6] of Atenolol include:

  • Dizziness, feeling sleepy or tired
  • Nausea
  • Cold fingers and/or toes
  • Diarrhea
  • Constipation
  • Depressed feelings

More serious side effects may include the following:

  • Shortness of breath
  • Difficulty breathing
  • Chest pain
  • Slow or uneven heartbeat
  • Allergic reaction (anaphylaxis)

If you notice side effects after taking Atenolol, particularly serious side effects or side effects that last a few days or more, call your doctor or seek medical advice immediately.

If you take Atenolol regularly, it should not be stopped all at once, as withdrawal symptoms such as an increase in blood pressure or an elevated heart rate may occur [3].

Interactions between Atenolol and other substances

A little known fact is that some fruit juices, particularly grapefruit, orange and apple juice, may reduce the effectiveness of Atenolol when taken at the same time, by decreasing the absorption of Atenolol by the body.

Atenolol may also have interactions with other prescription drugs. Drugs that affect blood pressure and heart rhythm may produce unwanted or unsafe reactions with Atenolol. These drugs may cancel each other out (in the case of drugs that increase blood pressure), or result in a dangerously low heartbeat or blood pressure [3].

Non-steroid anti-inflammatory drugs (NSAIDs) such as ibuprofen may reduce the effects of Atenolol, and monoamine oxidase inhibitors or MAOIs (often prescribed to treat depression) may increase the rate at which Atenolol reduces blood pressure.

If you’re taking any other drugs, prescription or otherwise, check with your doctor before taking Atenolol.

How effective is Atenolol for anxiety?

While not the originally intended use for Atenolol, there is some evidence to indicate that Atenolol may be effective at treating the symptoms of social anxiety disorders.

A 2020 study showed encouraging results for Atenolol as a treatment for anxiety in patients at a military mental health clinic in Japan [7].

81% of patients with diagnosed anxiety disorders reported that Atenolol had a positive effect on their condition. 90% of patients also reported that there were no adverse effects from taking Atenolol, or that the adverse effects were tolerable.

Interestingly, every patient who had previously taken Propranolol, another commonly used beta-blocker for anxiety, said they preferred Atenolol.

It should be mentioned, however, that this was just a preliminary investigation, and does not amount to a clinical trial.

Another study in 2019 looked at 22 patients, suffering from Generalized Anxiety Disorder, Social Anxiety Disorder and several other related conditions. The patients, who were treated with 25mg of Atenolol, experienced a calming effect within 60 minutes, which lasted up to 8 hours [8].

Most other evidence showing Atenolol as effective for anxiety is, at this point, anecdotal. Out of 45 user reviews on Drugs.com, Atenolol has a combined rating of 7.7 out of 10 for the treatment of anxiety [9].

The research that currently exists on Atenolol (and other beta-blockers) as a treatment for anxiety disorders is encouraging. However, it should be noted that more research is necessary to be sure of its efficacy.

Natural Alternatives to Atenolol for Anxiety

While beta-blockers are, for the most part, considered safe, some people may not see this as an ideal long-term treatment for anxiety disorders.

When taking pharmaceutical drugs long-term, there’s a risk of dependency or addiction. This could result in harmful side effects when you stop taking them.

There may also be a social stigma for some people, in being seen popping pills all the time, particularly if you take beta-blockers to address anxiety in a professional setting.

This is not to mention the fact that some people should not take beta-blockers due to interactions with other medicines or pre-existing medical conditions.

These people may prefer a natural alternative. Natural beta-blockers provide much of the same calming effect that Atenolol does, but with lower chances of negative side effects, dependence or social stigma.

Here are some natural alternatives to Atenolol:

GABA

Gamma-Aminobutyric Acid, or GABA for short, is a neurotransmitter, deficiency of which is shown to have a role in anxiety disorders [10]. Supplementing with GABA produces a calming effect in most people, which may provide relief of the symptoms of stress and anxiety.

L-theanine

The effects of L-theanine are much in line with those of GABA. Often found in green and oolong teas, as well as in dietary supplements, L-theanine has been shown to be effective in reducing symptoms of stress and anxiety, as well as promoting cognitive performance [11][12].

Magnesium

Magnesium is one of the most important minerals in our body, playing a part in over 300 vital functions at an enzymatic level [13]. Low levels of this mineral are associated with hypertension and cardiovascular disease, as well as neurological conditions and anxiety [14][15]. Magnesium is abundant in many food sources, as well as being widely available as a supplement.

PerformZen

Natural dietary supplements may effectively counteract the symptoms of social anxiety disorders. One I find effective is PerformZen [16]. This supplement contains all three of the natural beta-blockers mentioned above (GABA, L-theanine and Magnesium), as well as several other cognitive-enhancing ingredients, which work to promote a feeling of calm without the risk of addiction or harmful side effects.

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Final Thoughts on Atenolol as a Treatment for Anxiety

Beta-blockers, including Atenolol (also known as Tenormin), show strong potential for treating the symptoms of social anxiety, performance anxiety and similar afflictions.

While Atenolol and other beta-blockers are not officially approved for treating anxiety, there are a large number of people who take them for this reason and report positive results.

If you decide you want to try Atenolol as a treatment for anxiety, check with your doctor first to be sure it’s safe for you.

Alternatively, you may want to try a natural option, such as GABA, L-theanine, or a supplement like PerformZen, to address the symptoms of anxiety without the risks of prescription drugs.

Take a look at our other solution articles:

Beta Blockers for Anxiety: Guide
Natural Beta Blocker Alternatives for Anxiety
The best Performance Anxiety & Stage Fright books to help you with your fears
Propranolol Dose For Anxiety
Propranolol vs Metoprolol for Performance Anxiety - which is best?

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PerformanceAnxiety.com Owner & Lead Writer

Anita is the owner and lead writer for PerformanceAnxiety.com. A seasoned musician and public speaker herself, she is no stranger to the very real fear and anxiety that can strike right before a high-pressure situation. That's why Anita is passionate about writing content that helps people learn about and overcome their anxieties & social fears so that they can perform at their best when it counts and live anxiety-free lives.