The standing agreement is that I will continue on as the chief operator of PerformanceAnxiety.com, and none of the current content on this site (or on related social channels and communities) will be removed or changed. All that’s to say: if you like the current site as it is, and appreciate all of the content we’ve published over the last couple of years, then you have nothing to fear as all of that will remain (perhaps with some editing, updating and reviewing where needed in order to keep everything accurate and up-to-date).

Will Anything Change?

I am in the planning phases with the PerformZen team right now laying out the ‘how’, but we have already determined that PerformanceAnxiety.com will be changing in 3 significant ways:

1. PerformanceAnxiety.com Store: We are going to be introducing several products for sale on this very website! The obvious first additions will be the PerformZen natural supplement and Fear Workbook which are fantastic for managing performance anxiety and social anxiety issues (I reviewed the supplement independently a long while back here, if you’re interested in more info). But we are also developing some courses & workshops specifically to help with getting over stage fright and being the best performer you can be! The store is still being built, but will be available at PerformanceAnxiety.com/Store shortly.
2. Free Get Over Stage Fright (Fast) Course: I have been working on a ‘mini book’ for PerformanceAnxiety.com for some time, but I haven’t had the resources and time to complete it in addition to my client work. The book has the working title “Get Over Stage Fright (Fast)” (a nod to the popular book Getting Over Stage Fright by Janet Esposito, previous owner of PerformanceAnxiety.com). Now that I’m part of the team at PerformZen, we all agreed that focusing on the book as a priority is a very good idea, and I’m already back in the trenches (‘the trenches’ is what I call the desk in my living room) chipping away at it; I really believe this book will be one of the best things I’ve ever produced. But back to the course: I have taken the core ideas of the book, and put together an online course that will help anyone with an upcoming, high-anxiety event such as a keynote, wedding speech, critical sales presentation or practically any ‘on stage’ event. The course will provide you with several techniques that you can use to quickly defeat any performance anxiety/stage fright/pre-performance jitters you’ve been having, while helping you focus in and crush the scenario you’re facing down. The best part, this course is ABSOLUTELY FREE (for now), it’s spread out over 3 days to make sure you have enough time to implement the recommended techniques, and you can sign up and receive part 1 of the course instantly by heading over to PerformanceAnxiety.com/FreeCourse or clicking here!
3. YouTube Channel: We are going to begin producing video content for PerformanceAnxiety.com. You can check out the channel and subscribe to get future updates at YouTube.com/@PerformanceAnxietyVideos

We have A TON more planned, but for now these 3 changes will be taking up all of our time as we roll them out in the next month or two. This is going to be a lot of work, but I am excited and really think that we’re going to add a ton of value to PerformanceAnxiety.com

My goal has always been to make this website the go-to resource for performers, professional or amateur, seeking to overcome their performance anxiety issues and stage fright fears! I fully intend to see that mission through to completion, and then to maintain our status as a deeply researched, constantly up-to-date and trustworthy source of information for anyone suffering from performance fears!

Leave comments down below with any questions, clarification requests or general comments, and I’ll get back to you asap. Or you can always get in contact here with more specific or private questions.

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.

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!

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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.

One review of 288 studies focusing on test anxiety, with the earliest going back to 1988, discovered that there is significant correlation between test anxiety and a wide range of negative educational performance outcomes; including standardized tests, university entrance exams, and grade point average. Correlations were most pronounced at the middle grades level, likely because self-esteem is a significant and strong predictor of test anxiety in students ^[2].

Maybe you’ve been in this sort of situation. You did everything you could to prepare for an important exam. You paid attention during class, took copious notes, studied hard, and likely even sacrificed time with friends and family. You wanted to be prepared as possible because the test results could have a significant impact on your further education, or even your career.

But even though you’ve prepared as much as possible, when it comes time to take the test; it feels like your brain has frozen and your mind goes completely blank.

Of course, as you fail to think of the answers during the test, your anxiety levels increase even more! This makes it even harder to think clearly. At this point you’re probably experiencing the physical symptoms like sweating, trembling, racing heart rate, and even nausea!

If any of this sounds familiar; you have probably experienced test anxiety for yourself.

Here, we’re going to take a deep-dive into the subject of test anxiety, and try to understand what it is, what causes it, what the symptoms are, who is at higher risk of suffering from test anxiety, and then look at some test anxiety medications and natural solutions that can be used to overcome test anxiety symptoms so that you can ace your next exam.

What is Test Anxiety?

Test anxiety, sometimes called exam anxiety, is a type of performance anxiety that only occurs before and/or during an exam. Test anxiety is most common amongst the student populations of the world (perhaps due to regularity with which students take exams), and highly test-anxious students have been shown in studies to score about 12 percentile points below their low (or typical) anxiety peers ^[1][3][4].

A little bit of anxiety and nervousness before an exam is normal, and some even like the small spike in adrenaline it provides as it helps them focus the mind during the test.

For some, however, their test anxiety is so severe that it makes the act of taking exams painful, often leading to extreme measures like skipping exams or even dropping out of studies completely.

It’s common for students to turn to measures like pharmaceutical drugs, relaxants or alcohol to help them “relax” before a test ^[5].

So while a student suffering from test anxiety may seem trivial, or like something that everyone goes through, it’s worth addressing and developing management techniques for early if more severe symptoms start to show.

Symptoms of Test Anxiety

Test anxiety, and performance anxiety in general, is a complex condition. The causes and symptoms of test anxiety can vary depending on the individual and the underlying causes that contribute to their stress. Test anxiety can have physical, mental, as well as emotional effects ^[6].

Physical Symptoms

• Trembling hands
• Elevated blood pressure
• Excessive sweating
• Rapid and irregular heart rate (arrhythmia)
• Dry mouth
• Nauseousness
• Dryness in the mouth

Mental Symptoms

• Trouble concentrating
• Not being able to think despite having prepared for an exam
• Use of substances like alcohol or beta-blockers
• Racing uncontrolled thoughts
• Increased anxiety

Emotional Symptoms

• Frustration
• Feeling of helplessness when it comes to education or career
• Low self-esteem
• Tendency for blaming oneself for poor test performances
• Negative self-talk, which makes test anxiety worse

Causes of Test Anxiety

In order to try and come our exam anxiety, we must first try to understand why we experience the condition in the first place.

As with the symptoms of anxiety (listed above), the specific causes of test anxiety tend to vary heavily depending on the individual experiencing it. Generally speaking, however, there can be both mental and biological causes of test anxiety.

If you have a history of poor past performances during exams, and especially if you were judged negatively for it by your teachers, parents, peers, etc., you likely have a significant amount of stress and anxiety built up around the subject of exams ^[7].

You fear the negative experiences of the past may repeat itself, and you worry that you’ll have to face the disappointment and humiliation all over again ^[5].

Fight-or-flight Response

Due to the fear surrounding exams, you most likely experience a significant amount of stress when you’re about to take a test. This elicits a stress-response within your body, also known as the fight-or-flight response ^[8].

‘Fight-or-flight mode’ is a human response developed through thousands of years of evolution, where humans experience an acute stress response when faced with dangerous, potentially fatal, threats. Although society is, generally speaking, a lot safer today then when our ancestors lived amongst predatory animals with minimal defensive tools available to them — the stress response we experience in the face of perceived threats or dangers remains just as strong as if we were facing down an attacking lion ^[9].

When we are in this fight-or-flight mode, our bodies release a stress hormone known as adrenaline. As we explained previously, a slight adrenaline spike may even improve your testing abilities. But too much adrenaline puts your heart under increased pressure, resulting in the physical symptoms of test anxiety such as poor cognitive function, higher blood pressure, sweating, and more ^[5].

Anxiety before/during an exam can often become a self-fulfilling prophecy. When your test performance suffers due to worry, you might think that your fear was justified to begin with, and that you are indeed bad at tests. This negative self-talk can then increase your stress during future tests, or worse, stop you from pursuing your education or career advancement.

Who is at a Higher Risk of Test Anxiety?

Here are several factors that might increase ones odds of experiencing severe test anxiety ^[6]:

Patterns of Behavior During Previous Tests & Exams

As mentioned previously, if you have had negative outcomes during previous tests & exams, due to either anxiety or inadequate preparation (or some of both), you may be fearful of similar results going forward. The fear of being judged then makes your anxiety worse, and affects your ability to perform during the next exam.

Perfectionism

Perfectionism is “a propensity for being displeased with anything that is not perfect or does not meet extremely high standards.” ^[10]

If you’re a perfectionist by nature, then you may be more prone to test anxiety. It’s likely that you believe (and fear) that anything less than a perfect score will be considered a failure. The added pressure can exacerbate your stress.

If you had overcritical parents growing up, or if you were bullied as a child, you may be at a higher risk of social anxiety and test anxiety because of perfectionism.

Self-esteem Issues

If you suffer from self-esteem issues, then you may already doubt your ability to do well in tests, which could cause you to feel nervous during future exams.

If your test performance suffers due to anxiety, it could hurt your self-esteem even further, potentially making the problem worse and leading to a vicious cycle.

GABA Imbalance

Sometimes biology can play a larger role in test anxiety, more than mental and emotional causes. If specific neurotransmitters (chemical messengers in your nervous system) are out of balance, you may be at a higher risk of mental health conditions, including test anxiety ^[11].

Gamma aminobutyric acid (GABA) is a major neurotransmitter that plays a critical role when it comes to social anxiety and test anxiety. GABA reduces the level of activity in your nervous system and promotes alpha waves in your brain, both of which have been proven to increase calmness and relaxation.

In fact, one of the most effective ways to combat the symptoms of test anxiety is to boost GABA levels in your brain, as we’ll discuss later in this article.

Test Anxiety Medications

Although something like 18% of the adult US population suffer from anxiety disorders, only a quarter of those who do so actually seek medical treatment, according to the Anxiety and Depression Association of America (ADAA) ^[12].

An estimated 25% of the US population aged between 13 to 18 years old suffer from anxiety disorders, again with many cases going untreated ^[13].

With so many Americans suffering from anxiety symptoms, and many of those within school and further education age-ranges, it is estimated that many students are suffering from severe test anxiety. With severe test anxiety, symptoms are more intense and and persistent then usual. These students may be suffering from panic attacks in some cases, and are likely experiencing poor test performance despite preparing and studying thoroughly.

Doctors, pediatricians in some cases, might suggest and/or prescribe medications to help control severe test anxiety symptoms. While we always recommend counseling and trying mental and physical techniques to help overcome test anxiety first before using medication, if it is a path you are going down then let’s summarize the most common test anxiety medications used by students today, and attempt to understand how (and if) they work.

Beta Blockers for Test Anxiety

Beta blockers are a class of pharmaceutical drugs that work by blocking the effects of adrenaline hormone, which plays a vital role in triggering a fight-or-flight response in a stressful situation. Beta blockers reduce stress on the heart, while lowering the force with which it has to pump blood. This has a relaxing impact on the blood vessels found in the heart, brain, and around the body ^[4].

Doctors typically prescribe beta blockers for a variety of conditions such as abnormal heart rhythm, high blood pressure, angina, glaucoma, among others.

If a student uses a beta blocker like Propranolol (Inderal) or Metoprolol (Lopressor) prior to a test or exam, the drug would slow their heart rate, reduce trembling and sweating, and regulate their breathing and blood pressure (just as it would for someone using the medication to help with a cardiac condition). Beta blockers help the student to feel relaxed, essentially negating any stress response and helping them get through the exam ^[15].

Propranolol, the most prescribed beta blocker in the US, is typically used for short-term relief from the physical symptoms of social/performance/test anxiety. We compare Propranolol to Bisoprolol, another beta-blocker, in this article.

Atenolol is another beta blocker with longer lasting effects than Propranolol, but it carries some added risks. Metoprolol, which is also a popular beta blocker, is said to have (significantly) more side effects than the other beta blocker medications.

Beta-blockers are generally considered to be safe, especially if only used occasionally. But they do come with potential side effects, specifically ^[16]:

• Fatigue
• Mood disorders
• Digestive issues like gas, bloating, and constipation
• Nausea, and in some cases, vomiting
• Heartburn
• Dry mouth

In some rare, but severe cases, one might also experience the following side effects:

• Wheezing and/or shortness of breath
• Swelling of extremities like hands, feet, or ankles
• Fainting
• Pounding heartbeat

If you experience any of the side effects mentioned above, you should immediately notify your doctor.

The major issue for most with beta blockers is the convenience factor: they are prescription drugs that require you to visit and consult with a doctor every time you need more. This problem is partially solved through online services like Kick & Hims, but not completely.

Benzodiazepines for Test Anxiety

Benzodiazepines, typically prescribed under the brand names Valium, Xanax, Restoril, Ativan and Klonopin, are the oldest and most well-known controlled substances for anxiety ^[17].

Benzodiazepines like Xanax work by decreasing abnormal excitement within the brain. They act on the brain and central nervous system (CNS) to produce a calming effect ^[18].

Xanax, specifically, slows down the movement of brain chemicals that may have become unbalanced, resulting in a reduction in nervous tension and anxiety. Much like Ambien, Xanax does this by boosting the effects of a natural chemical called gamma-aminobutyric acid (GABA), which is made in the brain ^[19].

The issues with using benzo medications to help with your test anxiety are numerous ^[20]:

1. Benzodiazepine drugs reduces awareness and reaction times; a major issue for those completing an exam!
2. Benzodiazepines and similar prescription drugs have short term negative effects on memory, co-ordination, concentration and reaction times, and are (extremely) addictive if used for a long time, with withdrawal leading to fits, hallucinations, agitation and confusion. These drugs have also become widely used drugs of abuse since they first came on the market. The prescribing guidelines doctors have to follow say that use of benzos to treat short-term “mild” anxiety is inappropriate. Benzos are only supposed to be used short term for a ‘crisis in generalized anxiety’. Test anxiety in isolation is not a generalized anxiety disorder.
3. Benzodiazepine and similar controlled drugs are illegal in a number of countries. They may be confiscated or you may find yourself in trouble with law enforcement in some places.

Natural Test Anxiety Solutions That Don’t Require Medication

There are some things that you can do to overcome your test anxiety so that you can take exams confidently, and pursue your ideal life path without the use of medications.

Before we delve into the best natural techniques to overcome test anxiety, we should note that although all of these recommendations are natural, healthy, and backed by research, the person that can help you the best is a licensed therapist. He or she can evaluate your specific case and recommend a treatment plan based on your underlying issues.

That being said, all of the following methods will help you develop a more resilient body and brain, so you can handle your stress and anxiety better and get back to acing your exams.

Cognitive-behavioral Therapy (CBT)

Cognitive-behavioral therapy, abbreviated as CBT is a form of therapy designed to shift your thoughts around the idea of taking a test to make it less stressful for you.

CBT aims to take an idea that you find overwhelming, such as taking an exam or having a discussion with your family members about a sensitive issue, and break it down into smaller parts ^[21].

Instead of thinking of the entire exam process, which you may find scary, your CBT therapist will help you identify the numerous different aspects of an exam. He or she will then identify any negative thought patterns associated with each of the smaller elements, and work with you to replace them with more positive ones or be more prepared to face them down if they can’t be replaced.

Your therapist might give you mental exercises for practice, or even homework as a part of the CBT process. Studies have shown that if you’re enthusiastic and positive about CBT, there is a higher likelihood that it will be useful for you ^[5].

CBT has also been proven to be one of the more effective long-term solutions against mood disorders like anxiety and depression ^[22][23].

Improving Heart Rate Variability (HRV)

Broadly speaking, exercise in the form of cardiovascular or strength training (or other variations) is a very effective tool against anxiety.

Working out regularly strengthens your cardiovascular system, which could make you more resilient against the physical symptoms of test anxiety, such as higher blood pressure and palpitations. Exercise also promotes overall wellness, of course, while promoting relaxation.

Yoga, specifically, can be especially useful against test and exam anxiety. Yoga increases your heart rate variability (HRV), which is a measure of the variation in time between each heartbeat. HRV is also an indicator of your ability to respond to stress flexibly ^[24].

So, an increased HRV through yoga or other forms of exercise means that your body will be better equipped to handle any stress response, and combat the physical symptoms of test anxiety. If you can remain physically calm, you will be able to maintain focus during the exam.

Ideally, you should include strength training, cardiovascular exercises like cycling or swimming, as well as yoga, in your training plan throughout the week, especially in the run-up to a time period containing several tests and exams. Finding the time to regularly perform a well-rounded exercise routine will create a resilient mind and body that can combat stress and fight anxiety.

Visualization

Many students have success using the process of visualization to “practice” positive test outcomes in your mind prior to actually taking the exam. Having already experienced the situation in your mind, you might be less anxious when you’re going in for the actual test.

Visualization can reduce your anxiety by helping you manage your negative emotions. You put yourself in a relaxed state through mindfulness practice, or guided imagery, and then imagine a positive outcome in your mind.

For test anxiety, you could imagine yourself in the testing room, getting the test, seeing the questions, and instead of stress, you feel confident as you calmly answer all of the questions ^[5].

Visualization may take some time and practice to get used to, but it can be a powerful tool ^[25]. Some of the most successful people in the world like Oprah Winfrey, Will Smith, Arnold Schwarzenegger, and Michael Phelps, have all used visualization to achieve success ^[26].

Natural Supplement for Test Anxiety

Many of the clients I work with have had success using a supplement called PerformZen to help manage more severe test and exam anxiety issues. PerformZen is a natural supplement that is designed to promote calmness and mental focus, so you can perform at your optimal level, whether it’s during an exam, a performance, or at a social event. I even interviewed one of the founders of PerformZen and secured a limited-time discount for PerformanceAnxiety.com readers. Check that out here.

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So Is It Possible To Overcome Test Anxiety Using Medication?

If you feel like test and exam anxiety has been holding you back from pursuing the education or the career that you want, you should know that there are options and ways that you can overcome your fear of exams.

Yes, medications such as beta blockers or Benzodiazepines are one way to try and manage test anxiety, and if you do go this route you should consult with a licensed therapist or healthcare professional who can recommend a treatment plan based on your specific needs and health variables.

You can also try some of the research-backed tips mentioned in this article like exercise and yoga to improve HRV, cognitive behavioral therapy (CBT), and visualization to reduce your overall stress and promote calmness and confidence.

Best of luck in your upcoming exams, if you have them, and I hope these techniques mentioned here help you out! Leave a comment below sharing your experiences managing and overcoming test anxiety yourself.

For some people, anxiety or a slight fear of public speaking can turn into a full-blown phobia, clinically known as glossophobia. People with glossophobia can feel overwhelmed by the mental and physical effort of speaking publicly and it can cause different problems in the affected person’s life. Fortunately, different strategies can help you overcome glossophobia and improve your public speaking skills.

This article looks at the reasons and causes of glossophobia, and offers some effective public speaking tips to help anyone master the courage to speak in front of a crowd. We also look at the use of beta blockers & other anxiety medications and their effectiveness in overcoming glossophobia.

What Is Glossophobia?

Glossophobia is a medical term that refers to an intense phobia or fear of public speaking. This fear of public speaking is verycommon, affecting as many as 40% of Americans ^[1]. Glossophobia is not a chronic condition or a dangerous disease, however.

For those affected by Glossophobia, speaking in public (or just the thought of doing so) typically triggers intense anxiety and feelings of discomfort. With that, you may start to uncontrollably tremble, sweat, and experience a racing heartbeat. You might also get the overwhelming urge to walk away (or run) completely from the stress-inducing situation.

As a social anxiety disorder, the effects of glossophobia might extend beyond the occasional nervousness or worry. It might cause an intense fear that’s out of proportion to the thought or physical effort required to speak in public. Glossophobia can also get worse over time and may interfere with your normal functions and/or career tasks.

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Is Glossophobia (Fear of Public Speaking) The Number One Fear In The World?

You’ve probably heard that most people fear public speaking more than death. While that may sound crazy, the vast majority of people in the world rank glossophobia as their number one fear. According to the National Institute of Mental Health, glossophobia affects about 75% of people worldwide ^[3].

For some people, that simply means feeling uncomfortable when speaking to a group of people. For others, it’s the fear of speaking to even one person if they have the power to evaluate your performance; like a supervisor, professor, or interviewer.

The comedian Jerry Seinfeld tells his classic joke about public speaking being more scary then death!

Public Speaking Anxiety Symptoms

When faced with a situation where you have to give a presentation or speak in public, most people experience a fight-or-flight response. This is your body’s way of preparing to defend itself against perceived threats. This threat response is biologically programmed into us, and was a natural response to threats in nature that our ancestors likely faced constantly. Although we may live in a more civilized and (broadly speaking) safer world today, our biological responses and bodily processes still remain as if a tiger attack was just as likely as anything else.

If we can understand the triggers of this ‘threat response’ underlying our public speaking fears, then we can perhaps develop a glossophobia prevention and treatment strategy.

When our bodies feel threatened, the brain becomes hyper-alert and prompts the release of hormones like adrenaline. This increases the energy and blood sugar levels in the body, causing our heart rate and blood pressure to rise. It’s at this point that we see common flight-or-flight/anxiety symptoms such as ^[1]:

• Trembling
• Sweating
• Rapid heartbeat
• Muscle tension
• Vomiting or nausea
• Hyperventilating or shortness of breath
• Dizziness
• Urge to escape & get away

Beta Blockers For Public Speaking: Do They Work?

If you’re suffering from severe glossophobia and it’s interfering with your daily schedule, it’s best to consult a medical professional. A doctor, therapist or psychologist can help you develop an effective treatment plan tailored to your needs. Fortunately, most people can overcome their glossophobia using cognitive behavioral therapy, which would consist of working with a therapist/CBT practitioner to identify the root causes of their phobia.

When therapy fails to relieve any glossophobia symptoms, your doctor might prescribe pharmaceutical solutions such as beta-blockers to help treat your anxiety issues. Beta-blockers are normally used in treating cardiovascular conditions like high blood pressure, chest pains, and some heart conditions ^[5]. These medications limit the release of adrenaline and stress hormones in your body.

Because of how beta-blockers influence your body, many health professionals recommend them for treating performance anxiety and glossophobia symptoms. Some recent research into public speaking shows that performers actually experience physical glossophobia symptoms because of the adrenaline that their brain pumps into their bloodstream when on stage ^[4].

By using beta-blockers to limit the release of the stress hormones in your body, you are preventing your heart rate from spiking, maintaining low blood pressure and helping to hold off performance anxiety symptoms. However, using beta-blockers come with a risk of developing dependency and withdrawal symptoms that cause issues like high blood pressure ^[5].

So, while beta-blockers are safe for public speakers & performers looking for a quick solution to glossophobia, it’s wise to incorporate natural beta blocker alternatives for anxiety in order to be able to consistently perform for the long run. I constantly recommend the PerformZen supplement as a natural performance anxiety solution that can alleviate your physical glossophobia symptoms without developing dependency issues in the long run ^[6].

10 Public Speaking Tips To Help With Glossophobia

Many famous people have long struggled with glossophobia, ranging from politicians to actors and presidents. Warren Buffet, for instance, admitted in an interview that he was scared of speaking in public early in his career ^[7]. The successful investor and chairperson of Berkshire Hathaway had to overcome his glossophobia to achieve his full potential.

Another extreme case of glossophobia was Mahatma Gandhi. According to an article published in The Atlantic, Gandhi had such a severe case of glossophobia that he froze and ran out of the courtroom during his first case as a young lawyer ^[8]. Fortunately, Gandhi managed to overcome his fears over time and turn them to his advantage.

But how did Gandhi, Warren Buffet, and others overcome their fear of public speaking?

If you’re faced with similar public speaking problems, there are several public speaking tips you can use to overcome your glossophobia and master the courage to address a crowd. These public performance anxiety tips might not make you have the exact same results as Gandhi or Buffet (with your speeches or bank account), but having solid public speaking skills will serve you continuously throughout your life and career. Here are our 10 tips:

1. Practice, Practice, Practice

You don’t expect an athlete to win the Olympic gold without putting in hours of practice or rehearsal. And while your public speaking goals might be a little more modest than those of Olympic athletes, you will still have to put in the time if you want to get better at it. From creating a decent structure, storytelling, or ending compellingly, you’ll need to take note of your strengths and weaknesses at the end of every presentation.

A little practice or rehearsal can go a long way in helping you reduce that shaky feeling of performing in front of an audience. Preparing and rehearsing your speech will also help you get the timing right when delivering your speech. Of course, practice might be a pain in some cases, but nothing beats practice when preparing for a public speaking event.

Instead of letting fear build up in your body when you’re worried about giving a speech, take up the challenge early enough by starting your rehearsal with plenty of time to spare. Proper practice will help you time the message well and ensure you cover all the key elements without making things appear rushed.

Famed keynote speaker and best-selling author Brian Tracy says the best way to combat glossophobia is to “prepare your speech so well that you can answer any possible question the audience may throw at you” ^[9]. You’ll want to be prepared well for your presentation or speech so that you have ready answers for whatever surprise question that might be thrown your way. This isn’t always possible, but it’s a good mindset & approach to keep in mind while practicing.

2. Perform A Full Trial Run-Through/Rehearsal of your talk

This is a direct follow-up to the first tip on practice. I know it’s time-consuming, but practicing for your speech is the best way to reduce your anxiety and nervousness level ahead of your presentation. Of course, speech planning can be a nightmare with a busy schedule, but your presentation will not be as impactful without proper preparation.

Public speaking experts recommend writing down your whole speech and polishing up every minor detail until everything looks great without any unnecessary details ^[10]. I also recommend performing a ‘mock’ performance in front of your family, friends, or colleagues. You can simply ask someone to film your speech performance using a smartphone and look at it to identify any quirks or lines that are not flattering.

If you’re not close to anyone who you can run your speech by; talking in front of a mirror, wall, or indoor plant also works. You’ll want to talk loudly when rehearsing your speech ahead of a live event in order to memorize the key points and deliver them easily. Just writing down your speech without rehearsing it verbally usually isn’t enough.

3. Arrive Early At Venue & Mentally Conquer The Environment

According to celebrated public speaker, trainer, and author Michael Virardi, arriving early at the venue before going up on stage dramatically reduces stress ^[11]. Try and arrive at least two hours before you’re scheduled to be on the stage in order to give yourself enough time to find your bearings, get a feel for the room and focus on your speech delivery. If you arrive before the other speakers start taking the stage, you’ll be able to walk around the stage and visualize your audience and performance in the space; a great way to reduce your anxiety.

Speakers that arrive only minutes before they’re set to take the stage are often unprepared and flustered. This carries through to your presentation and your audience might feel like your speech is rushed. The hosts might also notice your lack of preparation if you don’t seem confident enough while on the stage.

For larger events, arriving early or visiting the venue ahead of the event will give you enough time to iron out technical difficulties like video, sound, and lighting control. Whether you’re working with a single technician or a large team, arriving early allows you to meet your crew and test the equipment. This can make a huge difference in how you deliver your speech.

More importantly, arriving early helps you to see & meet your audience in advance. This is a crucial step in mentally conquering your environment, which goes a long way in reducing your anxiety levels. The room might not fill up until a few minutes into the presentation, but you can build a rapport with the proactive audience that tends to arrive early.

4. Perform Breathing Exercises

Some breathing exercises have proven effective in dealing with the onset of the physical symptoms caused by your body’s response to stress ^[12]. When you’re exposed to stressful situations like public speaking, your breathing patterns change. Typically, you’ll take small shallow breaths using your shoulders instead of the diaphragm. This breathing style disrupts the gaseous balance in your body and is not good for blood flow.

Hyperventilating or shallow over-breathing can intensify feelings of anxiety by prolonging the physical symptoms of stress. As such, controlling your breathing patterns can help minimize these symptoms. When you’re relaxed, you breathe through your nose slowly and gently.

Deliberately mimicking a relaxed breathing pattern can help to calm your nervous system ^[13]. One way you can do that is by invoking a deep breathing technique known as diaphragmatic breathing or abdominal breathing. Deep diaphragmatic breathing encourages the full exchange of oxygen in your body, which helps to slow your heartbeat and stabilize your blood pressure.

5. Develop A Pre-Performance Routine

Many CEOs, actors, singers, comedians, and other successful celebrities have some type of pre-performance ritual before getting on the stage or going into important engagements. But why?

Does it mean that most public speakers or celebrities that have pre-performance rituals are superstitious or is it just for the warm-up? Well, “Psyched Up” author Daniel McGinn believes there’s a strong link between pre-performance rituals and mental preparedness, which is essential in effective public speaking ^[14].

If you’re too relaxed while on the stage, you risk boring your audience. For instance, if you’re taking long pauses, talking at a monotonous slow pace, and strolling on the stage, it might seem like you’ve forgotten why you’re there. Additionally, if you are over-stressed, you’re likely to speak too rapidly, making you seem inexperienced or unprofessional.

Any type of pre-performance routine will enhance your performance, put you in the right mind frame and help you combat anxiety ^[16]. While such rituals might seem superstitious, research suggests that it psyches you up, helping to focus your concentration and energy. Essentially, a pre-performance ritual helps puts you into your optimal performance zone. However, your routine needs to be unique to you and without any negative thoughts.

6. Join A Public Speaking Class

Whether you’re a seasoned public speaking veteran accustomed to delivering speeches to massive crowds, or you’re relatively new at speaking to people, taking a public speaking class is highly beneficial. A good public speaking class can teach you key communication skills that can help you achieve different goals.

For most people, learning how to deliver a speech in public is what comes to mind when they think about public speaking classes. In reality, a good public speaking class is designed to teach you essential communication skills that can be useful in everything from speech delivery at a family gathering to presenting ideas at work.

Of course, there are different public speaking courses available today, each with its unique benefits. That includes professional speaking classes, motivational speaking courses, and corporate or executive speaking classes.

7. Get ‘Into Your Body’

Getting into your body simply means taking on some physical exercises before your speech performance. Some people like to burn off energy by doing some yoga, cardio, or taking long walks. Whenever you feel the anxiety building up in your body ahead of a big presentation, play a basic yoga routine video on YouTube and burn some energy.

Research shows that physical activity makes your heart pump faster and stimulates the release of endorphins in your brain ^[16]. The endorphins interact with your brain’s receptors, helping to reduce any pre-presentation anxiety that you might have. Fortunately, yoga can increase your heart rate variability, which increases the body’s ability to handle stress ^[17].

Regular yoga practice can also make you more resilient towards stressful situations and change how you react to physical anxiety symptoms like trembling and heart palpitations ^[18]. The yoga exercises teach your brain to flexibly adapt to change easily, which is essential in building the stress resilience required to overcome glossophobia.

8. Try The Stoic ‘Fear Setting’ Exercise

You’ve probably heard that visualizing positive results can help you succeed in your endeavors. However, there’s another powerful approach that involves visualizing the worst scenario and coming to terms with it. That’s what stoic fear-setting is all about.

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!

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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.

For some, anxiety is a chronic condition interferes with daily life. While there may not be one definitive cause for anxiety; it is generally believed to be the result of a combination of genetic and environmental factors.

Recent research is also suggesting that anxiety may be neurodivergent, meaning that it may stem from differences in the brain. This theory is supported by the fact that anxiety disorders are often comorbid with other conditions, such as ADHD and autism.

While more research is needed within this area, the neurodivergence theory provides a potential explanation for why some people are more susceptible to anxiety than others.

Neurodivergence, or Neurodiversity, is quite a new concept within the mental health space itself. In this article we are going to look into what neurodivergence is, what the benefits & symptoms of neurodivergence are, and answer the question once and for all: is anxiety neurodivergent?

What is Neurodivergence?

The term “neurodivergent” was first coined by the Australian sociologist, Judy Singer, in the late-1990s and it refers to the idea that differences in the human brain are natural and normal and, in many cases, can lead to meaningful and positive insights and abilities ^[1]. People are described as neurodiverse when their thought patterns, behaviors, or learning styles fall outside of what is considered “normal,” or neurotypical.

Neurodiversity is:
– a state of nature to be respected
– an analytical tool for examining social issues
– an argument for the conservation and facilitation of human diversity

~ Judy Singer 2020

According to the Syracuse University National Symposium on Neurodiversity, neurological differences that fall under the banner of Neurodiverse include ^[2]:

• Dyspraxia
• Dyslexia
• Attention Deficit Hyperactivity Disorder (ADHD)
• Dyscalculia
• Autistic Spectrum
• Tourette Syndrome

You may notice that anxiety isn’t on that list, but we’ll return to that point later.

Although Neurodivergence is a growing idea in mainstream science, it does not (yet) receive official recognition in scientific and diagnostic circles. But it’s still become an important term, particularly for those within the neurodiverse community.

What is Neurotypical?

As an inverse to neurodivergence, the word “neurotypical” may be used to describe individuals whose brain develops and functions in ways that are considered usual or expected by society. This term may also be used to refer to those who do not have developmental disorders, like autism or the conditions in the list above ^[3].

This typically means that neurotypical individuals are:

• May not have cognitive, learning, or social difficulties that necessitate coping mechanisms
• May have lack of speech or certain motor impediments
• May have the ability to readily identify and respond to social cues
• May not experience sensory issues
• May hit all mental (and some physical) developmental milestones

What Is It Like to Be Neurodivergent?

There is no single, all-encompassing answer to what it’s like to be neurodivergent. There isn’t even an answer to what it’s like to have any kind of specific neurodivergent diagnosis as people are too individual and unique; in the same way that it doesn’t feel the same for all people to have bodies, it doesn’t feel the same for all people with different neurodivergent diagnoses.

Life is experienced differently by all humans, whether their brains function very similarly to the majority of people, or very different ^[4].

What Are The Benefits of Being Neurodivergent?

There are many people who are neurodivergent who are also quite accomplished and successful. Obviously “correlation does not imply causation” as the saying goes, but it seems clear that there can be benefits to being neurodivergent.

More and more people who are neurodivergent are talking about their experiences on public platforms, some examples of famous and successful people who are neurodivergent including ^[5]:

• Animal scientist and author Temple Grandin
• Oscar-winning actor Sir Anthony Hopkins
• Musician and singer Florence Welch
• Olympic gold medalist Simone Biles
• Climate activist Greta Thunberg

Experts also believe several accomplished historical figures were neurodivergent based on evidence from their lives, including:

• Nobel Prize-winning physicist and chemist Marie Curie
• Nobel Prize-winning theoretical physicist Albert Einstein
• Artist Vincent Van Gogh
• Inventor and engineer Nikola Tesla
• Author F. Scott Fitzgerald

Business leaders also have a growing understanding of the value of being neurodivergent. In 2017, the magazine Harvard Business Review published “Neurodiversity as a competitive advantage.” The article details the benefits of hiring people who are neurodivergent and why more businesses are doing so.

That same article noted that several major national and international corporations have hiring processes that can accommodate people who are neurodivergent ^[6]. Those corporations include some of the largest names in information technology, the automotive industry, the banking sector and more.

Is Anxiety a Form of Neurodivergence?

Anxiety is not technically a form of neurodivergence because people can have it whether they are neurodivergent or not. However, statistics from the Anxiety & Depression Association of America (ADAA) show how neurodiverse people can experience anxiety ^[7]:

• 1 in five autistic adults, or 40% of them, may have an anxiety disorder. They are 5 times more likely to have it than non-autistic adults
• 50% of adults with ADHD have a co-occuring anxiety disorder
• 49% of adults with Tourette syndrome may experience anxiety problems

Final Thoughts

As our understanding of mental disorders and traits has grown, the concept of Neurodiversity has woven deeper into the mainstream.

While it is not (yet) recognized officially, the word has found itself in scientific studies, special education, medicine, counseling, and more. This has led to a greater understanding of what we once considered disorders, as well as the importance of such traits in past, present, and future society.

In the US alone, Anxiety has become a prevalent problem in recent years with over 40 million people (approximately 19% of the population) afflicted every year ^[1]. Consequently, millions of prescriptions are doled out for anxiolytic (anti-anxiety) medications like Xanax every year despite increasingly apparent problems of abuse and addiction.

While there are many people who sing the praises of Xanax, many others have felt compelled to wean themselves off it due to the side effects and rapid tolerance build-up that can come with the drug. And that begs a few questions: why is Xanax both so effective and so problematic, and what can you replace it with? Is there a natural alternative that offers the same anxiety-fighting benefits but without the side-effects & addiction risk, while ideally being all-natural and available over the counter? In this article we look at how & why Xanax works for anxiety, what the side-effects & risks are and finally investigate several natural alternatives to Xanax that are available over-the-counter (OTC).

What is Xanax?

Xanax is an anti-anxiety medication in the benzodiazepine family. This is the same family that includes diazepam (Valium), clonazepam (Klonopin), lorazepam (Ativan), flurazepam (Dalmane), and others ^[2].

First approved for usage by the Food and Drug Administration (FDA) in October 1981, Xanax works by decreasing abnormal excitement within the brain.

What Do People Use Xanax For?

A fast-acting drug, the effects of Xanax can be felt very soon after taking a dose, typically within two hours at most ^[3]. Xanax acts on the brain and central nervous system by increasing the calming effect of the brain’s naturally-occurring chemical messengers.

Xanax is most commonly used for its sedative and calming effects in order to relieve the symptoms of anxiety and promote sleep.

What Does Xanax Do To The Brain?

Benzodiazepines like Xanax act on the brain and central nervous system (CNS) to produce a calming effect.

Xanax in particular slows down the movement of brain chemicals that may have become unbalanced, resulting in a reduction in nervous tension and anxiety. Xanax does this by boosting the effects of a natural chemical called gamma-aminobutyric acid (GABA), which is made in the brain ^[4].

How Long Does Xanax Stay In Your System?

Typically, Xanax has an elimination half-life of about 11 hours (though the range is from about 6-27 hours, and often higher in obese users of the medication). This means that it takes a healthy person’s body 11 hours to get rid of half of a dose of the drug ^[5].

There are a number of factors that can alter the rate that Xanax leaves the body, including ^[2]:

• Metabolism speed
• Height and weight
• Body fat content
• Age
• Health of the liver and/or kidneys
• Amount of the drug taken
• How long the drug has been used

Dosages & How Long Does It Take For Xanax To Work?

Xanax comes in either tablet form, an extended-release tablet, an orally disintegrating tablet (a tablet that dissolves quickly in the mouth), and a concentrated solution (liquid) to be taken by mouth ^[2].

Xanax should be taken by mouth exactly as a doctor directs. The dosage will be based on the following factors:

• Why the person is taking it
• Their age
• How their body responds to the treatment

A doctor may gradually increase the dosage of Xanax until the drug works effectively for that person and their needs. If using Xanax, you are advised to closely follow the doctor’s instructions to reduce the risk of side effects.

If a person has used Xanax regularly for a long time or in high dosages, withdrawal symptoms can/will occur if they suddenly stop taking it. Usually, to prevent this, a doctor will reduce the dosage of Xanax gradually.

Xanax is available in doses of:

• 0.25 milligrams (mg): This will be white, oval, scored, and imprinted with “XANAX 0.25.”
• 0.5 mg: This will be peach, oval, scored, and imprinted with “XANAX 0.5.”
• 1 mg: This will be blue, oval, scored, and imprinted with “XANAX 1.0.”
• 2 mg: This will be white, oblong, multi-scored, and imprinted with “XANAX” on one side and “2” on the reverse side.

A person should not crush, chew, or break a Xanax extended-release tablet. They should swallow the tablet whole. It is specially made to release the drug slowly into the body. Breaking the tablet can cause too much of the drug to be released at once.

And finally, it is not advised for people to share their medications with other people. It may not be suitable for them and may harm them ^[4].

What Are The Side Effects of Xanax?

Possible side effects of Xanax should be differentiated by the treatment duration (i.e. whether it’s being used over the short or medium/long term).

In the short term, the most common side effects of Xanax include ^[6]:

• Drowsiness
• Reduced cognitive alertness
• Dizziness
• Slurred speech
• Lack of muscle coordination and strength, which can lead to falls and other injuries
• Impairment of driving skills
• Decreased sexual appetite and erection problems in men

The following short-term side effects of Xanax are less common ^[6]:

• Depression and mood changes
• Disinhibition
• Nightmares
• Blurred vision
• Nausea and poor appetite
• Breathing difficulties
• Increased risk of seizures in epileptics

If benzodiazepines like Xanax are used for longer, especially if abused for recreation, the following side effects have been observed in some cases:

• Lasting behavioral changes
• Poor control over emotions
• General loss of interest (in leisure activities, other people, job, etc.)
• Increased anxiety
• Depression
• Loss of libido
• Suicidal ideation

It is also worth noting that Xanax is not considered a safe medication for several groups of people, including those who:

• Have an allergy to other benzodiazepines, including diazepam and lorazepam
• Have a history of liver disease or kidney disease
• Have personal or family history of substance abuse
• A history of glaucoma
• Are pregnant or currently nursing

It is incredibly important to consult with a healthcare provider to determine if any prescription medication is right for you.

When speaking with your healthcare professional, be sure to provide them with a full list of other medications and supplements you’re taking as negative drug interactions with Xanax are possible ^[2].

Why Is Xanax (and Similar Benzodiazepine Drugs) So Addictive?

Xanax is a controlled substance and has become an often abused drug due to what’s known as a “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.

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.

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.

Alternatives To Xanax & Benzodiazepines For Anxiety

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

Many foods, minerals and dietary supplements have similar properties to prescription anxiety medications like Xanax or SSRIs, in terms of lowering the negative effects of stress and anxiety.

The major difference is that natural Xanax alternatives are less likely to have detrimental side-effects, and carry a lower risk of dependence or addiction. They are also more widely available and can be bought ‘over the counter‘, 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 remedies for anxiety 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].

Several 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 anxiety in a similar way to benzodiazepines (Xanax included) without the associated addiction risk.

5-hydroxytryptophan (5-HTP)

5-HTP (5-hydroxytryptophan) may not sound too familiar to you, but you already have lots of it floating around in your body. 5-HTP is the parent compound to several brain chemicals (neurotransmitters), including serotonin. Serotonin is the neurotransmitter that’s thought to be associated with mood and mental health ^[10].

5-HTP is touted as a natural anxiety remedy because of its ability to boost serotonin. Many prescription medications for treating anxiety (like SSRIs and SNRIs) raise serotonin in your brain.

While there are several small studies about 5-HTP, both on its own and in combination with other drugs, where it’s used to alleviate anxiety symptoms; larger, higher-quality studies are still needed to completely confirm its benefits.

Since 5-HTP has an affect on serotonin levels, it may interact with other medications you’re taking, causing a potentially life-threatening condition called serotonin syndrome in rare cases. Because of this, it’s best to talk to a healthcare professional before giving 5-HTP a try ^[10].

Valerian

Valerian root (valeriana officinalis) is a herb derived from the root of Valerian plant, that was originally found growing in Europe and Asia. Valerian supplements are not, as yet, FDA-approved for any medical use but Valerian is generally considered safe for adults for short-term use ^[11].

There are many clinical studies involving Valerian but the results are varied and research covering exactly how valerian works in the body is sparse. Many studies end up concluding that inconsistent outcomes in studies of valerian root might be due to the “variable quality of herbal extracts” and that more reliable effects could be expected from the whole root/rhizome of the plant ^[12].

What studies have shown is that Valerian can boost GABA levels in the brain which, as we mentioned above, 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].

There is plenty of anecdotal evidence showing people experiencing a calmer state and reduced anxiety after taking GABA supplements ^[11]. Two (more detailed) studies carried out in 2006 looked at the effects of GABA supplements on the brain ^[13].

The first study involved 13 participants taking GABA, water, and L-theanine (an amino acid known to promote relaxation). Compared to water and L-theanine; GABA significantly increased alpha brain waves, which are associated with feeling calm and relaxed.

In the other study, eight subjects were divided into two groups. One group was given GABA, and the other a placebo. Then all subjects had to cross a suspended bridge for a stimulus of stress. The GABA group was found to be considerably more relaxed as they performed a stressful task. Researchers went on to conclude that GABA can work as a natural relaxant.

And this is exactly why performers of different kinds (musicians, singers, public speakers, actors facing auditions, etc) have experimented with using Valerian Root supplements to help with their anxiety symptoms. Valerian has proven to be an effective natural alternative to prescription medications like beta blockers and/or Xanax for anxiety.

Lavender/Silexan

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” ^[14].

At its core, Silexan is a standardized essential oil of L. angustifolia (lavender) flowers prepared by steam distillation ^[15]. Research involving the compound is showing that “uniquely prepared, pharmaceutical quality lavender oil” (potent silexan) can improve symptoms of mild anxiety. Two recent studies found lavender oil capsules to be just as effective as commonly prescribed benzodiazepine Lorazepam and the antidepressant Paroxetine ^[16].

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 mechanism of action for Silexan seems to be similar to anxiolytic and antidepressant drugs like SSRIs and Benzodiazepines (Xanax) ^[17].

The major upside to lavender/silexan over other anti-anxiety medications is the almost complete lack of abuse potential in healthy recreational users of the lavender extract ^[18]. 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 ^[19].

Final Thoughts About Natural Xanax Alternatives

If you are currently living with anxiety, you’re not alone. Like we said at the top of the page, anxiety disorders are the most prevalent psychiatric disorder in the world and in the US alone currently affect over 40 million adults per year ^[1].

It is common for anxiety symptoms to interfere with your daily life and cause significant distress. If this is your current situation, consider reaching out to a mental health professional who can properly advise you about the right treatment that can reduce your symptoms and significantly improve your quality of life.

Your doctor may recommend Xanax, but if you are not comfortable using the prescription medication with a high risk of addiction, talk with them about the alternatives listed here that are less risky and have less risk of dependence & addiction.

OTC Xanax Alternatives Frequently Asked Questions

I received some emails/comments from readers who had more specific questions about Xanax alternatives. 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.