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Bisoprolol (Zebeta) For Anxiety: Can Bisoprolol Help With Anxiety Symptoms?

Last Updated: June 8, 2022

Bisoprolol is a prescription beta-blocker, normally prescribed under the brand-name Zebeta to treat cardiovascular conditions like hypertension and irregular heartbeats. Many high-level performers, musicians, speakers & artists use beta blockers like Bisoprolol off-script to help reduce performance anxiety or stage fright before and during a big performance. Here, we take a look at why so many performers and celebrities are using Bisoprolol to help with their anxiety, and we determine if Bisoprolol is actually a good long-term solution to stage fright. We also look at how Bisoprolol works exactly, what the side-effects are, what the recommended dosages are and even check to see if there are any natural alternatives.

Are you considering trying Bisoprolol (Zebeta) to help with your performance anxiety? Perhaps you get a bad case of nerves and anxiety whenever you have to go on stage and perform for an audience? Or maybe you find social situations like dates and dinner party leave you mentally drained and worse-off at the end of the night?

Whatever the reason; know that many performers (musicians, public speakers, executives giving presentations, actors, etc) use beta-blockers just like Bisoprolol to help them with their stage fright, social anxiety and general performance anxiety symptoms.

You are likely here because you want to know what Bisoprolol is, if it can help with your performance anxiety issues and, if so, how it works. You probably also want to know if there are any side-effects to bisoprolol, what the correct dosages are for anxiety and how it compares to alternative anxiety solutions available.

In this article we will cover all of that (and more)… but first, we need to take a look at why you experience performance anxiety, stage fright and/or social anxiety in the first place.

Knowing why you experience anxiety symptoms will inevitably help you better understand how drugs like Bisoprolol, or similar alternatives, may be effective against your performance anxiety symptoms.

Why do I experience performance anxiety?

Performance anxiety, or stage fright, is the anxiousness that some people feel when they have to perform in front of an audience or in a generally high-pressure scenario.

Performance anxiety is, essentially, an exaggerated stress response. This is when your fear and worry about performing results in a stress response within your body, and this triggers the release of certain stress hormones.

If the level of these stress hormones gets too high, your cardiovascular system goes into overdrive, possibly causing shaking, sweating, nausea, and other symptoms of stage fright [1].

Some of the most popular performers known today have suffered from debilitating Performance Anxiety to the point where they contemplated quitting acting or performing altogether! Well-known examples include Adele, Shawn Mendes, Katy Perry, Taylor Swift, and many others.

It’s not surprising then, that so many people seek out solutions to their performance anxiety symptoms through medications like Bisoprolol, beta-blockers in general and others like Depakote and Clonidine.

What is Bisoprolol (Zebeta) and how does it help with anxiety symptoms?

Bisoprolol, commonly sold under the brand name Zebeta, is a beta-blocker medication that only comes as an oral tablet.

In India, Bisoprolol is sold under the trade name Bisotab and in Italy, it is sold under trade name Congescor [7].

Bisoprolol works by affecting the response to some nerve impulses in certain parts of the body, like the heart. As a result, the heart beats slower and decreases the blood pressure. When the blood pressure is lowered, the amount of blood and oxygen is increased to the heart [2].

Is Bisoprolol a beta-blocker?

Yes, Bisoprolol is a beta blocker. More specifically, bisoprolol is called a cardioselective beta-blocker, because at low dosages it only works on beta1 receptors in the heart, and is unlikely to affect beta2 receptors located in the airways [3].

For context, beta-blockers (also known as beta-adrenergic blocking agents) work by blocking the effects of adrenergic hormones, such as adrenaline, in the body. Adrenaline typically produces an elevated heart rate, so by blocking adrenaline beta-blockers actively reduce stress on the heart and lower blood pressure [4].

Why do performers take Bisoprolol?

A study performed in 1987 showed that beta-blockers are particularly popular among musicians. The survey, carried out by the International Conference of Symphony Orchestra Musicians who represent some of the largest orchestras in America, found that 27 percent of participating musicians were using beta-blockers to help with their performance anxiety symptoms [5]. Many experts estimate that this number is much higher today.

So why are so many people who regularly face high-pressure scenarios using beta blockers like Bisoprolol, Propranolol & Metoprolol to help with their performance anxiety?

Well, as we previously described, beta-blockers relax the load on your cardiovascular system by blocking the effects of the adrenaline hormone. This has major benefits for anyone about to enter a high-anxiety situation.

Adrenaline is a stress-related hormone. It binds itself to adrenergic receptors in the heart, also known as beta receptors [4]. As a result, the heart has to pump blood with greater force, which causes your blood pressure and heart rate to go up.

Beta-blockers block the effects of adrenaline and prevent it from binding to the beta receptors in the heart. This then means that the heart can return to its regular workload, and your blood pressure can remain steady [6].

So when you are preparing for a high-pressure scenario like giving a talk in front of a large audience, or auditioning or playing music on stage, it is to be expected that you will feel a certain level of stress. In these scenarios, you’ll naturally feel somewhat of an adrenaline rush as a part of that stress response.

As we described previously, when you are experiencing performance anxiety or stage fright, you are experiencing your stress response going too far. The adrenaline hormone is having a much greater effect on you, which causes your heart rate to skyrocket, along with other symptoms of performance anxiety.

As beta-blockers like Bisoprolol and Atenolol block the effects of adrenaline, they also prevent you from experiencing the physical symptoms of performance anxiety.

Remaining physically calm has an overall calming effect, which then allows you to get through your high-pressure scenario. And that is why so many performers use beta blockers like Bisoprolol to help them before getting on stage or facing a nerve-wracking event.

What is the recommended Bisoprolol dosage for anxiety?

If your doctor recommends Bisoprolol for your anxiety symptoms, he or she will recommend the right dosage for you based on your health, medical history, etc.

But here are the typical doses for Bisoprolol for different conditions:

  • Bisoprolol Adult Dose for Hypertension: 5mg orally once a day. If desired response is not achieved, may increase the dose to 10mg, then 20mg if necessary. Maximum recommended Bisoprolol dose is 20mg per day [8].
  • Bisoprolol Adult Dose for Anxiety: 5mg-10mg orally one to two hours before an anxiety-inducing event. Same maximum recommended Bisoprolol dose: 20mg in a single day.

Bisoprolol may be taken with or without food, and is pretty much always recommended that it is taken once per day.

If taking Bisoprolol consistently, note that sudden discontinuation has been associated with an exacerbation of angina, and sometimes myocardial infarction (heart attack) or ventricular arrhythmias. If you need to discontinue bisoprolol, your doctor should advise how to do this slowly over at least a week [3].

Are there any downsides or side-effects to using Bisoprolol for anxiety?

Beta-blockers like Bisoprolol are, in general, pretty safe. But here are some of the potential, albeit rare, side effects of Bisoprolol. Check with your doctor immediately if any of the following side effects occur:

  • If you have diabetes, bisoprolol may mask some of the symptoms of hypoglycemia (low blood sugar) [3].
  • Body aches or pain
  • Chest pain
  • Difficult or labored breathing
  • Ear congestion
  • Loss of voice
  • Pain or tenderness around eyes and cheekbones
  • Shortness of breath or troubled breathing
  • Tightness in chest
  • Unusual tiredness or weakness
  • Wheezing [2]

Severe side effects are quite rare, but if you experience any of the following symptoms after taking Bisoprolol, be sure to contact your doctor immediately [2]:

  • Chest discomfort
  • Lightheadedness, dizziness, or fainting
  • Slow or irregular heartbeat

Bisoprolol requires a prescription

Do note that, assuming your doctor approves of you taking Bisoprolol (or any beta-blockers) for your anxiety, and writes a prescription, you will have to refill that prescription every time you run out.

This will not be an issue if you only plan on using Bisoprolol a few times, but if you start using Zebeta more often, then it could become a significant inconvenience.

Are there any natural alternatives to Bisoprolol?

Let’s look at some natural alternatives to beta-blockers like Bisoprolol.

The obvious advantages to natural alternatives are that you don’t need a prescription, and all of them are beneficial to your health.

The other benefit is that you’re strengthening your mind and body to be less susceptible to stress, and also better equipped to handle a stress response. So instead of artificially blocking the release of adrenaline with beta-blockers, you will be releasing less adrenaline in the first place, and therefore experiencing less performance anxiety [9].

Bisoprolol Beta-Blocker Alternative #1: Brain boosting supplements

The first natural alternative to beta-blockers is using a brain-boosting supplement like PerformZen. I recommend this supplement to many of my clients, and even had an interview with the founders where I share my own review of the supplement. Check that out here.

PerformZen uses natural ingredients like GABA, L-theanine, and others, to reduce stress and help you remain calm under pressure [10]. There are also other ingredients like magnesium and vitamin B6 that work together to increase mental focus [11].

So, you get the best of both worlds. On one hand, you feel calm and relaxed, and on the other hand, you’re better focused so you can concentrate and deliver a great speech or performance.

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Bisoprolol Beta-Blocker Alternative #2: Green, black, and oolong tea

Green, black, and oolong tea are all excellent sources of L-theanine. And L-theanine is one of the ingredients that increases the availability of GABA in your brain. GABA helps you feel more relaxed by reducing excess activity in your brain [12].

So, before a performance, it can calm the nerves by reducing excessive mental chatter and helping you focus on your performance more constructively.

Bisoprolol Beta-Blocker Alternative #3: Diaphragmatic Breathing

‘Diaphragmatic breathing’ is another name for Deep Belly Breathing. This is the process of taking long breaths in and out of your stomach, instead of your chest. It’s the type of breathing that is the foundation for most meditation or relaxation techniques.

When you’re having a stress response, your body switches gears. It turns on something known as the sympathetic nervous system (which admittedly is a strange name for how it feels).

Diaphragmatic breaths deactivate the sympathetic nervous system and switches back to the parasympathetic nervous system. It brings your blood pressure down and restores equilibrium in your body [13].

Next time you start feeling jittery before a performance, close your eyes and start taking deep breaths into your stomach. Repeat till you feel your heart rate getting back to normal. Take a look at our Tactical Breathing guide as an option, too.

So can Bisoprolol help with anxiety? The conclusion

You really do not have to let anxiety control your life/career and prevent you from doing the things you love, especially if that’s performing for an audience or in high-pressure scenarios.

Beta blocker medications like Bisoprolol can provide a much-needed relief from the physical anxiety symptoms so you can get through what you need to do. But Bisoprolol, or other similar medications like Clonidine or Depakote, will never be the complete solution you’re really looking for, which is to not be fearful about performing in front of an audience in the first place.

To overcome performance anxiety in the long term, consider natural alternatives like diaphragmatic breathing, teas high in L-Theanine, and/or a natural alternative supplement like PerformZen.

In the meantime, If you are considering Bisoprolol as a short-term fix for your anxiety symptoms, be sure to consult with your doctor to make sure it is right for you.


Bisoprolol Frequently Asked Questions

Here are some more specific questions and answers about Bisoprolol (Zebeta). If you have your own questions, leave a comment down below or get in contact here.

  • Q: Will Bisoprolol calm me down?
  • A: In short, yes. Beta-blockers like Bisoprolol relax the load on your cardiovascular system by blocking the effects of the adrenaline hormone. This has major benefits for anyone about to enter a high-anxiety situation.Adrenaline is a stress-related hormone. It binds itself to adrenergic receptors in the heart, also known as beta receptors. As a result, the heart has to pump blood with greater force, which causes your blood pressure and heart rate to go up.

    Beta-blockers like bisoprolol block the effects of adrenaline and prevent it from binding to the beta receptors in the heart. This then means that the heart can return to its regular workload, and your blood pressure can remain steady. When preparing for a high-pressure scenario, it is to be expected that you will feel a certain level of stress. You’ll naturally feel somewhat of an adrenaline rush as a part of that stress response. Here, the adrenaline hormone is having a much greater effect on you, which causes your heart rate to skyrocket, along with other symptoms of performance anxiety.

    So Bisoprolol is blocking the effects of adrenaline, which also prevents you from experiencing the physical symptoms of performance anxiety.

    Remaining physically calm has an overall mental calming effect, which then allows you to get through your high-pressure scenario. And that is why so many performers use beta blockers like Bisoprolol to help them calm down before getting on stage or facing a nerve-wracking event.

Take a look at our other solution articles:

Natural Beta Blocker Alternatives for Anxiety
Propranolol Dose For Anxiety
The best Performance Anxiety & Stage Fright books to help you with your fears
Beta Blockers for Anxiety: Guide
SSRI vs SNRI for anxiety
Gabapentin For Anxiety

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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.