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Can Propranolol Help with Public Speaking Anxiety?

Last Updated: June 24, 2024

Considering that over 40 percent of US adults state (in certain surveys) that they have a signigicant fear of public speaking, it’s surprising that there isn’t a lot more talk in the media about overcoming and managing one of the nations largest collective phobias! Since the 60s, a heart-medication drug has been the secret tool for public speakers trying to get a handle on their performance anxiety/stage fright issues. That prescription drug is a beta-blocker called Propranolol, which is actually the most commonly prescribed beta blocker drug in the US. In this article, I’m going to take a look at why so many public speakers use Propranolol to help with their performance anxiety issues, I’ll share my personal experience with the drug, and you’ll find out what the side-effects and downsides are, as well as some alternatives.

Propranolol for Public Speaking Anxiety

Wondering if Propranolol can help manage your public speaking nerves? The prescription beta-blocker medication is used by performers and those suffering from anxiety to dampen the jitters and palpitations often associated with stage fright or performance anxiety. In this article I’m going to take a look at the role that Propranolol can take in preparing you for the stage, the sales presentation and/or the social event; while providing a first-hand account of the impact Propranolol can have on public speaking experiences.

Propranolol for public speaking Key Takeaways

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

  • Propranolol, a non-selective beta blocker, effectively manages performance anxiety by dulling physical anxiety symptoms, such as a rapid heartbeat and trembling, through a mechanism of surpressing — sometimes completely blocking — adrenaline release into the body.
  • The recommended dosage of Propranolol for situational anxiety ranges from 10mg to 40mg, and it should be ingested about 30 to 60 minutes before a public speaking event for optimal effectiveness.
  • While Propranolol can help performers transform their stage presence and reduce anxiety, potential side effects range from mild, like fatigue and nausea, to severe, such as allergic reactions and heart issues, necessitating consultation with healthcare professionals.

The Role of Propranolol in Managing Performance Anxiety

Illustration of a person speaking in front of an audience

Propranolol is one of the most commonly prescribed non-selective 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 [1].

Doctors typically prescribe beta-blockers to treat various heart conditions, when other lifestyle adjustments fail to do the job. Some of the typical conditions for which a doctor might recommend a beta-blocker such as Propranolol include[2]:

  • 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 [3].

Understanding Beta Blockers

Trying to understand how beta blockers work
Beta blockers serve as a defense against anxiety by preventing stress hormones like adrenaline from attaching to beta receptors. By blocking this attachment, the drug curbs the “fight-or-flight reaction” of the body, mitigating physical signs of stress and modulating how the body physically copes with stress responses.

There are two categories within beta blockers: selective and nonselective. Selective variants target only the heart’s beta-1 adrenoceptors while nonselective variants affect both beta-1 and beta-2 adrenoceptors throughout various bodily systems. For example, Propranolol is a broad-spectrum (non-selective) beta blocker that, alongside Metoprolol which is a selective type, helps alleviate performance-related anxiety by curbing adrenaline effects. This leads to slowed heart-rates and reduced blood pressure, tackling the major symptoms associated with anxiety and stage fright episodes.

Why is Propranolol popular with public speakers?

As stated above, Beta-blockers like Propranolol block the effects of adrenaline and prevent the hormone from binding to 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 blood pressure is stabilized [4].

An exaggerated stress response, like what a speaker experiences when suffering from performance anxiety, typically correlates with a dramatic spike in adrenaline.

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

When taking a beta-blocker, expect the drug to slow your heart rate, reduce a lot of trembling and sweating, and regulate your breathing and blood pressure. Beta-blockers can help you feel relaxed, essentially negating the stress response to help you get through any performance such as a speech or sales presentation.

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

It is important to note that each individual is different, especially when it comes to causes of anxiety. Individuals also vary widely in anxiety 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].

Personal Experience using Propranolol for Public Speaking

My personal experiences with Propranolol for anxiety purposes

I’ve shared in a few places on this site that I have used beta-blockers, including Propranolol (as well as others such as Metoprolol, Carvedilol/Coreg and others), several times.

Because of the way beta-blockers work within the body, I’ve worked with and spoken to a lot of performers and public speakers who use them to block the symptoms of performance anxiety. Actually, one of the first popular mentions of beta blockers being used for anxiety purposes was a Lancet article from 1965 [6]. That article, in-depth research into the field, plus plenty of personal accounts of Propranolol helping with stage fright & anxiety helped me understand why so many speakers are using Propranolol. In short: Propranolol is effective for nearly eliminating the effects of adrenaline during a speech, the side-effects are relatively minimal, and the only major downside (in my opinion) is a risk of becoming too reliant on the beta-blocker if you use it for every high-anxiety situation. If you can avoid becoming dependent on Propranolol, it’s a very effective tool for speakers!

Propranolol Dosage and Timing for Optimal Results

In the United States, Propranolol is classified as a prescription drug. So if you’re considering the use of Propranolol for public speaking and performance anxiety purposes, you will have to ask your doctor if it may be an option for you.

If the doctor decides to prescribe beta-blockers for you, then he or she will also let you know your recommended daily dosage. We strongly suggest sticking to the recommendations of your doctor. They know your medical history and all your other current medications and health issues. Going beyond what your doctor prescribes can have severe health consequences.

Purely for informational purposes, however: For most adults, an effective Propranolol dose is between 40-80 mg per day [7].

For those using Propranolol before a speech, the best time to take it is 1-3 hours before they’re about to go on stage/give their speech. You want to give it enough time for the effects of Propranolol to kick in, but not so early that it is no longer useful. Again, consult with your doctor for when and how much Propranolol you should take before you have to give your speech.

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Potential Propranolol Side Effects and Precautions

Beta-blockers like Propranolol are generally considered safe for public speakers (or any performer). Especially when only taken occasionally. But Propranolol can come with some potential side effects, although not too common among public speakers who only use beta-blockers every now and then.

More common side-effects of Propranolol include [8]:

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

More severe Propranolol 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

Alternatives to Propranolol for Public Speaking Anxiety

‘Glossophobia’ or Fear of public speaking does not have to be a chronic, lifelong affliction! We now have various strategies and tools available that can be used to overcome a fear of public speaking, including medications (like Propranolol, of course), mental strategies and dietary supplements.

Let’s take a look at a few alternative ways that people are fighting their public speaking fears:

Extensive Practice

Mild cases of public speaking anxiety may be treatable simply with practice.

Many people struggle with public speaking simply because it’s a new field to them. The fear of the unknown and lack of confidence may manifest itself in extreme fear or anxiety. However, once that person can get used to speaking in front of people, and develop confidence within these kinds of situations, the fear may go away [9].

This is not a unique ‘secret’ that’s supposed to solve the fear of public speaking for everyone. For more serious cases of glossophobia/public speaking fear, other tools and strategies will be needed in addition to extensive practice. Particularly if someone doesn’t experience anxiety in any other social situations, yet speaking in front of a crowd immediately sparks a stress response, one of the more concentrated strategies may work best [9].

Breathing Exercises

Certain breathing techniques can be effective in stopping the onset of physical anxiety symptoms caused by a stress response in the body. While extensive public speaking practice is a long-term fundamental practice, breathing exercises can offer a short-term fix that you can put into practice before you need to address an audience.

One particular breathing exercise that I teach clients is known as “diaphragmatic breathing” or “belly breathing”, in which you take deep breaths, engaging the stomach and the diaphragm. In contrast to regular, unconscious breathing, an effort is made to bring the breath down into the stomach, which should rise and fall with each breath.

Diaphragmatic breathing has long been used in meditation, and meditative practices like yoga and tai-chi. Studies have shown deep breathing to have positive effects on cognition and stress, adequately reducing levels of cortisol, a hormone that gets released when we are stressed or anxious [10]. Diaphragmatic breathing can also help reduce blood pressure and improve heart rate variability, which works to lessen the severity of symptoms one may experience with public speaking anxiety.

Natural Supplements

Some dietary supplements contain a mix of ingredients that support focus, calm and cognition, which may counteract the negative side-effects of performance anxiety and stage fright when giving speeches. Ideally the supplement should be all-natural as well, but that’s a personal preference of mine.

One example that I really 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. Not too long ago, I actually reviewed PerformZen in this article & interviewed the founder (as well as secured a limited-time discount for readers). See the review here.

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Summary: Should you integrate Propranolol into Your Speaking Routine?

Performance anxiety needs to be taken seriously if you want to perform at your best during key moments (like giving successful public speeches).

Beta-blockers like Propranolol can absolutely help relieve your public speaking anxiety issues, helping you to reclaim control of your fears and perform when it’s really important. You just need to understand that while Propranolol does provide temporary relief, it is not really a long-term solution (not to mention: there may be side-effects, and you will need a prescription).

I really suggest giving the alternatives a try before turning to Propranolol repeatedly and building a dependence: whether that’s ‘diaphragmatic breathing’ or a natural performance anxiety supplement like PerformZen.

But if you’re dead-set on trying Propranolol, speak with a medical professional first and give it a try. Assuming you use the beta-blocker safely, it really is a game-changer for your performance anxiety!

Is propranolol good for public speaking?

Yes, Propranolol has proven to be (very) effective in managing the physical manifestations of performance anxiety, particularly with regards to public speaking. It boasts a considerable success rate among those who utilize it for speaking purposes.

How early to take Propranolol before speech?

Approximately one hour prior to a public speaking event, which can provoke anxiety symptoms, it is advisable to take Propranolol. Doing so ensures that the medication has adequate time to activate and alleviate the symptoms of anxiety.

Who shouldn’t take Propranolol for anxiety?

If you suffer from respiratory conditions like asthma, bronchitis, or emphysema, or if you experience slow heart rates, have low blood pressure, or have been diagnosed with liver or kidney disease; then Propranolol is not a suitable treatment for anxiety as it comes with significant risks for you.

Before contemplating the use of this medication for your anxiety issues, it’s critical to consult with your physician and thoroughly disclose any health complications.

Take a look at our other beta blocker articles:

Kick Propranolol vs Hims Propranolol for Stage Fright & Performance Anxiety
Natural Metoprolol Alternatives
Robert Downey Jr using beta blockers for anxiety?
Metoprolol For Anxiety Reviews
Propranolol Dose For Anxiety
Atenolol for Anxiety - what you need to know

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Anita is the owner and lead writer for 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.