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What is Propranolol?

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

So Propranolol and other beta blockers block the effects of adrenaline and prevent it from binding to the beta receptors in the heart. This has a 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 blood pressure can remain steady.

An exaggerated stress response, like that experienced when effected by performance anxiety or stage fright, is associated with a dramatic spike in adrenaline.

By blocking the effects of adrenaline, you’re preventing the hormone from binding to the beta receptors in the heart. So, beta blockers like Propranolol essentially block the physical symptoms of performance anxiety.

When you take Propranolol or other beta-blockers like Metoprolol or Carvedilol/Coreg, it can slow your heart rate, reduce the trembling and sweating, and regulate your breathing and blood pressure. Propranolol can help you feel relaxed, essentially negating the stress response to help you get through the performance.

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.

How many Performers use Propranolol for Anxiety & Stage Fright?

A survey by the International Conference of Symphony Orchestra Musicians in 1987 found that 27 percent of their musicians were using beta-blockers like Propranolol for performance anxiety, and that was over 30 years ago! Experts estimate that the numbers are much higher today, but it is not entirely clear how many people are using the beta blocker medication ‘off script’ for the purposes of anxiety & stage fright.

What symptoms does Propranolol help with?

Doctors typically prescribe beta blockers like Propranolol 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 Propranolol:

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

Beta-blockers like Propranolol 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.

What are Propranolol side effects

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.

Here are several reported Propranolol side effects:

  • 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.

Propranolol Recommended Dosage

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. 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.