Robert Downey Jr Beta Blockers Key Takeaways

If you're looking for a quick, scannable summary of the rest of this article, here are several key takeways about Robert Downey Jr Beta Blockers:

• During his Golden Globe Award acceptance speaker, the actor Robert Downey Jr mentioned taking a beta-blocker prior to going on stage, which social media took to mean that beta blocker medication can be used to overcome anxiety and stage fright
• Beta blockers are a pharmaceutical drug that block the release of adrenaline, and are typically used for heart-related medical issues. Performers like Robert Downey Jr, Khloe Kardashian, Shawn Mendes, Katy Perry and others use beta blockers to help manage their anxiety and stage fright issues
• The most popular beta-blockers available with a prescription in the US are Propranolol, Metoprolol and Atenolol

At the 81st Annual Golden Globe Awards on January 7, 2024, the talented actor and media personality Robert Downey Jr. won a best supporting actor award for “Oppenheimer”, the hit 2023 movie that chronicled the life of J. Robert Oppenheimer, an American theoretical physicist credited with being the “father of the atomic bomb” for his role in the Manhattan Project — the World War II undertaking that developed the first nuclear weapons ^[1].

What stood out to me when I came across the acceptance speech that RDJ gave for this award, was his mention of beta-blockers in subtle reference to his nerves. See for yourself:

Robert Downey Jr. Golden Globe speech where the actor mentions using beta blockers for stage fright

“Yeah, yeah, I took a beta-blocker so this will be a breeze”

That throwaway line in his speech has caused a ton of people to email me asking about beta blockers, what they are and how (if?) they work? I’ve talked about beta-blockers extensively on PerformanceAnxiety.com but I figured this is a fantastic chance to summarize what the prescription medications are, why so many actors and celebrities seem to use beta-blockers for their anxiety (Khloé Kardashian being another celeb example!) and what the downsides & side-effects are. Ultimately, we will figure out if beta blockers are actually an effective tool to fight anxiety.

What Are Beta-Blockers?

Although it’s hard to completely pinpoint, it is said that a 1965 article in a medical journal/magazine called The Lancet about the use of Beta Blockers to help with stage fright and performance anxiety is what has caused the popularity of a heart medication drug amongst musicians, actors, public speakers, surgeons, and people of all kinds who regularly face down anxiety.

The late Oboist and ‘Mozart in the Jungle’ author, Blair Tindall, wrote about beta-blockers in a 2008 article for the Guardian newspaper ^[2]:

Beta blockers are not recreational drugs. They do not affect cognitive abilities, but instead block adrenaline-like chemicals in the human system. For a violinist, this means performance can feel like practice, with no bouncing bow or slippery fingers.

Called beta-adrenergic blocking agents in full, beta blockers are a class of pharmaceutical drugs that block the release of adrenaline hormone (also known as epinephrine) in the body ^[3].

Doctors typically prescribe beta-blockers to help with heart and blood pressure issues; including abnormal heart rhythm, high blood pressure, angina, glaucoma, and other (mostly cardiac) conditions ^[4].

Why Are Robert Downey Jr. and other celebs using beta blockers for anxiety?

When consumed, beta-blockers relax the load on the cardiovascular system by blocking the release of adrenaline, a stress-related hormone. Adrenaline typically binds to adrenergic receptors in the heart, called beta receptors ^[5]. As a result, the heart has to pump blood with greater force, which causes blood pressure and heart rate to go up.

What beta blockers are doing is blocking the release of adrenaline into the system in the first place, meaning the stress hormone cannot bind to beta receptors in the heart and the heart can maintain its typical (non-stressed and steady) workload, which also keeps blood pressure steady (explaining why beta-blockers are normally prescribed for people with high blood pressure and hypertension).

Actors and performers like Robert Downey Jr. are using beta-blockers ‘off-script’ (meaning for a purpose other than what it was initially developed for) in order to stave off adrenaline release into their systems. But they are not worried about hypertension or high blood pressure; instead they are concerned with stopping the performance anxiety symptoms that adrenaline directly causes! Too much adrenaline leads to a stress-response in humans, so if we can block adrenaline release we can typically remain physically (and often mentally) calm, which then allows performers to get through their speeches or high-pressure engagements while keeping their natural stress response at bay ^[4].

What are the most popular Beta Blockers?

Here is a list of the most popular beta-blockers available in the US today. If you’re considering any of these beta-blockers, or any other medications for performance anxiety, you must speak to your doctor before you begin taking them. This is especially critical if you’re currently on any other medications, to avoid any negative interactions:

• Propranolol
• Metoprolol
• Acebutolol
• Carvedilol
• Atenolol
• Bisoprolol
• Nebivolol

Propranolol (generic name Inderal) is the most common beta blocker when it comes to people using them for anxiety symptoms. Propranolol is also the most commonly prescribed beta blocker in the US, overall.

There are other medications that people commonly use off-script for anxiety, like Clonodine, Gabapentin and Depakote, but these are not technically beta-blockers so are not covered here.

Side-effects of Beta-Blockers

As long as they are only used occasionally, beta-blockers are considered to be relatively safe with minimal risk of side effects (Note: this is not medical advice, please consult a medical professional before using beta-blockers or any prescription drug!)

Problems can arise, however, if beta-blockers are needed in order to be able to perform, as this is when frequent usage can happen. When consumed frequently, beta-blockers can have a risk of dependency, and withdrawal could cause other unforeseen problems like high blood pressure.

So, beta-blockers are considered safe to use when a quick and temporary solution is needed, but it might be a good idea to start incorporating some natural alternatives to beta-blockers when looking for a more long-term or frequent solution to performance anxiety.

My most recommended alternative to beta-blockers for anxiety purposes is PerformZen supplement, which we reviewed here.

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Other celebrities using beta-blockers for anxiety

There are several celebrities who have recently talked openly about their use of beta-blockers in order to fight off their anxiety symptoms, besides Robert Downey Jr. Some popular examples include:

Katy Perry

The singer, songwriter & American Idol host talked about her use of beta blockers to help with her anxiety and stage fright during an interview with Cosmopolitan magazine. She stated that she “had a crippling fear that she would let everyone down, and so she used [beta blockers] to overcome performance anxiety” ^[6].

Katy Perry made it abundantly clear that her stage fright does not come from lack of preparation, but from a fear that “fans will rush the stage or that I’ll vomit on stage during a performance”

The singer feels intense pressure to ensure that she fends off competition from rivals in the music industry ^[7]:

“I have to take beta blockers [before each show], I get so nervous. [I think] that I have to get through this; I can’t let these people down, but mostly I can’t let myself down. I’ve been given a great opportunity and there are 500 bitches behind me who will snatch my weave off my head if I don’t kick-ball-change through this two-hour show.”

Whitney Cummings

The comedian Whitney Cummings, in an interview with Everyday Health, talked about her chronic migraine issues and how it led to her discovering beta-blockers to manage her anxiety that would come with her worry about said migraines ^[8]:

[The migraine attacks] started when I was a kid. I remember going to Disneyland, and being the person who ruined the trip because Whitney has to go to the car and put a pillow over her head. A trip to Six Flags amusement park had to be cut short because Whitney has a migraine. I feel like I was always the bummer in my childhood.

…A big one of my migraine triggers is an increase in adrenaline and cortisol — which comes from stress, which we all have. It’s a neurological imbalance.

…Sometimes the stress leading up to something can trigger the migraine, and even the stress of anticipating a migraine can bring one on.

…I take beta-blockers now, which help hugely. I didn’t find out about them until about three years ago. I know if I have a big meeting, or a big audition, or a big performance, or anything where I know I’m going to be nervous, I just take one preemptively, so that I’m not blasting my brain with adrenaline.

My goal is to keep my neurochemicals, my hormones, and my blood sugar levels as consistent as possible.

Shawn Mendes

While on a global tour, Canadian singer Shawn Mendes did an interview with Capital FM where he stated that he was finding his continuous performances difficult. He said he got so nervous for his live shows that he “needed medication to calm him for over a year” ^[9].

Here’s the social media post where Shawn Mendes opens up about his struggles with anxiety and pre-show nerves ^[10]:

.@ShawnMendes opens up to his fans about his anxiety, revealing that today is the first show in one year that he hasn't taken medicine to help him calm down. pic.twitter.com/GwbWOBDJtJ

— Pop Crave (@PopCrave) April 6, 2019

Do Beta-blockers work for anxiety?

Despite only a few celebrities being open about their stage fright & anxiety issues, it is clear that people within show biz are suffering from these issues and some, like Robert Downey Jr are (very) familiar with the use of beta-blockers to help overcome them.

There is definitely a little comfort to be had in knowing that even the most successful actors, singers and performers – the very people we think of as the most confident – also face the same self-doubt and insecurity that the rest of us do.

It’s clear that beta-blockers are one solution to anxiety issues, and we have written about beta blockers for anxiety use before. If you are looking for an alternative to beta-blockers for your own performance anxiety, however, check out our article covering natural beta blocker alternatives here.

With severe cases of performance anxiety before a speech or presentation, you might consider using a beta-blocker like Metoprolol, sold over-the-counter as Lopressor. Metoprolol is a selective beta-blocker typically prescribed for high blood pressure and other heart-related issues ^[3]. Metoprolol is also used off-label by performers struggling with stage fright and performance anxiety issues.

The same function that makes Metoprolol effective for blood pressure issues also makes it useful for anxiety. As with any drug, however, Metoprolol does have some side effects (albeit rare) that you need to be aware of, along with other particulars about the medication as there’s no one-size-fits-all in medicine. This article looks at how Metoprolol works, its side effects, dependency risks, and several reviews from users talking about its effectiveness in treating performance anxiety symptoms.

What Is Metoprolol?

Metoprolol is a type of medication that falls under the beta-blockers drug class. Like other popular beta-blockers such as Propranolol, Metoprolol is a prescription drug mostly used for treating cardiovascular conditions such as angina (chest pain) and hypertension. Metoprolol was approved by the FDA under the name Lopressor in 1978 ^[4].

While Metoprolol is most frequently used for treating high blood pressure, the drug isn’t typically the go-to medication for doctors treating cardiac conditions. Your physician might start with other medications like diuretics first, only moving to beta-blockers like metoprolol when other treatments prove ineffective.

A doctor might also prescribe Metoprolol for irregular heartbeats and to increase a persons chances of survival after suffering from heart failure or heart attack ^[5].

Metoprolol and other beta-blockers have also proven effective in preventing migraines and some types of tremors cause by the drugs used in treating mental disorders ^[5]. All of these use cases see the drug prescribed over 27 million times annually in the US.

Here’s an excellent video explaining Metoprolol for anxiety purposes:

Detailed video all about the beta-blocker Metoprolol and how it works for overcoming performance anxiety

Why Is Metoprolol So Popular Amongst Professional Performers?

Research shows that 20-30% of musicians in the world today use beta blockers like Metoprolol to deal with performance anxiety ^[6]. This number is gradually increasing within all sectors of the performing arts community, with Metoprolol (Betaloc or Lopresor) and Propranolol (Inderal or Angilol) being the go-to options for many.

Most professional performers take Metoprolol to manage the physical symptoms of anxiety and to prevent the body’s fight-or-flight response that comes with being nervous ^[6]. This use for Metoprolol is considered “off-label” use by the FDA and they warn that you might also experience some side effects like fatigue, heartburn, and nausea ^[7]. However, many public performers believe that the benefits of the drug far outweigh the side effects.

Beta-blockers like Metoprolol work by lowering the stress level in your cardiovascular system ^[8]. Metoprolol reduces the force which your heart pumps blood, creating a relaxing effect. According to research, beta-blockers (beta-adrenergic blocking agents) block adrenaline effects on your body ^[9]. Adrenaline is a stress-related hormone that binds with the beta receptors in your heart, making it pump faster and harder.

By limiting the release of the adrenaline hormone, beta blockers can prevent your heart from pumping fast and hard. This keeps your blood pressure low, reduces the stress on your cardiovascular system, and even controls your performance anxiety symptoms, helping you overcome your stage fright.

How Does Metoprolol Relate To Performance Anxiety

To understand how Metoprolol can help you combat performance anxiety, it’s important to understand what stage fright is and why you might experience physical symptoms of stage fright/performance anxiety in the first place.

What is Performance Anxiety?

Performance anxiety is simply a set of physical symptoms that some people may experience before performing in front of an audience or while under pressure ^[1]. This happens because of an underlying fear of getting negative outcomes. Some people fear that they might fail, get judged negatively, or feel humiliated for their performance.

While the main reasons why people suffer from stage fright are complex, researchers attribute performance anxiety to a combination of physical, environmental, mental, and emotional factors ^[10]. However, when it comes to performing, it’s the physical symptoms that limit performers from presenting at an optimal level.

Some of the symptoms that you may experience when suffering from performance anxiety include ^[1]:

• Excessive sweating
• Rapid heartbeats (heart palpitations)
• Sweaty and cold palms
• Trembling of the lips, hands, knees, and voice

In severe cases of performance anxiety, you might experience nausea, blurred vision and even vomiting. These physical symptoms of performance anxiety are a result of how your body responds to stress.

When your body perceives a stressful situation, it activates your fight-or-flight response and causes an increase in the release of the adrenaline hormone. This adrenaline boost is entirely normal for some people, even enhancing the performance of some because of the added intensity. For others, the adrenaline spike is too much to handle and their body’s stress response goes overboard, to the point that it’s almost impossible to perform. If the stage fright is too severe, it can affect your confidence levels and hold you back from pursuing a life or career that you love. That’s exactly why many public performers turn to beta blockers like Metoprolol.

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How Metoprolol Helps Performers

When you take Metoprolol ahead of a public performance, a date, or an exam, you’re effectively limiting the physical symptoms of performance anxiety from appearing. In the absence of the physical symptoms of stage fright, you’ll feel more relaxed when performing in public, allowing you to get through your audition, interview, or speech.

Typically, your physician will prescribe your Metoprolol dosage depending on your individual needs. The normal Metoprolol dosage for treating anxiety symptoms ranges from 50-100mg per day and it can be administered once or divided into several doses ^[11].

Depending on how a patient responds to the first dosage, your doctor might recommend increasing your daily Metoprolol intake. However, the maximum dosage recommended is about 450mg per day ^[11]. As such, patients should be careful to avoid exceeding the recommended Metoprolol/Lopressor dosage as taking too much can be dangerous.

What Are the Commonly Known Side-effects of Metoprolol?

Lopressor/Metoprolol (and beta-blockers in general) are widely considered as safe to use, but there are some reported side effects, albeit rare. Reported Metoprolol side-effects include nausea, sweating, heartburn, dry mouth, irritability or mood swings, and gut issues like bloating, gas, and constipation ^[11].

More severe side-effects of Metoprolol are even more rare, but if you are experiencing any of these listed symptoms after taking this beta blocker, be sure to contact a physician immediately ^[12]:

• Shortness of breath
• Fainting
• Unexplained swelling of your feet, hands, and/or ankles

Generally speaking, using Metoprolol to assist with anxiety symptoms doesn’t have too many downsides. I would say, however, that Metoprolol does have several limitations:

1. Metoprolol is only a temporary solution to performance anxiety as it doesn’t address the root cause of your stage fright. Metoprolol is only a quick fix to the physical symptoms of anxiety. ^[7]
2. You’ll need a prescription for Lopressor or Metoprolol if you’re in the United States (and several other countries where the medication is popular). That means you must visit your physician every time you run out; which can be an inconvenience if you use the drug frequently.
3. Metoprolol may interact with other medications including antipsychotics, antidepressants, and other blood pressure medications.
4. While there is not adequate study on the use of Metoprolol in pregnant women, animal studies show that Metoprolol can be excreted through breast milk ^[12].

Is There A Risk Of Addiction Or Dependence With Metoprolol?

While Metoprolol is not generally considered to be physically addictive, there is a risk of developing psychological addiction and/or dependence on the drug. This risk is likely to be higher for people who regularly use Metoprolol for anxiety, like public speakers and musicians who rely on the its calming effects regularly.

A more common concern is the withdrawal symptoms associated with stopping the use of Metoprolol abruptly, or after taking it consistently over a long period of time ^[13]. According to research, the withdrawal symptoms of Metoprolol after continued use may include headaches, chest pain, and even heart palpitations ^[14]. Sudden withdrawal from Metoprolol may also exacerbate angina and increase risk of developing a heart condition later in life.

Abruptly stopping the use of Metoprolol after prolonged use has anecdotally been shown to sometimes cause anxiety symptoms. As such, Metoprolol users should reduce their dosage gradually over several weeks, as per their doctor’s instruction. You should also visit your doctor immediately if withdrawal from Metoprolol causes anxiety symptoms.

Metoprolol For Anxiety Reviews

Considering that Metoprolol is one of the most prescribed beta blockers in the US, it is not surprising that there are plenty of Metoprolol reviews online. We have honed in on the reviews focusing on Metoprolol use for alleviating anxiety symptoms. Sometimes the reviews outright state that, and other times we extracted the context while giving some feedback from a professional perspective.

Metoprolol Review #1: For High Blood Pressure & Physical Anxiety Symptoms

My Thoughts

This is one of the Metoprolol reviews that stuck out to me the most. The main reason is the initial Metoprolol intended use of helping with high blood pressure and physical anxiety symptoms. The reviewer is a young female with a healthy diet and, reportedly, no aggravating lifestyle factors.

As the reviewer mentions, Metoprolol was not the first solution that she had tried for high blood pressure and anxiety. After trying meditation, breathing exercises and other over-the-counter medications to reduce her anxiety symptoms and remain calm, nothing seemed to work. That explains why her physician prescribed Metoprolol beta-blockers as they’re usually effective where other solutions may have failed.

The user also mentioned using diuretics and ACE inhibitors, but Metoprolol has the biggest effect on her symptoms. According to her, skipping a dose of Metoprolol can make her skip work, unlike the other two medications she uses. Honestly, it’s unclear whether this is because she experiences withdrawal symptoms due to prolonged use, but I suspect it’s because of the calmness that Metoprolol can give to anxiety sufferers.

Metoprolol Review #2: Heart Palpitations and Panic Attacks

My Thoughts

This reviewer was grateful to have found a solution that helped with his palpitations by slowing down his heart rate. As explained earlier, Metoprolol blocks adrenaline effects by binding with adrenergic receptors, lowering your blood pressure, so this makes sense ^[9].

By blocking the release of adrenaline, Metoprolol prevented the reviewer’s heart from going into overdrive, keeping his blood pressure low and keeping his panic attack symptoms at bay. However, the reviewer does complain about having some pretty severe side-effects like chest pain, migraines, fatigue, tingling feet and hands, and a burning sensation in his chest.

Side effects like heartburn, nausea, and gut issues that may affect the loss of appetite are potential side-effects/downsides of Metoprolol. Unfortunately for the user, Metoprolol also significantly dropped his heart rate to dangerous levels, and it was wise for him to seek immediate help from a physician.

Because the reviewer claims to have stopped taking Metoprolol for over a month, and yet still experiences these negative side-effects: it might be worth consulting a physician again. I say this because Metoprolol may worsen heart failure symptoms in some patients. The symptoms include extreme fatigue and chest pain or discomfort, consistent with the reviewer’s current symptoms.

Metoprolol Review #3: Metoprolol Helps Migraines?

My Thoughts

Often prescribed for high blood pressure and heart palpitations, Metoprolol can also act as a great tool to preventing migraine attacks. People with migraines often suffer from too much blood supply in the blood vessels within their brains, causing the infamous pounding feeling. Metoprolol helps to keep things narrow and straight, reducing the incoming blood traffic in your brain.

According to this reviewer, Metoprolol was an effective solution for their migraines and helped them remain calm. It also exponentially helped her with the heart palpitations and anxiety that come with the onset of hyperthyroidism. Hyperthyroidism is a condition that makes your thyroid glands produce too much thyroid hormone; causing anxiety, fatigue, difficulty concentrating, heart palpitations, and nervousness ^[15].

Despite its effectiveness, the patient reported several adverse effects to Metoprolol including constipation, temporary dizziness, and discomfort.

These side effects are fairly common with people who use Metoprolol alongside other medications, even though this reviewer states that these effects are only a minor inconvenience compared to the benefits. However, I would recommend visiting a doctor if symptoms like fainting become an issue while using Metoprolol.

Metoprolol Review #4: Asthma and Anxiety

My Thoughts

While Metoprolol does not address the root cause of your anxiety, this reviewer found it useful in lowering high blood pressure. The user previously tried using other beta-blockers (Propranolol), but it proved to be risky as it could induce breathing problems for asthmatic people.

While most doctors are hesitant to prescribe non-selective beta-blockers like Metoprolol to asthmatic people ^[16], the benefits seem to outweigh the risks for many people, including this reviewer. Metoprolol has been shown in some studies to exacerbate asthma symptoms ^[16], and that’s why they its only prescribed in low doses to asthma sufferers who have tried using other therapeutic solutions to their anxiety issues without results.

So What Do These Metoprolol Reviews Tell Us?

For many performers and people regularly facing high-anxiety scenarios, stage fright or performance anxiety can become debilitating to the point where it’s impossible to perform. For countless others, it can hold them back from getting their dream job, getting a date, and/or landing their dream job. Fortunately, beta-blockers like Metoprolol can give you much-needed relief from the physical symptoms of anxiety. However, the reported Metoprolol side-effects can be quite bad, as these reviews show, and might prevent you from considering this beta-blocker.

My advice is that you consult a medical expert when considering using Metoprolol to help with your anxiety symptoms. Discuss how some of these side-effects could play out for you, and make sure there’s no negative interactions with other drugs & medications that you use.

I know that’s perhaps not the clear-cut advice that you want to hear: but we are all too different to offer ‘one-size-fits-all’ advice on beta-blocker usage. Understand what the risks and benefits are for you, and make a decision accordingly.

Metoprolol Reviews Frequently Asked Questions

I received some emails/comments from readers who had more specific questions about Metoprolol. I’m publishing my responses here to refer people to in future. If you have your own questions, leave a comment down below or get in contact here.

In my time working with clients suffering from performance anxiety and generalized anxiety issues, as well as in writing about propranolol here on PerformanceAnxiety.com (see ‘Propranolol vs Metoprolol for Anxiety‘ & ‘Ultimate Guide To Propranolol‘ & ‘Propranolol Dosage For Anxiety‘) I have come to learn that while Propranolol is widely-used — being the most commonly prescribed beta-blocker medication in the US and also the drug most commonly used by those I have surveyed as an off-script aid for anxiety-related issues — it is not without its detractors and critics.

A recent client of mine had been experiencing some fairly severe side-effects from Propranolol since she started using the beta-blocker several years ago, and had gone on a deep-dive to see if she was alone with her experiences. She pulled up as many Propranolol reviews as she could find that leaned towards, or plainly mentioned, using propranolol for anxiety purposes, and she forwarded them all to me in a neatly-formatted google doc. I asked her permission to share my feedback on all of these propranolol reviews for anxiety purposes here in article format, so that others might also be able to understand Propranolol, it’s side-effects & potential downsides, and ultimately judge for themselves if they want to use Propranolol to help with their own anxiety symptoms. My client obliged, so below I will go through some of the propranolol reviews that I found, offer my thoughts and feedback and link through to the reviews source so you can read further, if you like.

But first, it’s worth explaining what Propranolol is, how it works and why it’s so popular amongst performers and those who regularly face high-anxiety situations (think those who perform in front of crowds for a living like public speakers & actors facing auditions)…

What is Propranolol?

Propranolol is the most commonly prescribed beta-blocker medications in America. Beta-blockers, which have the full medical name beta-adrenergic blocking agents, work by blocking the effects of adrenergic hormones in the body; the main one being adrenaline ^[1].

Doctors typically prescribe beta-blockers to treat various heart conditions, if lifestyle adjustments fail to do the job.

Here are some of the typical conditions for which your doctor might recommend a beta-blocker like Propranolol ^[2]:

• High blood pressure
• Irregular heartbeat
• Angina (chest pain)

Beta-blockers can help those with cardiovascular issues by influencing the force with which your heart pumps blood.

Sometimes, beta-blockers like propranolol are also prescribed for conditions like migraines, and harmless tremors of the arms, hands, etc ^[3]. Propranolol is sold over the counter in the US under the following brand names:

• Inderal
• Inderal LA
• Hemangeol
• Inderal XL

Propranolol requires a prescription from your doctor, whether you need it for a heart condition, or you’re considering beta-blockers for performance anxiety ^[1].

Here’s an excellent short video all about Propranolol usage for anxiety:

A quick video all about the beta-blocker Propranolol & it’s uses for anxiety

Why is Propranolol so popular amongst professional performers?

In a, now famous, 1987 survey by the International Conference of Symphony Orchestra Musicians, representing some of the largest orchestras in the U.S., it was found that 27 percent of their participating musicians were using beta-blockers for performance anxiety ^[4]. Many experts assume that this number is much higher today.

Beta-blockers like Propranolol block the effects of adrenaline and prevent it from binding to the beta receptors in the heart. This has an overall calming effect on the heart and the force with which it has to pump blood. Consequently, the heart can return to its regular workload, and your blood pressure can remain steady ^[5].

An exaggerated stress response like what a performer experiences when suffering from performance anxiety, is associated with a dramatic spike in adrenaline.

So, by blocking the effects of adrenaline, you are preventing it from binding to the beta receptors in the heart. So, beta-blockers essentially block the physical symptoms of performance anxiety.

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When you take a beta-blocker like Propranolol, it can slow your heart rate, reduce the trembling and sweating, and regulate your breathing and blood pressure. It can help you feel relaxed, essentially negating the stress response to help you get through any performance or high-anxiety situation.

You can easily see why a performer would find massive value in being able to block performance anxiety or stage fright, almost on-demand, using propranolol!

It is worth noting that each individual is different, especially when it comes to causes of anxiety. We also vary widely in symptoms, the severity of those symptoms, and how we react to specific medications. So, how you respond to a beta-blocker can be different from someone else ^[6].

What are the commonly known side-effects of Propranolol?

While Propranolol is a commonly prescribed drug, and shows efficacy (effectiveness) for a number of conditions (including anxiety), it does have some reported side effects.

These side effects may vary in intensity from person-to-person. Depending on the severity of the condition Propranolol is prescribed for, the side effects may be worth it. In other cases, these side effects may be enough to make people want to consider alternative treatments to beta-blockers like Propranolol.

Here are several reported Propranolol side effects ^[2][7]:

• Dizziness or feeling lightheaded
• Fatigue or weakness
• Dry eyes
• Cold fingers and toes
• Nausea
• Stomach pain
• Diarrhea or constipation
• Low heart rate
• Low blood pressure
• Trouble sleeping or vivid dreams
• Decreased sex drive
• Mood changes or depression
• Memory loss
• Hallucinations
• Anaphylaxis (allergic reaction)

It has been estimated that at least 1 in 100 people experience some form of side-effect when taking Propranolol ^[2].

Propranolol can cause light-headedness and fatigue, due to the way that Propranolol reduces heart rate and blood pressure. This also slows circulation, which can lead to coldness in the fingers, hands, toes and feet in more serious cases.

Additionally, side effects such as personality or mood changes, and memory issues can happen because Propranolol slows the release of certain hormones, such as epinephrine (adrenaline).

These hormones, released as part of the bodies fight or flight response, also act as neurotransmitters ^[8]. Thus, when you alter the release of these hormones, you may encounter neurological issues.

Altogether, these side-effects are generally pretty rare, but do occur in some cases.

Is there a risk of addiction/dependence with Propranolol?

Propranolol is not considered to be a physically addictive substance. Yet there is still a risk of developing a psychological dependence to this drug ^[9].

The risk is likely to be greater for someone taking Propranolol for anxiety, particularly professionals who rely on the calming effects of Propranolol on a regular basis.

While it’s not a widely discussed issue, there are cases reported of Propranolol abuse, most commonly due to the positive effect it can have on symptoms of anxiety ^[10].

A more common issue is Withdrawal symptoms when stopping Propranolol abruptly, or after taking Propranolol for a long time. Studies have shown symptoms such as chest pain, headache, palpitations and sweating from Propranolol withdrawal ^[11]. You may also experience a dangerous spike in blood pressure and/or heart rate when going off it all of a sudden ^[12].

If you do stop taking Propranolol, you should consult with a medical professional first, in order to discuss a plan to safely get off your medication. A taper-down period of four to seven days is often recommended to avoid any withdrawal issues ^[13].

Propranolol For Anxiety Reviews

Considering that Propranolol is the most prescribed beta-blocker in the US, it should come as no surprise that there’s now plenty of Propranolol reviews available online. As I mentioned at the top of this page, I honed in on the reviews that are focused on Propranolol being used for anxiety purposes (sometimes the review just out-right states this, other times I extracted this context myself) and below, I’m going to share these reviews and provide some feedback from the perspective of a professional who helps clients overcome their anxieties and perform/operate at their best.

Propranolol Review #1: Panic attacks, anxiety, tachycardia and public speaking

My Thoughts

This is one of the propranolol reviews that stuck out to me the most. The main reasons being the initial intended use of helping with random panic attacks, as well as generalized anxiety and mild Tachycardia (a condition where your heart rate is regularly more than 100 beats per minute ^[14]) and the mention of propranolol being useful for public speaking engagements.

As the reviewer mentions, Propranolol worked to helped solve their generalized anxiety, random panic attacks and mild Tachycardia — but came with some pretty severe side-effects that make it arguable if the medication was worth using, or if the person should consider some Propranolol alternatives.

The user mentioned “unusual loquaciousness”, or a desire to vocalize all of their thoughts while using Propranolol. To be honest, this is the first time I have heard of such a side-effect, but I suspect this was just the reviewers unique way of describing unusual mental quietness, which is an effect I’ve experienced when using propranolol myself, or listening to my clients experiences doing so. For most people, our minds are constantly racing with numerous thoughts at differing levels of consciousness (imagine holding a broad to-do list for your day, information about an ongoing conversation you’re having over messages with your friend, thoughts and plans about the current days work you’re currently engaged in plus 15 other data points, all at once. Our minds are fast-driving engines from birth until death, looked at through a certain lens). If we quieten all this mental noise down, we’re left with an unusual level of clarity that, for some, might leave them excited and “chatty” about this hyper-clear thought!

The effects on memory can happen, but there are other lifestyle choices that can be a much stronger catalyst for things like this (poor sleep being a major one) so there is a chance that the reviewer over-attributed this to Propranolol. Shortness of breath linked with lowered blood pressure caused by Propranolol also sounds likely, but the same issue of over-attribution could be occurring too.

It’s unfortunate to hear about the reviewers stints with alcoholism and job issues experienced due to their anxiety issues, so I am glad to hear that Propranolol was relatively effective in solving some of their problems. I would heavily consider looking at beta-blocker alternatives for this particular reviewer, to help with these severe side-effects.

Propranolol Review #2: The Propranolol Evangelist

My Thoughts

This reviewer was obviously happy to have found a solution to their performance anxiety issues! In our article about Propranolol vs Metoprolol for anxiety, we revealed that propranolol does work just as the reviewer states for performance anxiety:

…beta-blockers like Propranolol and Metoprolol work by blocking the effects of adrenaline. They reduce the force with which your heart pumps blood and help stabilize blood pressure, heartbeat, etc ^[15].

Beta-blockers keep the jitters at bay in a similar manner, by blocking the effects of adrenaline.

The reason you experience extreme nervousness before a performance is because your body goes into survival mode.

Even though you’re not in actual physical danger, the fear of rejection, humiliation, failure, etc. is strong enough to the extent that your brain perceives the situation to be a real threat.

Your body reacts with what is known as a stress response ^[16]. It shuts down any functions that aren’t necessary for survival (which is why you get that gut-wrenching feeling), and gets ready to fight, or run fast, to survive.

That is why your heart starts racing, your palms get sweaty, and your blood pressure skyrockets.

When your body goes into survival mode, it releases stress hormones, including adrenaline. And it is the adrenaline that is responsible for ramping up your cardiovascular system to the point where it results in the jittery symptoms of stage fright.

And by blocking the effects of adrenaline, beta-blockers help your heart maintain its natural rhythm and prevent anxiety symptoms.

Propranolol Review #3: Effects on blood pressure

My Thoughts

It is known that low blood pressure is a long-term effect of Propranolol (that is, after all, what the drug is commonly prescribed to do: lower blood pressure). We’ve also mentioned on our Propranolol page that users need to be careful about coming off of Propranolol too quickly, as it does present significant risk:

Propranolol does not come with a high risk of addiction or dependency. However, there is a risk of Propranolol withdrawal if taken for a long time and abruptly stopped.

The symptoms of withdrawal are consistent with a spike in blood pressure, and can be serious ^[17]. For this reason, it’s recommended to taper off over a period of four to seven days after long-term use ^[18].

Propranolol Review #4: Don’t struggle alone

My Thoughts

I wanted to share this review specifically to highlight a note made by the writer: “For anyone struggling with anxiety, please don’t struggle alone, or in silence. We are fortunate enough to be alive at a time when there are all sorts of medical solutions available and they really do work.”

This is exactly the mentality we operate on at PerformanceAnxiety.com ~ there are solutions to anxiety and you don’t need to struggle alone. We aim to be your companion in overcoming your anxiety issues.

So what do the Propranolol Reviews tell us?

There are plenty more Propranolol reviews that you can read online if you’re curious, to get started in your search I recommend WebMD, IWantGreatCare & Drugs.com

The biggest takeaway from reading all of these reviews is that Propranolol can be effective, but comes with some pretty serious side-effects for some users. If you are considering using propranolol (or any other beta-blocker like Metoprolol, Coreg/Carvedilol or Atenolol) to help with your anxiety issues, please speak with a medical professional and consider looking at some natural alternatives to beta blockers first.

Propranolol Reviews Frequently Asked Questions

I received some emails/comments from readers who had more specific questions about Propranolol. I’m publishing my responses here to refer people to in future. If you have your own questions, leave a comment down below or get in contact here.

Both of these companies seem to offer access to medications that can help with performance anxiety and stage fright, all through a seemingly easy process that involves a consultation with a doctor (I’m assuming online or over the phone — perhaps both?) and reasonable pricing plus timely delivery of the actual medication following that.

I’m super intrigued by these startups who seem to be on the same path I am; to overcome performance anxiety and fears that come with performing in social, high-pressure or large audience situations. How legit are these startups? Are the ‘consultations’ with real doctors or a young-teenager in an overseas call-center? What medications do they prescribe and deliver and — the ultimate question — do they actually work?

And so, of course, I went through the consultation and order process of both Hims & Kick in order to answer all of these questions (and much more). In this article I share my findings and finally answer the question: Hims vs Kick – who provides the best service and anxiety medications online?

What is Propranolol, The Beta Blocker that both Hims & Kick prescribe?

Both of these companies offer Propranolol as their performance anxiety treatment. Propranolol is a beta blocker and we’ve written in-depth about several different beta-blockers that are used off-script for performance anxiety (Metoprolol, Coreg, Bisoprolol, Atenolol, etc.) and out specific resource on Propranolol can be seen here for a deep-dive into why Propranolol works for anxiety.

A quick video explaining how the beta-blocker Propranolol can be used for anxiety

Propranolol is actually the most commonly prescribed beta-blocker in the US. Beta-blockers, full medical name beta-adrenergic blocking agents, work by blocking the effects of adrenergic hormones in the body, such as adrenaline.

Doctors typically prescribe beta-blockers to treat various heart conditions, normally after lifestyle adjustments fail to do the job. Some of the typical conditions for which a doctor might recommend a beta-blocker include ^[1]:

• High blood pressure
• Irregular heartbeat
• Angina (chest pain)

Another condition that Propranolol is sometimes used for is benign essential tremors, a disorder that can cause uncontrolled shaking in the arms, hands, or your torso.

With cardiovascular issues like those listed above, beta-blockers are useful in influencing the force with which the heart pumps blood through the body, and this happens through the medication blocking the effects of adrenaline and preventing it from binding to the beta receptors in the heart.

In the process of blocking the effects of adrenaline, a calming effect is felt (by the heart, and then the rest of the body) and the heart can return to its regular workload, allowing blood pressure to remain steady ^[2].

Why is Propranolol popular with performers like musicians, speakers & other professions that involve getting on stage?

A 1987 survey by the International Conference of Symphony Orchestra Musicians, representing some of the largest orchestras in the U.S., found that 27 percent of their musicians were using beta-blockers for performance anxiety ^[3]. Many experts assume that this number is much higher today.

As we previously explained, Beta-blockers like Propranolol block the effects of adrenaline and prevent it from binding to the beta receptors in the heart. This has an overall calming effect on the heart and the force with which it has to pump blood. Consequently, the heart can return to its regular workload, and your blood pressure can remain steady ^[2].

An exaggerated stress response like what a performer experiences when suffering from performance anxiety, is associated with a dramatic spike in adrenaline.

So, by blocking the effects of adrenaline, you are preventing it from binding to the beta receptors in the heart. It follows, then, that beta-blockers essentially block the physical symptoms of performance anxiety.

When you take a beta-blocker, it can slow your heart rate, reduce the trembling and sweating, and regulate your breathing and blood pressure. It can help you feel relaxed, essentially negating the stress response to help you get through any performance or high-anxiety situation ^[4].

You can easily see why a performer would find massive value in being able to block performance anxiety or stage fright, almost on-demand, using propranolol.

We should make a note that each individual is different, especially when it comes to causes of anxiety. We also vary widely in symptoms, the severity of those symptoms, and how we react to specific medications. So, how you respond to a beta-blocker like propranolol can be vastly different from someone else ^[5].

Does Propranolol actually work for Anxiety?

Compared to other beta blockers and other anxiety medications such as Coreg and Bisoprolol, Propranolol has proven to be an effective tool for overcoming anxiety with minimal side effects if used properly.

Propranolol has proven so effective in recent years that several prominent celebrities have gone public about their use of the beta-blocker medication, including singers Shawn Mendes and Katy Perry, as well as comedians Whitney Cummings & Bobby Lee.

So it has been shown that propranolol works as an effective short term relief from the physical symptoms of stage fright. If a musician takes Propranolol before going on stage, he or she might still feel the stress, but not the symptoms like trembling hands, racing heart rate, or nausea.

It should be noted that when people talk about taking beta-blockers for performance anxiety, it is important to note that they are not talking about addressing the root causes of the fear, or a long-term solution.

They are talking about a short-term fix. But Propranolol is a short-term fix that can be the difference between whether someone gets to keep pursuing a career in performing, or give up on their passion and move on to something else.

As useful as they may be, you shouldn’t expect beta-blockers like propranolol to completely cure your performance anxiety in the long run if you do choose to take them.

Why Propranolol for Performance Anxiety Instead of Xanax or Valium?

Benzodiazepines such as Xanax & Valium belong to a class of drugs that have a tranquilizing effect and thus have been used to treat anxiety disorder, agitation, muscle spasms, and many other conditions for nearly six decades.

We wrote an entire article about how Benzodiazepines like Xanax & Valium compare to Propranolol for the purposes of performance anxiety, but I would say that the main differences can be summarized as addiction risk, brain and heart functions of the two drugs and medium-term vs one-off usage.

Addiction Risk

Xanax, in particular, is a controlled substance and has become an often abused drug due to what’s known as the “Xanax high”. It is fairly easy to develop a tolerance to Xanax and the drug is abused by people both with and without a prescription ^[6].

Signs of Xanax abuse include:

• Continued use despite side effects
• Inability to stop using Xanax
• Loss of interest in other activities
• Obsession with obtaining more Xanax
• Risky behavior; like combining your prescription and alcohol or driving after taking your medicine

Similar to other addictions, Xanax abuse can lead to poor health, ruined relationships, forgotten responsibilities, and maybe worse.

Benzodiazepine abuse is a widespread problem, which is why the more potent variations are banned in many countries. Benzodiazepine overdose can be fatal, and the risk of overdose is higher when combined with other drugs. In contrast, Propranolol hasn’t been found to cause addiction, even after long-term use ^[7].

If you, or someone you know, is suffering from addiction please contact the Substance Abuse and Mental Health Services Administration (SAMHSA) at 1-800-662-HELP (4357) or through the website.

Xanax Targets The Brain; Propranolol Targets The Heart

If we look at the way the two drugs work, it’s easier to see which is better suited to the purposes of fighting performance anxiety. Xanax and other benzodiazepines target the brain and central nervous system, whereas propranolol is focused on the cardiovascular system. The former primarily has a psychoactive impact, while the latter mostly influence you physically (although the act of taking a beta-blocker in itself does has a reassuring psychological effect) ^[7].

Propranolol Is More Suited For One-off Use; Xanax Fits Medium-term Treatment

Since Propranolol’s effect on the body is, to put it bluntly, more straight-forward and doesn’t require re-wiring the brain. It only takes 30-60 minutes after taking a pill to yield the desired effect. This makes the drug useful for single-event performance anxiety, for example prior to an important presentation, public speech or test ^[6].

In contrast, Xanax is typically prescribed for medium-term treatment (as in several weeks to 4 months) to tackle more serious anxiety disorders. It takes several days and sometimes even weeks for Xanax to reach its maximum effect. Additionally, at the end of the treatment period, the drug can’t be abruptly stopped but instead needs to be gradually phased out to avoid withdrawal-related side effects ^[7].

How are you supposed to use beta blockers from Hims or Kick to help with your performance anxiety?

The propranolol supplied by Kick or Hims is supposed to be taken an 1-2 hours before an upcoming high-anxiety event. Depending on the dose you are prescribed (typical propranolol effective dose for most adults is between 40-80 mg per day ^[6]), effects of the drug — namely relief from stage fright/performance anxiety symptoms — will be experienced for up to 12 hours, and lower doses will be felt for shorter periods (and possibly have less of an overall effect).

Generally speaking, with Propranolol you want to give the drug enough time for the effects to kick in, but not take it so early that it is no longer useful.

Known side effects of Propranolol

Beta-blockers, in general, are pretty safe but here are some of the potential, albeit rare, side effects of Propranolol, the medication prescribed by both Hims & Kick ^[1]:

• Dry eyes
• Abnormally low heart rate
• Fatigue or weakness
• Nausea

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

• Allergic reactions like skin hives or rashes
• Swelling in the face – lips, tongue, etc.
• Shortness of breath

Both companies provide their own list of propranolol side effects, and you should make sure you follow their guidelines/warnings for usage to make sure you don’t experience negative effects of any medication.

There’s also a questionnaire that you fill out during the online visit, along with plenty of chances to ask about side effects during the online doctors visit. Try and be as accurate as possible during both of these, as you want to make sure that the doctors know broadly about your state of health in case there is something in your medical history that might disqualify you as a candidate for a prescription.

Kick Vs Hims: which propranolol for anxiety program is better?

Considering that both Kick & Hims are providing the same prescription medication — there are several broad areas to compare the companies on that will give a better picture on which you should go with: Cost & Experience (particularly the doctors visit). So lets delve right into the comparisons:

How Much does Kick anxiety medication treatment cost?

Kick has a pretty simple pricing structure, they charge you to have the online doctor’s visit, and then charge you a fee to ship the Propranolol medication to you.

Kick offers two different pricing options: $59 for 24 doses (10mg), or $79 for 48 doses (10mg). Both require a $40 doctor’s visit fee for the first purchase, in addition.

Kick does not offer a monthly subscription, you simply order the medication following the initial doctors visit as and when you need it.

How much does Hims anxiety medication treatment cost?

Hims and Hers (the female-focused version of Hims) have a similarly simple pricing structure that actually works out cheaper up-front.

Their Propranolol options require an initial online doctor’s visit at the lower price of $5, and then they charge $25 for 5 doses (20mg). They also offer a nice introductory discount: pay just $5 for your first month’s Propranolol shipment, as long as you qualify.

Hims (and Hers) offer a monthly subscription, meaning that they will send you prescription Propranolol every month. This has the upside of lowering your chances of running out of the medication, but the downside is that you will have to manually cancel your subscription if you only want small dosages for, say, a one-time event or performance.

What is the doctors visit like with Kick & Hims?

The real innovation of both of these startups is the “telemedicine” process; they are using technology and a thorough (and stress-reducing) focus on the rules and regulations surrounding prescription medications to make obtaining Propranolol a really simple process.

The online doctors visits of both Kick & Hims is really stress-free. In several states you don’t even have to talk with a physician. All of the interaction is done online through easy to understand forms. It is important, however, that you answer the questions honestly and carefully, as you want the doctor reviewing your case to have all the information they need to make an informed prescription ^[8].

During the ‘doctors visit’ you will click through a series of online forms, answering questions about your medical history, conditions and symptoms. There’s also a part where you enter your contact info, and snap a photo of yourself and your driver’s license in order to prove to the doctor that you are who you say you are, meeting regulatory requirements for telemedicine.

For both Hims & Kick doctors visits, the process took me about 10 minutes. There was a few surprises for both, like being asked what my blood pressure is (you need to know both your systolic and diastolic readings – so Google & look these up before starting), and you of course have to detail your anxiety symptoms and answer some questions about alcohol and drug usage.

Overall, the online doctors visit for both companies was extremely simple, apart from the need to have accurate and recent blood pressure readings handy!

How are the medications from Hims & Kick delivered? Is it discrete?

Both Kick and Hims will ship your propranolol prescriptions to you in discrete, nondescript packaging that anyone scanning by eye will not be able to tell what’s inside. The Propranolol itself is packaged in small, individual pouches by both companies so you can easily and discretely take them with you in your pockets, purse, or bag. Here’s are a couple of pictures of the little medicine pouches from Kick and Hims:

Are there any solid alternatives medications or treatments available OTC for Performance Anxiety?

There are a few other online startups who have got into the Propranolol prescription for anxiety game, the most popular I came across being Cerebral Propranolol and Roman’s Ro Mind Propranolol. I’m in the process of signing up for both of these companies and testing them out, and will post my review of both once I’ve extensively used them.

If you are turned off by the potential side-effects of propranolol, or you just don’t like the idea of using a prescription medication to try and solve your performance anxiety issues, then you might be interested in trying some of these equally effective alternatives to propranolol. From my own research and work with clients, these are the best natural alternatives to Propranolol for anxiety available today:

Propranolol Alternative #1: GABA Supplements

GABA, or Gamma-Aminobutyric Acid, is a naturally-occurring amino acid that acts as a neurotransmitter. GABA is widely recognized as having a calming effect, and GABA deficiency is believed to play a part in anxiety disorders ^[10].

According to an article published in the Journal of Neuropsychiatric Disease and Treatment, when GABA levels are out of balance in your body, you might be more susceptible to more severe symptoms of depression, PTSD, and social anxiety disorders (SAD) ^[9].

Performance anxiety falls within the umbrella of social anxiety disorders (SAD). It is possible that if your GABA levels are disrupted, the part of the brain that handles stress may be overactive, and you’re more susceptible to severe symptoms of stage fright.

On the other hand, optimal GABA levels promote calmness in stressful situations, like during a performance or a speech in front of an audience.

We recommend NOW Supplements GABA which contains 500mg of GABA per serving, has some great reviews & is very well priced from a trusted brand.

Buy NOW Supplements GABA

Propranolol Alternative #2: Silexan Supplements

Silexan is a branded extract of lavender oil created by Wilmar Schwabe GmbH, a German pharmaceutical company. Schwabe pharmaceuticals claim that silexan is “introducing a new therapeutic alternative in the field of anxiety disorder treatment” ^[11].

Put simply, Silexan is just a standardized essential oil of lavender flowers prepared by steam distillation ^[12].

Research involving Silexan is showing that potent silexan can improve symptoms of mild anxiety. Two recent studies have found lavender oil capsules to be just as effective as commonly prescribed benzodiazepine Lorazepam and the antidepressant Paroxetine ^[13].

The anxiolytic (anti-anxiety) properties of lavender/silexan seemingly come from the antagonization of NMDA and GABA-related receptors in the central nervous system that influence muscle contraction, as well as inhibition of the serotonin transporter.

In this way, the method of action for Silexan seems to be similar to anxiolytic and antidepressant drugs like SSRIs and Benzodiazepines ^[14].

The major upside to lavender/silexan over similar prescription anti-anxiety medications (like benzodiazepines) is the almost complete lack of abuse potential in healthy recreational users of the lavender extract ^[15].

Downsides can include the affectionately-titled “lavender burps” which are potential mild gastrointestinal issues, and recent studies showing that chemicals in lavender oil are potential endocrine disruptors with varying effects on receptors for two hormones — estrogen and androgen ^[16].

Nature’s Way CalmAid is made with Silexan; “a clinically studied lavender oil, to reduce feelings of occasional tension and stress.”

It’s gluten-free and contains no salt, yeast-derived ingredients, wheat, or dairy while also being manufactured by a well-respected company who have been producing well-loved supplements for more than a decade. Each serving contains 80mg of Silexan.

Buy Natures Way CalmAid

Propranolol Alternative #3: PerformZen Supplement

Some dietary supplements contain a mix of ingredients that support focus, calm and cognition, which may counteract the negative side-effects of performance anxiety and stage fright just as well as beta-blockers like Propranolol.

One example that I personally like and recommend to clients is PerformZen, which contains GABA, L-theanine and Magnesium, as well as cognitive-enhancing ingredients Ginkgo Biloba, Vitamin B6 and Theacrine.

These ingredients have been shown to help induce a calming effect on the body, as well as keeping the brain as sharp as it needs to be during your performance.

I actually reviewed PerformZen in a previous article & interviewed the founder (as well as secured a limited-time discount for PerformanceAnxiety.com readers). See the review here.

Instant All-Natural Performance Anxiety Relief

PerformZen is a natural supplement uniquely crafted to overcome stage fright and performance anxiety so you can perform at your best on demand!

Crush Performance Anxiety with PerformZen

Final verdict: Is Hims or Kick the better provider of anti-anxiety medication?

As both Hims and Kick are offering the same propranolol medication prescriptions to help with your performance anxiety issues, there’s only really the usability of the website and the pricing that you can use to properly compare the two.

On the website usability and service side of these two companies, both are pretty similar and one really can’t be faulted or put-ahead of the other. I would say that if you like the idea of picking up your prescriptions at your local pharmacy, hate subscription services, or only need 10mg of Propranolol and can’t stand the thought of cutting your propranolol pills in half, Kick is the slightly better option! They make it easy to attain propranolol pills to combat performance anxiety without any ongoing commitment.

Hims is actually cheaper up-front, but then you have to deal with manually cancelling your subscription if you only want a small dose of Propranolol for a one-time event or use-case.

Also consider some natural alternatives to beta blockers like the supplements mentioned above (GABA, Silexan, PerformZen, etc) if you’re not comfortable using a prescription medication for your performance anxiety symptoms.

Hims Vs Kick Beta-Blockers Frequently Asked Questions

I received some emails/comments from readers who had more specific questions about beta blockers form Hims & Kick brands. I’m publishing my responses here to refer people to in future. If you have your own questions, leave a comment down below or get in contact here.

If so, you are not alone! Performance anxiety, also known as stage fright, is a common phenomenon that affects millions of people around the world. It stems from the fear of being judged negatively because of your performance, even if it is irrational and there’s no real evidence to justify the fear.

Performance anxiety is very common with professional musicians, public speakers, and even stand-up comedians – as you would expect. Many of these professional performers turn to Propranolol and similar beta-blocker drugs to deal with their performance anxiety symptoms.

In this article, we are going to cover what Propranolol is; how it works & why it’s popular among performers; famous celebrities who have publicly stated that they use propranolol for their anxiety symptoms; what the downsides & side-effects of Propranolol are and how the beta blocker compares to both prescription and natural alternatives available to help with performance anxiety symptoms.

What is Propranolol?

Propranolol is one of the most commonly prescribed beta-blocker medications in the US. Beta-blockers, full medical name beta-adrenergic blocking agents, work by blocking the effects of adrenergic hormones in the body, such as adrenaline.

Doctors typically prescribe beta-blockers to treat various heart conditions, if lifestyle adjustments fail to do the job.

Here are some of the typical conditions for which your doctor might recommend a beta-blocker ^[1]:

• High blood pressure
• Irregular heartbeat
• Angina (chest pain)

Beta-blockers help those with cardiovascular issues by influencing the force with which your heart pumps blood.

Sometimes, beta-blockers are also prescribed for conditions like migraines, and harmless tremors of the arms, hands, etc ^[2].

Here’s a solid video all about Propranolol:

A fast yet accurate video description of the beta-blocker Propranolol & it’s uses for anxiety

Propranolol Over-The-Counter (OTC) brand names

Propranolol is sold over the counter under the following brand names:

• Inderal
• Inderal LA
• Hemangeol
• Inderal XL

Propranolol requires a prescription from your doctor, whether you need it for a heart condition, or you’re considering beta-blockers for performance anxiety.

Why is Propranolol popular with musicians, speakers & public performers?

A 1987 survey by the International Conference of Symphony Orchestra Musicians, representing some of the largest orchestras in the U.S., found that 27 percent of their musicians were using beta-blockers for performance anxiety ^[3]. Many experts assume that this number is much higher today.

As we previously explained, Beta-blockers like Propranolol block the effects of adrenaline and prevent it from binding to the beta receptors in the heart. This has an overall calming effect on the heart and the force with which it has to pump blood. Consequently, the heart can return to its regular workload, and your blood pressure can remain steady ^[4].

An exaggerated stress response like what a performer experiences when suffering from performance anxiety, is associated with a dramatic spike in adrenaline.

So, by blocking the effects of adrenaline, you are preventing it from binding to the beta receptors in the heart. So, beta-blockers essentially block the physical symptoms of performance anxiety.

When you take a beta-blocker, it can slow your heart rate, reduce the trembling and sweating, and regulate your breathing and blood pressure. It can help you feel relaxed, essentially negating the stress response to help you get through any performance or high-anxiety situation.

You can easily see why a performer would find massive value in being able to block performance anxiety or stage fright, almost on-demand, using propranolol.

We should make a note that each individual is different, especially when it comes to causes of anxiety. We also vary widely in symptoms, the severity of those symptoms, and how we react to specific medications. So, how you respond to a beta-blocker can be different from someone else ^[5].

4 celebrities who use Propranolol for their stage fright

In recent years, several celebrities have gone public about their usage of beta blockers like propranolol to help with their stage fright and performance anxiety symptoms, including Shawn Mendes, Katy Perry, Whitney Cummings and Bobby Lee.

How Shawn Mendes Uses Propranolol

Shawn Mendes, during a global tour stated that he was finding the continuous performances difficult in a Capital FM interview. Only 20 years old at the time, Shawn Mendes admitted to getting so nervous for his live shows that he “needed medication to calm him for over a year” ^[6].

The Canadian singer opened up about his struggles with anxiety and pre-show nerves ^[7], when telling fans:

“As a performer you get very nervous, sometimes you freak out and things can become a lot for you. And there’s medicine and things you can do to help and I meditate and I do a lot of things.

There’s a medicine called beta blockers and basically it’s a very calm medicine, but what it does is it slows your heart rate down so you can be less stressed out and calm down and breathe, but nevertheless it’s medicine and I want you guys to know that for the last year I’ve been taking the medicine that’s been slowing down my heart rate so that I can be calm on stage.”

Here’s the video of Shawn Mendes talking about his beta blocker/Propranolol and anxiety struggles during a performance:

.@ShawnMendes opens up to his fans about his anxiety, revealing that today is the first show in one year that he hasn’t taken medicine to help him calm down. pic.twitter.com/GwbWOBDJtJ

— Pop Crave (@PopCrave) April 6, 2019

Katy Perry Uses Propranolol to Help With Her Anxiety

Katy Perry, the American singer, songwriter and television judge for American Idol, has performed in front of millions of fans and is (in)famous for her wild, electrifying performances ^[8].

In a 2014 Cosmopolitan magazine interview, Katy Perry talked about her use of beta-blockers to help with her anxiety in the past. In the interview she talked about how she “had a crippling fear that she would let everyone down, and so she used [beta blockers/propranolol] to overcome performance anxiety” ^[9].

Katy Perry made clear that her stage fright does not come from not being prepared, but from a fear that “fans will rush the stage or that I’ll vomit on stage during a performance”

The singer feels intense pressure to ensure that she fends off competition from rivals in the music industry ^[10]:

“I have to take beta blockers [before each show], I get so nervous. [I think] that I have to get through this; I can’t let these people down, but mostly I can’t let myself down. I’ve been given a great opportunity and there are 500 bitches behind me who will snatch my weave off my head if I don’t kick-ball-change through this two-hour show.”

Whitney Cummings on her use of Propranolol to help her chronic migraine Issues

Whitney Cummings is a world-class comedian, actress, and screenwriter recognized for her prolific output and perfect comic timing. Many recognize her unique tall and lean frame and emphatic voice that quickly creates strong connections with her fans ^[8].

In an interview with Everyday Health, Whitney talked about her chronic migraine issues and how it led to her discovering beta-blockers to manage her anxiety that would come with her worry about said migraines ^[11]:

[The migraine attacks] started when I was a kid. I remember going to Disneyland, and being the person who ruined the trip because Whitney has to go to the car and put a pillow over her head. A trip to Six Flags amusement park had to be cut short because Whitney has a migraine. I feel like I was always the bummer in my childhood.

…A big one of my migraine triggers is an increase in adrenaline and cortisol — which comes from stress, which we all have. It’s a neurological imbalance.

…Sometimes the stress leading up to something can trigger the migraine, and even the stress of anticipating a migraine can bring one on.

…I take beta-blockers now, which help hugely. I didn’t find out about them until about three years ago. I know if I have a big meeting, or a big audition, or a big performance, or anything where I know I’m going to be nervous, I just take one preemptively, so that I’m not blasting my brain with adrenaline.

My goal is to keep my neurochemicals, my hormones, and my blood sugar levels as consistent as possible.

Bobby Lee learned about Propranolol from Whitney Cummings

Bobby Lee is an actor and comedian from San Diego, California. The first Asian-American cast member on MADtv, he has appeared in movies like “Harold & Kumar Go to White Castle”, “Pineapple Express”, and “The Dictator”. To put it simply, Bobby Lee has staked his claim in the comedy scene and in Hollywood ^[8].

On the Good For You Podcast with Whitney Cummings, Bobby Lee talked to Whitney the host about how she was the first to tell him about beta-blockers and how they helped him stay calm during auditions ^[12]:

“You also changed this about me. You’re so influential in my life [pointing at Whitney]…

Years ago, I used to sometimes go in to audition, and I would freeze… I would have a panic attack. And I came up to you one day, and I go “It’s so embarrassing… I get these little panic attacks”

And you’re the one who introduced me to beta blockers. In fact, I did this pilot in Chicago, and I wouldn’t have been able to do it without beta blockers.”

What are the recommended dosages for Propranolol?

We have an excellent article up on the site already detailing what the propranolol dose for anxiety are depending on different variables. To summarize, however:

Much of the dosage information you’ll find for Propranolol [is] for treating heart conditions and high blood pressure. Thus, it’s vital that you understand the recommended Propranolol dosage for anxiety, if this is the reason you’re taking it.

Propranolol in tablet form ranges in strength from 10mg tablets to 160mg. It also may be prescribed in liquid form, however this is most often used for infants, so we’ll stick to Propranolol in tablet form here.

Adult doses for things like hypertension, angina and arrhythmia generally range from 40mg to 320mg per day, depending on the condition ^[13]. That may be split into several doses per day.

These doses are likely to be overkill for anxiety however, and increase the risk of negative side effects, dependence and withdrawal symptoms, without any significant benefit.

The recommended Propranolol dose for anxiety is between 10mg to 40mg. 10mg may be enough to see relief from your symptoms. If not, it is generally safe to increase the dosage up to 40mg. However, keeping to the smallest dose that proves effective will help minimize any side effects.

Be aware, this is just a guideline, and not medical advice. Pay attention to the dosage prescribed by your doctor, as you may have other medical conditions or prescriptions that have to be taken into account.

Recommended time to take Propranolol for anxiety

If you take Propranolol for performance anxiety and stage fright, you can take it only when necessary for the relief of performance anxiety symptoms. There’s no need to maintain a regular dose. In fact, doing so increases the risk of harm, specifically withdrawal.

Take your dose approximately one hour before the event, performance or whatever reason you need relief. Propranolol can be taken with or without food, so there is no need to worry about timing it with your meals ^[14].

How fast does Propranolol start working?

Propranolol generally provides relief from symptoms within 30 to 60 minutes. This may vary from person to person, depending on factors like body composition, dose, severity of symptoms, and more.

For some people it may start working in as little as 20 minutes, or in rare cases, several hours.

For performers, it’s best to take your dose around an hour before you need it, to give enough time for it to kick in ^[14].

How long does Propranolol last?

The exact length will vary from person to person, but for most, the effects of Propranolol last for around four hours.

The half-life of Propranolol is between 3-6 hours ^[15]. Half-life means the time it takes for half of the drug to be processed and no longer active in your body.

Small amounts of Propranolol may remain active for as long as one or two days, so in rare cases, side effects may remain for this length of time.

Are there known downsides to Propranolol?

Propranolol, and beta-blockers as a whole, are generally considered to be safe, especially if you only take them occasionally before a big performance, speech, exam, or job interview.

But if you start performing more frequently, and you find that Propranolol is really helping you get a handle on the jitteriness, you might start using it more regularly.

And if you’re going to use Propranolol regularly, then you should be aware of the potential downsides of Propranolol, and beta-blockers in general ^[5].

Potential Propranolol side effects

Severe side effects are not very common in people that use Propranolol for anxiety. But you should still know the potential side effects, so you can notify your doctor if you experience any of them. Your doctor can then evaluate if you should continue taking them.

Here are some of the potential side effects of Propranolol ^[16]:

• Dryness in the eyes
• Below normal heart rate
• Tiredness or feeling weak
• Nausea

Severe side effects are rare, but if you experience any of the following, be sure to notify your doctor immediately.

• Allergic reactions like skin rash or hives
• Swollen face, lips, or tongue
• Trouble breathing

Drowsiness

One of the main benefits of beta-blockers like Propranolol could also be a potential downside for some people.

For most people that experience severe stage fright, Propranolol will help them avoid the symptoms in a way that calms them down enough to be able to get through a performance. But for others, the calming effects of Propranolol may go too far. If Propranolol relaxes you to the point where you start feeling drowsy, that’s obviously not going to be good for your performance.

What you ideally want is to remain calm, but also mentally sharp and focused so you can perform at your best.

The good news is that there are ways to do just that, and we’ll discuss alternatives later in the article.

Propranolol interactions with other medications

If you’re taking any medications on a regular basis, you should let your doctor know when discussing whether Propranolol might be right for you. Propranolol may interact with other medications in a harmful/sub-optimal way. It may also impact how well another drug works.

Here are some of the common medications that may interact with Propranolol, and you might be advised to avoid Propranolol if you’re currently taking any of them ^[16].

• Arrhythmia (irregular heartbeat) medications
• Other blood pressure medications
• Asthma medications
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Blood thinners
• Stomach ulcer medications

Does Propranolol require a prescription?

Yes, Propranolol is a prescription medication.

Assuming your doctor approves of you taking Propranolol for performance 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 Propranolol occasionally. But if you start using the drug more often, then it could become a significant inconvenience.

Is there a dependence/addiction risk with Propranolol?

Propranolol does not come with a high risk of addiction or dependency. However, there is a risk of Propranolol withdrawal if taken for a long time and abruptly stopped.

The symptoms of withdrawal are consistent with a spike in blood pressure, and can be serious ^[17]. For this reason, it’s recommended to taper off over a period of four to seven days after long-term use ^[18].

Prescription alternatives to Propranolol for performance anxiety

Propranolol/Inderal is the most popular prescription beta-blocker in the US, sold under the brand names Hemangeol, Inderal, and InnoPran; but here are some of the other most commonly prescribed beta-blockers that are used for anxiety:

• Zebeta (Bisoprolol)
• Sectral (Acebutolol)
• Coreg (Carvedilol)
• Lopressor (Metoprolol)
• Tenormin (Atenolol)
• Bystolic (Nebivolol)

Other prescription medications that people commonly use off-script for performance anxiety include Gabapentin, Clonodine, Depakote and Dramamine.

There is also typical anxiety medications like benzodiazepines (Xanax, Valium, etc) but I hesitate to recommend these medications due to significant dependence & addiction risks. There are several non-addictive Xanax & benzo alternatives available today.

Natural alternatives to Propranolol for anxiety

When it comes to the question: “Is Propranolol the best way to deal with anxiety?” – the answer is complex as Propranolol certainly shows efficacy in treating the physical symptoms of anxiety, particularly those of performance anxiety and stage fright. Doctors even prescribe it for this use, and it’s quite commonly used by classical musicians to treat anxiety during a performance ^[19].

But perhaps you’re not too excited about becoming dependent on a beta-blocker like Propranolol every time you want to perform, or having to get a prescription whenever you run out? If so, you might be wondering if there are any natural alternatives to Propranolol.

A natural alternative would achieve the same end-result as propranolol, which is to provide relief from symptoms of performance anxiety. But it would do so by supporting your mind and body in a way that, over time, makes you more resilient to anxiety. Ideally, you would become better equipped to handle any stress response and you would learn to think about your performance in a way that makes it less stressful, to begin with.

Here are some of the most effective natural remedies to performance anxiety that I’ve personally come across:

GABA

GABA, or Gamma-Aminobutyric Acid, is a naturally-occurring amino acid that acts as a neurotransmitter. GABA is widely recognized as having a calming effect, and GABA deficiency is believed to play a part in anxiety disorders ^[20].

Studies performed on GABA supplementation have found it may have a positive effect on stress and anxiety ^[21], which would help block the symptoms associated with performance anxiety.

L-theanine

L-theanine is an amino acid well known for its relaxing properties ^[23]. Studies have shown that L-theanine may decrease the severity of stress-related symptoms, while increasing cognitive performance ^[24].

Thus, taking L-theanine may help performers counteract the nerves that come with performance anxiety, as well as providing better focus during their performance. Taylor Swift is known to use L-theanine to help her handle the stress of stage performances, to serve as one popular example ^[22].

L-theanine can be taken as a supplement, and is also present in green, black and oolong teas, as well as some mushrooms.

Magnesium

Magnesium is a vital mineral, necessary for a wide range of the body’s natural functions. Magnesium deficiency is linked to cardiovascular diseases and hypertension ^[25].

Another of magnesium’s essential roles is to protect and regulate the nervous system ^[26].

Furthermore, several studies have found magnesium to have a positive effect on stress and anxiety ^[23][27][28], which leads us to believe it may be helpful in preventing or lessening the effects of performance anxiety.

L-arginine

Another natural amino acid, L-arginine can lower blood pressure, and may provide relief for the symptoms of hypertension and some forms of heart disease ^[29][30]. It increases the release of nitric oxide in the blood, causing blood vessels to open and allowing blood to flow more freely.

More research is necessary to show whether or not L-arginine also proves effective for nerves and anxiety the same way that beta-blockers like Propranolol do.

L-arginine can be supplemented, as well as found in red meat, dairy, poultry and fish. Seek a doctor’s advice before taking any L-arginine supplement, however.

Garlic

Garlic can be a natural alternative to beta-blockers like propranolol, providing many of the same positive effects on cardiovascular health and blood pressure.

Studies have shown significant beneficial effects of garlic on hypertension ^[31]. Garlic works in much the same way as L-arginine, stimulating the production of nitric oxide and relaxing blood vessels ^[32].

In fact, one study showed garlic can have an equal effect on blood pressure as atenolol, a commonly prescribed beta-blocker ^[33].

Whether the antihypertensive benefits of garlic provide beneficial for performance anxiety is unproven, however its ability to replicate the effects of prescription beta-blockers is very promising!

PerformZen

Some dietary supplements contain a mix of ingredients that support focus, calm and cognition, which may counteract the negative side-effects of performance anxiety and stage fright.

One example that I personally like and recommend to clients is PerformZen, which contains GABA, L-theanine and Magnesium, as well as cognitive-enhancing ingredients Ginkgo Biloba, Vitamin B6 and Theacrine.

These ingredients have been shown to help induce a calming effect on the body, as well as keeping the brain as sharp as it needs to be during your performance. I recently reviewed PerformZen in this article & interviewed the founder (as well as secured a limited-time discount for PerformanceAnxiety.com readers). See the review here.

Instant All-Natural Performance Anxiety Relief

PerformZen is a natural supplement uniquely crafted to overcome stage fright and performance anxiety so you can perform at your best on demand!

Crush Performance Anxiety with PerformZen

Final thoughts on Propranolol for anxiety

You don’t have to let performance anxiety control you and get in the way of doing the things you love, like performing in front of an audience. For some, getting jittery has negative effects on their professional and/or personal life.

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

To overcome performance anxiety in the long term, consider natural alternatives like those mentioned above: magnesium, GABA, L-theanine, L-arginine, garlic or a natural supplement like PerformZen.

In the meantime, If you’re considering Propranolol for a quick-fix to your anxiety symptoms, be sure to consult with your doctor to make sure it is right for you.

Propranolol Frequently Asked Questions

I received some emails from readers who had more specific questions about Propranolol. I’m publishing my responses here to refer people to in future. If you have your own questions, leave a comment down below or get in contact here.

As with any drug, there are some side effects with Metoprolol that you should be aware of. In this article, we are going to look at how Metoprolol works, what the side effects of Metoprolol are when using the drug specifically for treating performance anxiety symptoms and, finally, we’ll share some natural alternatives to Metoprolol that are less likely to have undesirable side effects and/or dangers while still offering the same anxiety-fighting qualities.

What is Metoprolol?

The brand name, over-the-counter version of Metoprolol is Lopressor. Sometime during the year 1978, the FDA approved the use of Metoprolol under the name Lopressor ^[1].

A video all about Metoprolol beta blocker and how it works for anxiety

Is Metoprolol a Beta Blocker?

As mentioned, Metoprolol (chemical name ‘Metoprolol tartrate’) falls under the drug class of Cardioselective beta blockers and is a β1 receptor blocker or “beta1-adrenoreceptor blocking agent”. In short: yes Metoprolol is a beta blocker.

As with other popular beta-blocker medications such as Propranolol and Carvedilol, Metoprolol requires a prescription from a doctor to acquire. Metoprolol is a widely used medication, and is prescribed around 27 million times each year in the United States.

Although Metoprolol is frequently used to treat high blood pressure and similar cardiovascular conditions, beta-blockers typically aren’t the first medications doctors would prescribe for such health conditions. They might start with other drugs, like diuretics, and only move on to beta-blockers if other treatments are ineffective. Beta-blockers are also often used in combination with other medications to treat hypertension ^[2].

Doctors may also prescribe Metoprolol to treat irregular heartbeats and to increase someone’s chances of survival after a heart attack or heart failure.

Metoprolol/Lopressor and other beta-blockers have also been shown to be useful when it comes to migraines, and for certain types of tremors caused by drugs used to treat mental disorders.

How Does Metoprolol work for Anxiety?

Metoprolol, and beta-blockers in general, work by reducing the stress on your cardiovascular system. They lower the force with which your heart has to pump blood, causing a relaxing effect.

Beta-adrenergic blocking agents (beta-blockers) block the effects of adrenaline, a hormone that binds to adrenergic receptors in your body ^[3]. There are adrenergic receptors in the heart called beta receptors and adrenaline, which is a stress-related hormone, binds to these beta receptors in the heart to make it pump harder and faster ^[4].

By blocking the release of these stress hormones, beta-blockers are preventing your heart from going into overdrive, which can keep your blood pressure low, lower stress on your cardiovascular systems and even (critically, for most people suffering from stage fright) keep your performance anxiety symptoms at bay ^[5].

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Fight-or-Flight Response

The reason you might be experiencing performance anxiety symptoms might be due to the effects of the adrenaline hormone. If your fight-or-flight response gets activated in a stressful situation (like before a speaking engagement, for example), then your adrenaline levels can spike, causing you to experience performance anxiety symptoms.

As we now know, Metoprolol works by blocking the effects of the adrenaline hormone ^[3]. Metoprolol is preventing adrenaline from binding with beta-receptors in your heart ^[4], which reduces the force with which your heart has to pump blood. Overall, this has a relaxing effect on your cardiovascular system.

So, when you take Metoprolol before a performance, exam, audition or date, you are effectively blocking the physical symptoms of performance anxiety from showing up. In the absence of the physical symptoms, you may find yourself in a more relaxed state, which then allows you to get through the high-anxiety scenario.

What are the Metoprolol side-effects?

Beta-blockers, in general, are pretty safe. But here are some of the potential, albeit rare, side effects of Metoprolol ^[1]:

• Irritability or mood swings
• Dry mouth
• Gut issues like gas, bloating, constipation
• Heartburn
• Nausea

Severe side effects are quite rare with Metoprolol, but if you experience any of the following symptoms after taking the beta-blocker, be sure to contact your doctor immediately:

• Shortness of breath
• Unexplained swelling of hands, feet, or ankles
• Fainting

What are the downsides of Metoprolol?

There are several known limitations that come with beta-blockers like Metoprolol when it comes to dealing with anxiety & stage fright ^[6]:

1. Metoprolol will always be a temporary solution for stage fright as it does nothing to address the root causes of your performance anxiety & stage fright. You’re applying a quick-fix to stop the physical symptoms (which may be all you need!).
2. You will need a prescription for Lopressor/Metoprolol, at least in the United States. So, you may need to visit your doctor every time you run out of Lopressor, which can become an inconvenience if you use the drug frequently.
3. In rare cases, beta-blockers like Metoprolol can cause dependency and if you make it a habit of using Metoprolol frequently, then you shouldn’t stop taking it too suddenly. Stopping abruptly might cause your blood pressure to spike, which can have negative consequences, so talk to your doctor if you want to stop the medication.

Prescription alternatives to Metoprolol for Anxiety

There are several other beta-blockers medications that perform the same role as Metoprolol, in regards to slowing down the release of adrenaline and lessening the physiological symptoms of anxiety and stage fright. The main alternatives include:

• Coreg/Carvedilol
• Propranolol/Inderal
• Atenolol/Tenormin
• Bisoprolol/Zebeta
• Acebutolol/Sectral
• Clonidine/Catapres

There’s also Valproic Acid (Depakote) but it’s not, technically, a beta-blocker although some have experienced similar results from it.

You may have better luck with the side-effects of these drugs. But, as they all fall under the same ‘beta-blocker’ umbrella, it is likely that any problems you have with Metoprolol will persist with another beta-blocker.

Natural Metoprolol Alternatives for Anxiety

With the potential risks and downsides of Metoprolol, as well as the risk of dependence when you take any drug habitually, it may be best to consider which natural alternatives to Metoprolol can provide the same benefits for performance anxiety.

Many foods, minerals and dietary supplements have similar properties as beta-blockers like Metoprolol, in terms of lowering the negative effects of stress and anxiety.

The major difference is that natural beta-blockers are less likely to have detrimental side-effects, and carry a lower risk of dependence or addiction. They’re also more widely available, as you do not need a prescription, and almost all are beneficial to your health in more areas than one ^[7].

Here are some notable natural Metoprolol alternatives that you can consider trying:

GABA

Gamma-Aminobutyric Acid, shortened to GABA, is a naturally-occurring amino acid that acts as a neurotransmitter within the body. GABA has been shown in numerous studies to have a calming effect, and GABA deficiency is believed to play a part in several anxiety disorders ^[8].

Studies that used GABA supplementation have found it may have a positive effect on stress and anxiety ^[9], which would help block the symptoms associated with performance anxiety.

L-theanine

L-theanine is an amino acid well known for its relaxing properties ^[10]. Studies have shown that L-theanine may decrease the severity of stress-related symptoms in test subjects, while also increasing cognitive performance ^[11].

Taking L-theanine, therefore, may help people counteract the nerves that come with performance anxiety, while also providing better focus during their performance.

L-theanine can be taken in supplement form, and is also present in green, black and oolong teas, as well as some mushrooms.

L-arginine

Another natural amino acid, L-arginine effectively lowers blood pressure, and may provide relief from the symptoms of hypertension and even some forms of heart disease ^[12][13]. L-arginine increases the release of nitric oxide in the blood, causing blood vessels to open which allows blood to flow more freely.

More research is necessary to show whether or not L-arginine also proves effective for nerves and anxiety the same way beta-blockers like Metoprolol do.

L-arginine can be found in supplement form, as well as found in red meat, dairy, poultry and fish.

Garlic

Garlic can be a natural alternative to Metoprolol, providing many of the same positive effects to cardiovascular health and blood pressure.

Studies have shown garlic extracts having significant beneficial effects on hypertension ^[14]. Garlic works in much the same way as L-arginine, stimulating the production of nitric oxide and relaxing blood vessels ^[15].

Whether the anti-hypertensive benefits of garlic provide benefits for performance anxiety is unproven. However, garlic’s ability to replicate the effects of prescription beta-blockers is very promising.

Natural Anxiety Supplements

Some dietary supplements contain a mix of ingredients that support focus, calm and cognition, which may counteract the negative side-effects of performance anxiety and stage fright.

One example that I personally like and recommend to clients is PerformZen, which contains GABA, L-theanine and Magnesium, as well as cognitive-enhancing ingredients Ginkgo Biloba, Vitamin B6 and Theacrine. These ingredients have been shown to help induce a calming effect on the body, as well as keeping the brain as sharp as it needs to be during your performance. I even interviewed the founder of PerformZen and secured a limited-time discount for PerformanceAnxiety.com readers. Check that out here.

Instant All-Natural Performance Anxiety Relief

PerformZen is a natural supplement uniquely crafted to overcome stage fright and performance anxiety so you can perform at your best on demand!

Crush Performance Anxiety with PerformZen

Does a Natural alternative to Metoprolol exist?

Performance anxiety, stage fright, and similar conditions are not fun to deal with. It’s even worse when you’re commonly asked to perform in high-pressure situations, especially when this is your profession.

While many people are using Metoprolol off-script to help with their performance anxiety, there are many natural ways to treat those same symptoms, or even to prevent the cause of performance anxiety itself. With amino acids like GABA and L-theanine, cognitive-enhancing supplements like PerformZen or physical relaxation techniques, you can have a go-to technique to fight off nerves and perform without anxiety.

In some cases, this is a one-off, and the person never thinks about it again. For others, performing or speaking in front of a crowd is a regular thing – for example for musicians or other professional performers.

Even if performing isn’t your job, anxiety disorders can flare up in all kinds of occasions, such as a best man’s speech at a wedding, meetings or job interviews, or even dates and social outings.

There are a number of treatments for the symptoms of performance anxiety, which a lot of people rely on to get them through a speech, interview, gig, or otherwise. These treatments range from lifestyle changes, to dietary choices and supplements, to pharmaceuticals.

Propranolol is one of these, which may be prescribed by a doctor if you suffer from regular bouts of anxiety. Yet anxiety is not the originally intended use for Propranolol, so there are some things you should know before taking it to try and treat your condition.

Read on and we’ll briefly cover how Propranolol works, and let you know the common dosage and all other relevant information you need to know before taking Propranolol for performance anxiety.

How Propranolol works for anxiety

Propranolol is part of a class of drugs known as beta-blockers ^[2]. Beta-blockers are, first and foremost, heart medication, prescribed or supplied over the counter to treat conditions like:

• Angina (chest pain)
• Arrhythmia (irregular heartbeat)
• Hypertension (high blood pressure)
• Migraines

Propranolol slows the heartbeat and lowers blood pressure, by blocking the release of the hormone epinephrine (commonly known as adrenaline), which has the opposite effect. When adrenaline is released, the heart beats faster, more blood gets pumped around the body, and for some people, undue stress is caused to the heart and cardiovascular system.

It just so happens, adrenaline is also the cause of many of the physical symptoms of anxiety and stage fright. The reason we experience high blood pressure, sweating and rapid breathing before a performance or social setting is our body’s “fight or flight” response, a natural process of the nervous system designed to help us survive dangerous or threatening situations.

When our brain interprets that we may be in danger, it kicks the fight or flight response into action, which releases a flood of adrenaline into the bloodstream ^[3].

With anxiety disorders, our system incorrectly interprets some situations, such as a performance, as a life-threatening situation, and thus starts to release adrenaline into the bloodstream. This results in symptoms synonymous with anxiety, such as trembling, sweating, and high blood pressure.

Propranolol counters by slowing the rate at which adrenaline is released, and thus providing relief for many of the unwanted and unnecessary physical symptoms.

So, while Propranolol does not address the root causes of anxiety, it can be effective in treating and reducing the symptoms, which can get in the way of a performance or produce a degree of discomfort in social settings.

A video explaining how Propranolol beta-blocker works for anxiety including dosage

Is Propranolol safe?

Generally speaking, Propranolol is safe, including for long-term use ^[4]. While taking beta-blockers for anxiety is often done “off-script”, meaning for something other than the original use, doctors do prescribe Propranolol to treat anxiety.

While there are no major risks, there are some side-effects that come with Propranolol. It’s common to feel slight dizziness or light-headedness, due to how the drug lowers your blood pressure.

It can also have interactions with other medicines, and may not be suitable for people who already have low blood pressure, or people taking other medicine for high blood pressure.

There is also a risk of withdrawal if taken for a long time and abruptly stopped. The symptoms of withdrawal are consistent with a spike in blood pressure, and can be serious ^[5]. For this reason, it’s recommended to taper off over a period of four to seven days after long-term use ^[6].

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Propranolol dosage for anxiety

Much of the dosage information you’ll find for Propranolol are for treating heart conditions and high blood pressure. Thus, it’s vital that you understand the recommended Propranolol dosage for anxiety, if this is the reason you’re taking it.

Propranolol in tablet form ranges in strength from 10mg tablets to 160mg. It also may be prescribed in liquid form, however this is most often used for infants, so we’ll stick to Propranolol in tablet form here.

Adult doses for things like hypertension, angina and arrhythmia generally range from 40mg to 320mg per day, depending on the condition ^[7]. That may be split into several doses per day.

These doses are likely to be overkill for anxiety however, and increase the risk of negative side effects, dependence and withdrawal symptoms, without any significant benefit.

The recommended Propranolol dose for anxiety is between 10mg to 40mg. 10mg may be enough to see relief from your symptoms. If not, it is generally safe to increase the dosage up to 40mg. However, keeping to the smallest dose that proves effective will help minimize any side effects.

Be aware, this is just a guideline, and not medical advice. Pay attention to the dosage prescribed by your doctor, as you may have other medical conditions or prescriptions that have to be taken into account.

When to take Propranolol for anxiety

If you take Propranolol for performance anxiety and stage fright, you can take it only when necessary for the relief of performance anxiety symptoms. There’s no need to maintain a regular dose. In fact, doing so increases the risk of harm, specifically withdrawal.

Take your dose approximately one hour before the event, performance or whatever reason you need relief. Propranolol can be taken with or without food, so there is no need to worry about timing it with your meals.

Standard release vs sustained release

Note that Propranolol tablets come in two forms: standard release (also referred to as immediate release) and sustained release.

Standard release tablets are absorbed by the body and start working almost right away, whereas sustained release tablets dissolve slowly, and continue to be absorbed throughout the day.

Sometimes sustained release tablets are prescribed for conditions that require consistent treatment, as they don’t need to be taken as often. However, for performance anxiety, you need immediate relief, so only standard release tablets should be considered.

How fast does Propranolol start working?

Propranolol generally provides relief from symptoms within 30 to 60 minutes. This may vary from person to person, depending on factors like body composition, dose, severity of symptoms, and more.

For some people it may start working in as little as 20 minutes, or in rare cases, several hours.

For performers, it’s best to take your dose around an hour before you need it, to give enough time for it to kick in.

How long does Propranolol last?

The exact length will vary from person to person, but for most, the effects of Propranolol last for around four hours.

The half-life of Propranolol is between 3-6 hours ^[8]. Half-life means the time it takes for half of the drug to be processed and no longer active in your body.

Small amounts of Propranolol may remain active for as long as one or two days, so in rare cases, side effects may remain for this length of time.

Is Propranolol the best solution for performance anxiety?

Propranolol certainly shows efficacy in treating the physical symptoms of anxiety, particularly those of performance anxiety and stage fright. Doctors even prescribe it for this use, and it’s quite commonly used by classical musicians to treat anxiety during a performance ^[9].

Is it the best way to deal with performance anxiety, though?

Lifestyle changes, if possible, should always be preferred. Try breathing exercises, yoga, meditation, or cognitive-behavioral therapy to address the root issues of your condition. Fear Setting is an interesting exercise for overcoming stage fright, recently made famous by the author Tim Ferris.

Alternatively, if you need immediate, short-term relief, natural alternatives may provide similar benefits to beta-blockers like Propranolol, with less risk of side-effects, dependence or withdrawal.

Cognitive-enhancing supplements like GABA and L-theanine may help boost mental clarity and help you de-stress before a performance ^[10]. Additionally, supplementing with certain vitamins and minerals, such as Magnesium and Vitamin B6, may be effective in reducing even severe cases of stress ^[11].

Another natural solution, PerformZen, has proved extremely effective in my experience at treating performance anxiety. This supplement features a combination of the four ingredients mentioned above, as well as Theacrine, which aids mental clarity and energy, and Ginkgo Biloba, which is an effective stress reducer ^[12].

This combination provides the positive calming effects of Propranolol, but also boosts alertness and mental clarity, which are more subtle symptoms of performance anxiety that beta-blocker drugs do not address.

This may mean a natural solution such as the one above is not only safer, but more effective than beta-blockers for performance anxiety.

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Final thoughts on the right Propranolol dosage for anxiety

The effective dose for Propranolol will vary from person to person, as each person’s body is likely to react to it a little differently. However, you can generally expect a dose from 10 mg to 40 mg to provide sufficient relief.

It’s important to understand that the Propranolol dose for anxiety is much less than that which is recommended for many other conditions, such as angina or hypertension.

Be sure to follow your doctor’s advice when taking Propranolol, and if you’re concerned about the side effects or risk of withdrawal, consider trying a natural alternative.

Whether you’re a musician, actor, or public speaker, you might have colleagues that you know take beta-blockers before they go into an audition, speech, or performance.

And you might be wondering if beta-blockers would work for you and if they’re safe?

Here, we’ll cover how beta-blockers work for performance anxiety, as well as their potential benefits and downsides, so you can decide if they’re right for you.

We’ll also cover some natural remedies that might work as alternatives to beta-blockers.

How do beta blockers work for performance anxiety

To gain an understanding of why so many performers take beta-blockers to deal with anxiety, it would be helpful if you first understood what happens inside your body when you experience performance anxiety.

Then you can better grasp the mechanism through which beta-blockers prevent the symptoms.

What happens when you experience performance anxiety

In a nutshell, you experience anxiety symptoms like sweating, trembling, racing heart, etc., because performing in front of an audience is a stressful event for you.

Performance anxiety falls under the broader umbrella of social anxiety disorder (SAD). People with SAD tend to get nervous in various social situations, including performing for an audience ^[1].

You might have developed social anxiety because you had parents/teachers who were overly critical, or you were bullied as a child, or it could also be that social anxiety runs in your family.

Regardless of the reason, when you’re about to walk on stage, your fear and worry sets in. You perceive that there is a threat to your reputation, or that the audience will reject you and you will experience humiliation.

Perhaps you also fear that a bad performance could lead to a loss of future career opportunities.

Your fear and worry about the consequences of a bad performance trigger a stress response within your body ^[2]. This is commonly referred to as the “fight-or-flight” response.

The “fight-or-flight” response

When in the fight-or-flight mode, your brain signals to the rest of your body that you’re in danger (even though you’re not actually in physical danger backstage), and that it needs to get ready to fight or flee to survive.

In response, your body releases a bunch of stress hormones that are meant to amp up your physical performance abilities (like fighting or running as fast as possible).

Your body amps you up by pumping epinephrine (also known as adrenaline) into your bloodstream. The Epinephrine hormone elevates you to a heightened state and causes your heart to pump blood with greater force ^[3].

This results in high blood pressure, racing heartbeat, sweaty palms, and other physical symptoms of social anxiety.

How do beta-blockers work for social and performance anxiety?

Beta-blockers are also known as beta-adrenergic blocking agents. Their main function is to block the release of adrenaline and other stress hormones ^[4].

They are usually prescribed for health conditions like high blood pressure, angina (chest pains), irregular heart rhythm (arrhythmia), and migraines.

But it is well-known that beta-blockers have also long been used by performers to deal with anxiety ^[5].

As we explained above, you experience the physical symptoms of social anxiety because of the adrenaline pumping through your bloodstream and your heart working with greater force.

By blocking the release of stress hormones, beta-blockers prevent your heart from going into overdrive, they keep your blood pressure low, and keep your performance anxiety symptoms at bay ^[6].

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Benefits of beta blockers for anxiety

As we’ll discuss below, many performers, whether it’s actors, musicians, or public speakers, rely on beta-blockers to get through their performances and speeches.

To these performers, beta-blockers can be the difference when it comes to being able to pursue a life and career they’re passionate about.

The reason beta-blockers are so effective is that they essentially block the physical symptoms of social anxiety as we explained in the previous section.

By preventing physical symptoms like sweating, nausea, trembling, etc., you’re able to maintain your composure. It allows you to focus on the task at hand, which is to go out and perform for your audience.

Beta blockers and classical musicians

One group of performers that we know have heavily relied on beta-blockers are classical musicians.

One 2012 German study found that 30 percent of the orchestra musicians surveyed reported that they experienced performance anxiety. Among them, the anxiety was severe among 13 percent ^[7].

Another survey back in 1987 by the International Conference of Symphony Orchestra Musician, representing the largest group of orchestras in America, found that almost 30 percent of their musicians had used beta-blockers for performance anxiety ^[8].

That number is most likely higher today.

Holly Mulcahy, a violinist and concertmaster of the Chattanooga Symphony & Opera ^[9], provides some insight about the use of beta-blockers in a chat with WQXR, New York Public Radio ^[10].

She tells WQXR that “in some backstage areas, beta-blockers are passed around as mints among performers”.

She also explains that in an industry where the use of beta-blockers is so common, not taking one could be a competitive disadvantage.

If you’re at an audition competing for a spot in the orchestra, and others are using beta-blockers to stay calm, you could potentially be at a disadvantage if you’re jittery and it affects your performance.

But still, Mulcahy is aware that beta-blockers are not magic pills. They don’t improve your performance. But they do help prevent too much of a panic, so you can get through a performance or audition.

What are the most popular Beta Blockers?

Here’s a list of the most popular beta-blockers and how they’re used for performance anxiety.

If you’re considering any of these beta-blockers, or any other medications for performance anxiety, you must speak to your doctor before you begin taking them. And that is especially critical if you’re currently on any other medications.

Propranolol (Inderal) for anxiety

Propranolol is used for short-term relief from performance anxiety symptoms. It can help bring your heart rate back to normal, and reduce sweating and trembling.

One of the more popular beta-blockers among performers due to its minimal side-effects, when used only occasionally before a big performance, speech, or audition.

For anxiety, the typical dosage is around 40 mg once a day ^[11].

Atenolol (Tenormin) for anxiety

Atenolol is another beta-blocker popular among performers.

Atenolol has one advantage over Propranolol because it is longer lasting. So, if you have a long day of multiple performances or auditions, and you don’t want to take a beta-blocker before each performance, Atenolol (Tenormin) might be the way to go.

The only risk of Atenolol is that if you take it too often, then sudden withdrawal might cause very high blood pressure.

Dosage varies between 25mg – 100mg for adults depending on various factors. Ask your doctor what would be a safe dosage for you for anxiety symptoms ^[12].

Metoprolol (Lopressor) for anxiety

Metoprolol is less popular than the other two due to a higher risk of side effects, dizziness, tiredness, or nausea. It is typically used for treating high blood pressure ^[13].

Performers seem to prefer Atenolol and Propranolol because they can be equally effective and have a lower risk of side effects. We specifically compare Metoprolol and Propranolol for anxiety purposes in this article.

Another commonly prescribed beta-blocker is Bisoprolol (sold under the brand ‘Zebeta‘) and while it is still effective against anxiety symptoms, it’s just not as popular as the other beta-blockers listed here.

Are beta-blockers safe?

As long as you only use it occasionally, beta-blockers seem to be quite safe with minimal risk of side effects.

But the problem could be that if you need beta-blockers to be able to perform, then you might start using them frequently.

And if you use them too much, then it could get to a point where you become dependent on beta-blockers, and withdrawal could cause other problems like high blood pressure.

So, it is safe to use when you need a quick fix, but it might be a good idea to start incorporating some natural alternatives to beta-blockers, as we’ll discuss below.

What are some natural alternatives to beta blockers?

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

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

But the other benefit of these natural alternatives 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’re releasing less adrenaline in the first place, and therefore experiencing less performance anxiety.

Brain boosting supplements

The first natural alternative is to use a brain-boosting supplement like PerformZen.

PerformZen uses natural ingredients like GABA, L-theanine, and others, to reduce stress and help you remain calm under pressure ^[14].

There are also other ingredients like magnesium and vitamin B6 that work together to increase mental focus ^[15].

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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Green, black, and oolong tea

Green, black, and oolong tea are all excellent sources of L-theanine.

L-theanine is one of the ingredients that increase the availability of GABA in your brain. As we mentioned above, GABA helps you feel more relaxed by reducing excess activity in your brain ^[16].

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

Cognitive-behavioral therapy (CBT)

Cognitive-behavioral therapy (CBT) helps you take challenges you find overwhelming, such as social anxiety, and to shift your mindset around them.

CBT seeks to replace your harmful thought patterns by breaking them down into smaller parts, and then by replacing them with positive ones ^[17].

You would work with a therapist and he or she will help you identify specific aspects of performing that you find stressful.

Then you would do mental exercises and assignments that create new positive associations with those performance aspects to make it less stressful, and eventually, something you look forward to.

Deep belly breathing

Deep belly breathing 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).

Deep belly breaths deactivate the sympathetic nervous system and switch back to the parasympathetic nervous system. It brings your blood pressure down and restores equilibrium in your body ^[18].

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.

Key takeaways about using beta-blockers for anxiety

If you feel like your social anxiety is keeping you from pursuing a career as a performer or speaker, then beta-blockers might help you maintain your composure and help you get through your performances.

But know that they’re not a long-term solution to your anxiety. Beta-blockers are only blocking the release of adrenaline and stopping the physical symptoms at the moment.

And if you need a quick fix, beta-blockers could be exactly what works best for you. But in the long-term, you might only reach your true potential if you address the root causes of your anxiety, and train your brain and body to better deal with stress.

To become more resilient to stress, try some of the natural alternatives to beta-blockers like supplements, CBT, and breathing exercises.

And please, if you do want to try beta-blockers for performance anxiety, be sure to check with your doctor first.

Beta Blockers For Anxiety Frequently Asked Questions

I received some emails from readers who had more specific questions about beta blockers for anxiety. I’m publishing my responses here to refer people to in future. If you have your own questions, leave a comment down below or get in contact here.