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Beta blockers and anxiety

Authoring team

Beta - blockers such as propranolol may sometimes be used in the management of the physical symptoms of anxiety.

Propranolol in anxiety (1,2,3):

  • non - sedative. No dependence or abuse

  • does not help psychological symptoms. High doses may lead to cardiac side effects

  • recommended adult dosing in the UK is 40mg once daily, increased to 40mg three times daily if necessary
    • standard licensed doses (these may need to be individualised according to patient response and disease state - eg, hepatic or renal impairment).
    • unless specifically provided, doses for the elderly are the same as for adults

  • licensed for anxiety with somatic symptoms

Consult the summary of product characteristics before prescribing propranolol.

Reference:

  1. South West Yorkshire Partnership NHS Trust. Guidelines for the pharmacological treatment of anxiety (Accessed 8/7/2014)
  2. MIMS. GPonline.com (Accessed 8/7/2014)
  3. Heaton LJ et al. Propranolol and D-cycloserine as adjunctive medications in reducing dental fear in sedation practice. SAAD Dig. 2010 Jan;26:27-35.

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