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Metoprolol Reviews – Feedback from Metoprolol for Anxiety Users

Last Updated: May 11, 2024

Metoprolol is one of the most common selective beta-blockers prescribed over 25 million times every year in the US. This prescription beta-blocker commonly sold as Lopressor is used in treating high blood pressure and other cardiovascular conditions. Metoprolol is also commonly used off-script by high-level performers like actors, musicians, and public speakers to overcome stage fright and performance anxiety issues. This article looks at several user reviews of Metoprolol, and we respond after explaining how metoprolol works, what its side-effects are, and whether it has a risk of dependency, finally determining whether Metoprolol is a suitable solution for stage fright and performance anxiety symptoms.

If the idea of getting in front of people and performing is enough to give you a trembling voice or a racing pulse, you might be suffering from performance anxiety, sometimes called stage fright. Performance anxiety is a common condition that affects millions of performers across the world; including actors, musicians, dancers, and public speakers [1]. It can also affect anyone feeling pressured to perform, like a person on their first date or a student taking a critical exam.

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.

Metoprolol Reviews Key Takeaways

If you're looking for a quick, scannable summary of the rest of this article, here are several key takeways about Metoprolol Reviews:

  • Metoprolol is a prescription beta-blocker medication primarily used for treating cardiovascular & heart conditions, but also used off-script by many to help control adrenaline and anxiety symptoms to help with high pressure performances and situations
  • Typical Metoprolol dosage for treating anxiety symptoms ranges from 50-100mg per day
  • There are several side-effects of Metoprolol that reviewers mention including swelling, headaches and fatigue. However the effectiveness of Metoprolol for aiding with anxiety symptoms is enough for many people to overlook these metoprolol side-effects

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.

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.

shortness of breath is a common side-effect of Metoprolol

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

Review Source: Drugs.com

I have not only super high blood pressure but also very high pulse & physical anxiety symptoms. It’s idiopathic; I’m young, slim & female, with a good diet & no aggravating lifestyle factors. I’ve been this way since age 18. Tried several solutions including OTC & prescription medications, diet changes & hippie-dippie placebo stuff like breathing exercises/meditation. Currently, I’m on 3 meds for my BP. The only one I miss when I skip it is metoprolol. If I skip my ACE inhibitor or my diuretic, there’s barely any difference. Skip my metoprolol? I’d better call in sick.

You shouldn’t give a hoot about my experience; my body chemistry has nothing to do with yours. Your body may not give a damn about beta blockers but care everything about a calcium channel blocker for all we know. All bodies are different, with different reactions to different meds. I can’t believe we’re still reviewing medication like it’s a one-size-fits-all deal that we can take each other’s advice on.

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

Review Source: WebMD.com

I was put on Metoprolol 25mg for palpitations and panic attacks, although it help slow my heart rate I was still having chest pains, severe headaches, tingling in my hands and feet, numbing feeling in my head, fatigue, burning sensation in my chest, my heart rate would drop to the 40’s, loss of appetite loss 20lbs and I had only been taking it for a month my doctor weaned me off it’s been a month since I’ve been off and still having side effects from it. Again this is just my personal experience.

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?

Review Source: Everydayhealth.com

I’m 32 and I started taking metoprolol to help with my daily headaches which turned into migraines. Not only was this a miracle drug for my migraines, but it also helped me remain calm. My husband joked that my road rage decreases when I’m on this. I was just diagnosed with hyperthyroidism and it’s also helped exponentially with the anxiety and heart palpitations that come with it. The only side effects I get are some temporary dizziness, constipation, and the occasional hot/cold discomfort, but they are all worth the relief I receive from it. Waking up without a headache is life-changing. Having my anxiety controlled, especially during our current pandemic, is also worth any side effects I’ve felt.

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

Review Source: SocialAnxietySupport.com

I take metoprolol (regular ol’ Lopressor immediate-release; NOT Toprol XL) as both a way to counter the blood pressure problems that Adderall can cause and my beta blocker of choice to help fight the physical symptoms of anxiety. I started beta blocker usage with Inderal, but it is too cardiac non-selective for an asthmatic like me, so I looked into the cardiac selective beta blockers and narrowed it down to metoprolol or atenolol. I don’t remember what made me choose metoprolol over atenolol, but I do remember reading that metoprolol is reportedly better for those with asthma compared to most other beta blockers. I may have read some (most likely unfounded) claims that metoprolol has studies behind its potential use in treating social anxiety disorder – that may have been the deciding factor for my choice of metoprolol over atenolol, who knows.

At any rate, metoprolol is much better on my airways than Inderal. I haven’t experienced any asthma exacerbation since starting metoprolol. I take half a 50mg tablet up to twice daily. I think I remember reading that cardiac selective beta blockers become less cardiac selective at higher doses, so I tend to stay in the shallow end of the metoprolol swimming pool (nobody likes an asthma attack!) As for effectiveness, metoprolol works just fine. It is not as useful as Inderal was for vascular headache treatment/prevention, but eh, beggars can’t be choosers, I suppose.

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.

Take a look at our other beta blocker articles:

Nebivolol For Anxiety & Stage Fright
Bisoprolol for Anxiety
Natural Beta Blocker Alternatives for Anxiety
Propranolol Reviews for Anxiety
Over the counter beta blocker substitutes
Natural Metoprolol Alternatives

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PerformanceAnxiety.com Owner & Lead Writer

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