Propranolol for anxiety

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Question

Have you heard of the drug Propranolol and its possibility of use to control anxiety for public speaking?

I'm not a medical doctor (MD) so this is not medical advice 🙂 But I'll give you my personal opinion.

Beta-blockers (Propranolol/Inderal being one of them) can be very helpful for public speaking especially if you're in the medium-to-high fear group (as explained here). The reason is that your brain has started to interpret the symptoms themselves as a threat, which floods your body with more adrenaline, which you interpret as a threat, which floods your body with more adrenaline...and so on. Fear can escalate into panic very quickly. Beta-blockers actually dampen the symptoms (slow your heart rate), so they can help you work your way out of the self-perpetuating cycle of fear.

Another med that works with a beta-blocker is a benzodiazepine ("benzo") such as Xanax. This med is addictive so you have to be very careful with it and use only as needed. It works a bit like a glass of wine and releases muscle tension.

They aren't a magic bullet. You can take meds and still get into an escalating cycle of fear if you keep telling yourself something horrible is going to happen. So it's important to work on changing your self-talk. When you change your self-talk and take meds, it can help.

One of the reasons it's better not to use meds if you can avoid it is: you may start attributing your success to the meds and not to yourself which can get in the way of your self-confidence and self-improvement. But if a beta-blocker/benzo helps, use it. Beta-blockers/benzo are more benign (and are used only as needed ~30 minutes before a presentation) compared to SSRIs which take several weeks to take effect and can have a lot more side-effects.

Talk to your doctor. Be aware of side effects with all meds. Beta-blockers reduce your blood pressure. If you already have low blood-pressure, tell your doctor.

I recommend using it first in a "laboratory" setting (see cheat sheet #5) where you're practicing and learning how to manage fear in a group with others who share your fear.

Dr. Cheryl Mathews Anxiety Coach