People who seek professional help for anxiety have usually prescribed a class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs).  However, in some cases, these individuals may benefit from a different type of medication called beta-blockers—either in addition to or in place of SSRIs.  This is particularly the case if they have performance anxiety.

Performance anxiety tends to occur in social situations that involve evaluation by others (e.g., a work presentation, a blind date).  Performance anxiety is associated with symptoms such as rapid and shallow breathing, sweating, tremors, and heart palpitations.  These symptoms are not only unpleasant but interfere with functioning.  For instance, it can be difficult to speak confidently in front of a group while shaking, sweating, and feeling dizzy.

If you have performance anxiety, you may be wondering if it is possible to reduce your anxiety.  Yes, it is indeed possible to do so, using psychotherapy and medications, including beta-blockers.  In this article, we examine what beta-blockers are and how they help.


According to Stahl’s Essential Psychopharmacology, a group of medications useful in the treatment of certain forms of social anxiety, particularly performance anxiety, are beta-blockers for Anxiety.

Traditionally, beta-blockers have been used to treat heart problems—high blood pressure, arrhythmias (abnormal heart rhythms), chest pain, heart attacks, and heart failure.  Some examples of beta-blockers for Anxiety are:

  • Atenolol (Tenormin)
  • Bisoprolol (Zebeta)
  • Metoprolol (Lopressor)
  • Nadolol (Corgard)
  • Nebivolol (Bystolic)
  • Propranolol (Inderal)

To understand why beta-blockers may reduce anxiety, we need to understand how they work.  This is described below.

Beta-blockers for Anxiety and the fight-or-flight response

Beta-blockers work by blocking the effects of adrenaline, a hormone involved in the fight-or-flight response.

The fight-or-flight response is a mechanism that prepares your body to fight the source of danger or to run away.  It does so by elevating your heart rate, speeding up your breathing rate, increasing the blood flow to major muscles involved in the movement, etc.

The biological changes of the fight-or-flight response are necessary for survival.  But what if the fight-or-flight system is activated even when there is no danger—such as when you are giving a toast at a wedding, an oral presentation in class, or singing a song in front of friends?  When this occurs, your body will react as though you are in a life or death situation.  And, needless to say, it will be very difficult to focus on the task at hand (e.g., your presentation) during these times.  Unless you have taken a beta-blocker.

Uses of beta-blockers for anxiety

According to a paper in Expert Opinion on Pharmacotherapy, beta-blockers are widely prescribed for social anxiety.  And although taking beta-blockers for Anxiety on a regular basis does not appear to be effective in reducing generalized social anxiety, studies indicate that socially anxious people do benefit from taking beta-blockers prior to performance-related situations.

But are there any risks to taking beta-blockers?  All medications have risks and benefits, and the same is true of beta-blockers.  Beta-blockers for Anxiety can have a number of side effects, including low blood pressure, slow heart rate, fatigue, cold hands and feet, insomnia, and depression.

In terms of benefits, as mentioned, beta-blockers help to reduce social anxiety and improve functioning in performance-related situations.  And, unlike antidepressants such as SSRIs, beta-blockers for Anxiety can be taken only as needed.  And unlike many anti-anxiety agents, they are not addictive.

So, if you suffer from performance anxiety and are bothered by physical or psychological symptoms, or if you feel these symptoms make it difficult for you to function in performance-based situations, you might want to talk to your doctor about beta-blockers.