Metoprolol Dosage For Anxiety & Potential Lopressor Side Effects

The beta-blocker Metoprolol is commonly used ‘off-script’ by professional performers (public speakers, musicians, singers, etc) to help overcome anxiety symptoms, and two very common questions Metoprolol users ask is ‘what is the right Metoprolol dosage for anxiety’ and ‘are there any Metoprolol side-effects’. Here we answer these questions about the beta-blocker Metoprolol as well as looking at how Metoprolol works and considering if there any valid alternatives for anxiety.

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Metoprolol is a type of prescription drug known as a “beta-blocker”, or beta-adrenergic blocking agents, because they work by blocking the effects of adrenergic (adrenaline) hormones. Metoprolol is most commonly used to treat issues related to the cardiovascular system like high blood pressure and irregular heartbeat.

Metoprolol is also sometimes used ‘off-script‘ as a treatment for performance anxiety (known by most as ‘stage fright‘).

Like with any drug, there are dosage recommendations and some side effects of Metoprolol that you should be aware of. In this article we’re going to look at what the specific dose recommendations and side effects of Metoprolol are when using the drug specifically for treating performance anxiety symptoms. We’ll also share some alternatives to Metoprolol, which are less likely to have undesirable side effects or dangers.

Metoprolol Brand Name

The brand name version of Metoprolol is Lopressor. Sometime during the year 1978, the FDA approved the use of Metoprolol under the name Lopressor [1].

Like other popular beta-blocker medications like Propranolol, Metoprolol requires a prescription from your doctor to acquire. Metoprolol is prescribed around 27 million times each year in the United States.

Bisoprolol is an over-the-counter alternative to Metoprolol.

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How does Metoprolol work?

Metoprolol and similar beta-blockers work by reducing the stress on your cardiovascular system. They lower the force with which your heart has to pump blood, causing a relaxing effect.

How Metoprolol works for anxiety

Beta-adrenergic blocking agents (beta blockers) block the effects of adrenaline, a hormone that binds to adrenergic receptors in your body [2]. And there are adrenergic receptors in the heart called beta receptors [3]. Adrenaline, which is a stress-related hormone, binds to these beta receptors in the heart to make it pump harder and faster.

By blocking the release of these stress hormones, beta-blockers are preventing your heart from going into overdrive, which can keep your blood pressure low, lower stress on your cardiovascular systems and even (critically for most performers) keep your performance anxiety symptoms at bay [4].

Physical anxiety symptoms

Beta-blockers like Metoprolol can make a big difference when it comes to the physical symptoms of performance anxiety & stage fright.

The physical symptoms of performance anxiety are typically a combination of several, or all, of these symptoms [5]:

  • Shaky voice
  • Dry mouth
  • Trembling hands
  • Too much sweating
  • Racing heartbeat
  • Nausea
  • A sense of nervousness in the gut
  • Panic attack in severe cases

Does Metoprolol help with anxiety symptoms?

The reason you might be experiencing the symptoms of performance anxiety can be due to the effects of the adrenaline hormone. If your fight-or-flight response gets activated in a stressful situation (for example, before a speaking engagement), then your adrenaline levels can spike, causing you to experience performance anxiety symptoms.

As stated, Metoprolol works by blocking the effects of the adrenaline hormone [2]. It’s preventing adrenaline from binding with beta-receptors in your heart [3], which reduces the force with which your heart has to pump blood. Overall, this has a relaxing effect on your cardiovascular system.

So, when you take Metoprolol before a performance, exam, or a date, you are effectively blocking the physical symptoms of performance anxiety from showing up. In the absence of the physical symptoms, you might find yourself in a more relaxed state, which then allows you to get through the speech, audition, or interview.

What is the recommended Metoprolol dosage for anxiety?

Metoprolol recommended dosage

Typically, your doctor will recommend your Metoprolol dosage based on your specific needs.

Usual dosage for anxiety is between 50mg per day and 100mg per day. It may be taken at once or divided up in different doses [6]. Depending on how you respond to the initial dosage, your physician may recommend that you increase your daily intake. The maximum recommended dosage is 450mg per day.

You should be careful not to go over your recommended dosage of Metoprolol/Lopressor. Taking too much can slow down your heart rate to dangerous levels and cause breathing difficulties, dizziness, and possibly tremors.

You may also be prescribed other medications, like diuretics, together with Metoprolol/Lopressor to treat high blood pressure.

How long for Metoprolol to take effect

It is a common question: How long does Metoprolol take to work for anxiety?

Metoprolol is available in immediate-release tablets, generically known as ‘Metoprolol tartrate‘, that is very fast-acting (under 1 hour).

The extended-release form of Metoprolol, known as ‘Metoprolol succinate‘, is a little-slower to interact with the body, as the name suggests.

The half-life of Metoprolol tartrate is about three hours, and the half-life of metoprolol succinate is about seven hours. This means that the extended-release formulation does not have to be dosed nearly as often [7].

Common Metoprolol side effects

Beta-blockers, in general, are pretty safe. But here are some of the potential, albeit rare, side effects of Metoprolol [1]:

  • Irritability or mood swings
  • Gut issues like gas, bloating, constipation
  • Nausea
  • Heartburn
  • Dry mouth

Severe side effects are quite rare, but if you experience any of the following symptoms after taking Metoprolol, be sure to contact your doctor immediately:

  • Shortness of breath
  • Unexplained swelling of hands, feet, or ankles
  • Fainting

Metoprolol Downsides

Generally speaking, beta-blockers like Metoprolol do have certain limitations when it comes to dealing with anxiety:

  1. Metoprolol will always be a temporary solution for stage fright as it does nothing to address the root causes of your performance anxiety. You’re applying a quick-fix to stop the physical symptoms.
  2. You will need a prescription for Metoprolol/Lopressor, at least in the United States. So, you may need to go visit your doctor every time you run out, which can become an inconvenience if you use the drug frequently.
  3. In rare cases, beta-blockers like Metoprolol can cause dependency and if you make it a habit of taking Metoprolol frequently, then you shouldn’t stop it all of a sudden. Stopping abruptly might cause your blood pressure to spike so talk to your doctor if you want to stop the medication.

Metoprolol alternatives for Anxiety

Metoprolol is one of many potential solutions for people who suffer performance anxiety or similar bouts of social anxiety. And while Metoprolol does show potential in treating the symptoms of anxiety, the possible side effects may have you considering alternatives.

Other beta-blockers perform the same role as Metoprolol, in regards to slowing the release of adrenaline and lessening the physiological symptoms of anxiety. Other beta blockers on the market include:

You may have better luck with the side effects from these drugs. However, as they all come under the same umbrella, it is likely that any problems you have with Metoprolol will persist with another beta-blocker.

Natural alternatives to Metoprolol for anxiety

If you’re not too excited about becoming dependent on a prescription beta-blocker every time you want to perform, or having to get a prescription whenever you run out, you may want to consider a natural alternative to Metoprolol.

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A natural alternative would achieve the same end-result as a beta-blocker like Metoprolol, which is to provide relief from symptoms of performance anxiety and stage fright.

But it would do so by supporting your mind and body in a way that, over time, makes you even more resilient. You’d become better equipped to handle the stress response and learn to think about your performance in a way that makes it less stressful, to begin with.

Here are some of the most effective natural beta blocker alternatives for performance anxiety that we know about today:

Cognitive Behavioral Therapy (CBT)

Cognitive-behavioral therapy (CBT) is a form of therapy designed to modify your thoughts in a way that makes the idea of performing less stressful.

CBT has been shown in studies to be effective in treating a variety of anxiety disorders, especially in the long term when patients stick with the therapy.

The goal of CBT is to take something you find overwhelming (like, say, giving a public speech in front of a large audience), break it down into smaller parts, and then replace any negative patterns with more positive and productive ones [8][9].

A licensed CBT therapist will typically help you understand the thoughts and emotions that are responsible for your anxiety, and how you can adjust your perceptions about performing for an audience in a positive way.

Yoga

Yoga makes it possible to train your body to learn how to better deal with stress. The result is that you typically have less severe stress-responses, and your symptoms of anxiety can become less severe.

According to a well-known Harvard Health article, yoga can work as a natural anxiety relief by reducing the impact of an exaggerated stress response, which is what causes stage fright in the first place [10].

Yoga trains your body to exist in a state of calm. So, whenever there is a stressful situation, you will be more habituated to breathing easier, keeping your heart rate steady, and your blood pressure stable.

Yoga has also been shown to increase your heart rate variability (HRV), which is the difference in the time interval between heartbeats [11]. A higher HRV indicates your body’s increased ability to deal with stress.

PerformZen Calm Performance Formula

The most effective natural remedy to performance anxiety available today is PerformZen, as confirmed by plenty of happy, stage-fright-free customers.

PerformZen has proved extremely effective at overcoming performance anxiety symptoms as it contains a combination of GABA & L-theanine, which help boost mental clarity; Theacrine, which aids mental clarity and energy; Ginkgo Biloba, which is an effective stress reducer; plus vitamins and minerals like Magnesium & Vitamin B6, which have proven effective in reducing even severe cases of stress.

This combination provides the positive anti-anxiety effects of beta blockers like Metoprolol & Propranolol, but also boosts alertness and mental clarity, which are more subtle symptoms of performance anxiety that beta blockers don’t typically address.

Overall, this may mean a natural solution such as PerformZen is not only safer, but more effective than many beta-blockers for performance anxiety.

Final thoughts on Metoprolol Dosage, potential side effects, and alternatives

Metoprolol is generally considered safe, especially if you properly follow dosage reccomendations, and the drug is often prescribed in confidence by doctors who know what they’re doing.

But, like with any drug, there are some interactions to watch out for, and a small number of people may experience negative side effects using Metoprolol, ranging from minor to severe.

If you decide to take Metoprolol for anxiety, please be sure to seek out professional medical advice first, disclose why you’re taking it, what other medications you may be taking, and any conditions that may be affected by Metoprolol. Also, closely monitor any side effects and be ready to wean off it if side effects become unmanageable.

If side effects or constant prescriptions are not your thing, consider a natural alternative like PerformZen, which provides clean mental clarity and stress reduction without the risk of side effects.


Eric is a performance expert and a member of the PerformZen team since it was founded. Eric has battled anxiety his entire life and he is passionate about helping people gain control over the things that they fear most, with anxiety being at the top of that list for many!

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