Metoprolol for Anxiety – Everything You Need to Know

Metoprolol is a prescription beta blocker, typically prescribed under the brand-name Lopressor to treat cardiovascular conditions like hypertension, as well as irregular heartbeats and similar conditions. Metoprolol is often used off-script to help high level performers reduce performance anxiety before and during a performance that usually would strike fear in even the most well-practiced individuals. We take a closer look at Metoprolol and determine if it is a suitable solution to performance anxiety, why it is said to work, what the side effects are, and if there are any natural & effective alternatives.

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If you’re someone that regularly experiences the butterflies before going on stage, you may suffer from performance anxiety, which is also known as stage fright.

Stage fright is a common condition that affects performers like public speakers, musicians, dancers, actors, or anyone else that has to perform in front of an audience. It can also affect anyone that has to perform under pressure, like someone taking a critical exam, or a nervous person before a first date.

They might experience symptoms like excessive sweating, heart palpitations, or elevated blood pressure right before they walk on stage, as they’re getting ready to start the test, or as they’re walking up to meet their date.

If you’re someone that experiences performance anxiety, you may have come across the drug Metoprolol during your research for potential remedies, and you’re wondering if it is an effective remedy for stage fright. You may also have questions about any side effects or long-term health consequences of Metoprolol.

Here, we’ll discuss what Metoprolol is, how it works, and how it may help you overcome performance anxiety. We’ll also list some pros and cons, and talk about some natural remedies that could work as an alternative to Metoprolol.

What is Metoprolol?

Metoprolol is a type of drug known as a beta-blocker. Doctors typically prescribe Metoprolol and other beta-blocker medications to treat cardiovascular conditions like hypertension and chest pain (angina).

Metoprolol is the generic name of the brand-name drug known as Lopressor. The FDA approved the use of Metoprolol under the name Lopressor back in 1978.

Although frequently used to treat high blood pressure, beta-blockers typically aren’t the first medications doctors would prescribe. They might start with other drugs, like diuretics, and only move on to beta-blockers if other treatments are ineffective. Beta-blockers are also often used in combination with other medications to treat hypertension.

Doctors may also prescribe Metoprolol to treat irregular heartbeats and to increase someone’s chances of survival after a heart attack or heart failure.

Lopressor and other beta-blockers have also been shown to be useful when it comes to migraines, and for certain types of tremors caused by drugs used to treat mental disorders.

Metoprolol is a widely used drug with around 27 million prescriptions each year in the United States.

How do Metoprolol and other beta-blockers work?

Metoprolol and other 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.

Beta-blockers are also known as beta-adrenergic blocking agents. They block the effects of adrenaline, a hormone that binds to adrenergic receptors in your body [1].

There are adrenergic receptors in the heart known as beta receptors [2]. Adrenaline, which is a stress-related hormone, binds to these beta receptors in the heart to make it pump harder and faster.

When you experience a fight-or-flight response, also known as a stress response, your adrenaline levels are elevated, which results in symptoms like racing heartbeat and higher blood pressure.

By blocking the effects of adrenaline, beta-blockers prevent them from binding with the beta-receptors in the heart. As a result, the heart can pump blood with less force, which has an overall relaxing effect on your cardiovascular system, including the blood vessels.

Elevated blood pressure is often a result of tightened blood vessels. Relaxing the blood vessels can have a lowering effect on your blood pressure.

What is the recommended dosage of Lopressor?

Lopressor is a prescription medication. Your doctor will recommend your dosage based on your specific needs.

Typically, your dosage may start around 100 mg per day. It may be taken at once or divided up in different doses [4]. Depending on how you respond to the initial dosage, your physician may recommend that you increase your daily intake. The maximum dosage is 450 mg per day.

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

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

What are the potential side effects of Lopressor?

Lopressor, and beta-blockers, in general, are considered safe. But depending on the individual, there may be some side effects.

Here are some of the most common side effects of Metoprolol [3]:

  • Fatigue
  • Mood disorders
  • Digestive issues like gas, bloating, and constipation
  • Nausea, and in some cases, vomiting
  • Heartburn
  • Dry mouth

In some rare, but severe cases, one might also experience the following side effects:

  • Wheezing and/or shortness of breath
  • Swelling of extremities like hands, feet, or ankles
  • Fainting
  • Pounding heartbeat

If you experience any of the side effects mentioned above, you should immediately notify your doctor.

Who shouldn’t take Lopressor (Metoprolol)?

Although Metoprolol is generally considered safe, some people should avoid Lopressor and other beta-blockers. Since Lopressor is a prescription medication, your doctor can decide if it’s right for you based on your medical history, underlying conditions, and any other medicines that you’re currently taking.

That being said, you should generally avoid beta-blockers if you have any of the following [3]:

  • History of severe asthma or another lung disease
  • Low blood pressure
  • Slow heart rate
  • If you’ve had an allergic reaction to beta-blockers in the past
  • Metabolic acidosis (if you have too much acid in your blood)
  • Hyperthyroidism
  • Blood circulation problems
  • A liver condition

If you’re currently on any other medications, your doctor might also take that into account when prescribing Lopressor, to avoid any potential adverse interactions between the drugs.

Now that we know a little more about Metoprolol and beta-blockers, let’s discuss how they are connected to performance anxiety.

How is Metoprolol connected with performance anxiety?

To understand how Metoprolol or other beta-blockers may help someone combat stage fright, let’s first take a look at what stage fright is, and why it causes someone to experience symptoms.

What is performance anxiety?

As we explained above, performance anxiety is a set of symptoms some people experience before they have to perform in front of an audience, or under pressure. It happens due to an underlying fear of adverse outcomes. You might fear that you will fail, feel humiliated, or judged negatively for your performance.

The reasons why someone may suffer from stage fright are complex. It could be a combination of physical, mental, emotional, and environmental factors.

But when it’s time to perform, it’s the physical symptoms that take front and center and prevent you from performing at an optimal level. Here are some of the symptoms you might experience if you suffer from stage fright [5]:

  • Rapid heartbeats (palpitations)
  • Excessive sweating
  • Trembling of the hands, lips, knees, and voice
  • Sweaty and cold palms

In more severe cases, people may experience blurred vision, nausea, or even vomiting.

You experience these physical symptoms of stage fright because of your stress response.

When you perceive to be in a stressful situation, your fight-or-flight response mode takes over and causes a spike in the adrenaline hormone [6].

For most people, the boost in adrenaline is entirely normal, and it might even enhance their performance due to the added intensity.

But for some people, the spike in adrenaline is too much, and the stress response goes too far. To the point where it becomes difficult, or even impossible, to perform [7]. If severe enough, stage fright can impact your confidence levels and keep you from pursuing a career and life that you love.

And that is why many performers turn to drugs like Metoprolol and other beta-blockers. They might find that these medications allow them to keep performing and pursuing their dreams.

Let’s take a look at why Metoprolol may work when it comes to preventing stage fright symptoms.

Why do some performers take Metoprolol to fight performance anxiety?

If you noticed in the previous section, we explained that the reason you might experience the symptoms of performance anxiety is due to the effects of the adrenaline hormone.

When your fight-or-flight response gets activated in a stressful situation (for example, before a speaking engagement), your adrenaline level spikes, causing you to get the jitters.

And as we also mentioned earlier, Metoprolol works by blocking the effects of the adrenaline hormone [1]. It prevents adrenaline from binding with beta-receptors in your heart [2], 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’re effectively blocking the physical symptoms of stage fright 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.

Beta-blockers like Metoprolol can make the difference

A quick search on the Internet will reveal countless stories of speakers, musicians, and other performers who claim that using beta-blockers have helped them in their careers.

For example, according to a story in the New York Times [8], Ruth Ann McCann, a flutist from Memphis, used to suffer debilitating on-stage jitters. Her heart would thump loudly, and her hands would get cold and wet. At times, she would drop her flute.

But ever since the first time she tried beta-blockers, her life changed. She went back to performing at a high level without any anxiety symptoms.

And she’s not alone. A 1987 survey by the International Conference of Symphony Orchestra Musicians, representing some of the largest orchestras in the U.S., found that 27 percent of their musicians were using beta-blockers for performance anxiety [9]. Experts estimate that number is much higher today.

Needless to say, beta-blockers can be a powerful tool for someone who suffers from stage fright. But are there any downsides to these medications?

Are there any downsides to taking Metoprolol for performance anxiety?

Most of the anecdotal stories on performers and beta-blockers suggest that the benefits of drugs like Lopressor outweigh any potential downsides. The vast majority of performers seem to find that beta-blockers positively affect their careers and lives. And they’re considered to be generally safe for most people.

But beta-blockers do have certain limitations when it comes to dealing with stage fright.

1. Metoprolol will always be a temporary solution for stage fright

When you take beta-blockers, you’re not doing anything to address the root causes of your performance anxiety. You’re applying a quick-fix to stop the physical symptoms.

That’s not to say beta-blockers don’t work, because they can. But if you’re only relying on beta-blockers, you’ll most likely have to keep taking them every time you need to perform under pressure.

2. You will need a prescription for Lopressor

In the United States, you need a prescription for Lopressor. 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 may cause dependency

This is most likely not a concern for most people who only take beta-blockers occasionally for performance anxiety. But if you make it a habit of taking Metoprolol frequently, then you shouldn’t stop it all of a sudden.

When you take beta-blockers frequently, your body becomes dependent on it to some extent. So, stopping abruptly might cause your blood pressure to spike. If you’ve been taking Metoprolol regularly, talk to your doctor if you want to stop the medication.

Is Metoprolol right for me?

Whether Metoprolol is right for you will depend on a few different factors.

The most critical thing to consider is your health, and if Metoprolol is a good fit with your medical history. This is something you can talk to your doctor about if you’re interested in Metoprolol for performance anxiety.

Assuming your health allows you to take Metoprolol, then you have to consider how severe your performance anxiety symptoms are.

If you get a bad case of the jitters every time you have to perform, and you feel like it is holding you back, then there may be a good reason for you to give beta-blockers a try.

Even if you start taking beta-blockers, you may also want to consider more long-term solutions for your stage fright. For that, you’d have to address the root causes of your anxiety with tools like meditation or cognitive behavior therapy (CBT).

In conjunction with a long-term solution like CBT, you can use Metoprolol as a quick-fix when you need to get through a performance.

Is there a natural alternative to Metoprolol?

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 Lopressor.

A natural supplement would achieve the same end-result as a beta-blocker, which is to provide relief from symptoms of performance anxiety. But it would do so by supporting your brain in a way that promotes overall relaxation, calmness, and improved cognitive function.

PerformZen for performance anxiety

PerformZen is a supplement designed to help performers reduce anxiety so they can perform at their highest level.

PerfromZen works by promoting GABA levels in your brain. GABA is a neurotransmitter that relaxes the body, slows down the thoughts, and increases calmness.

Whether you’re a speaker, musician, professional athlete, or a university student, you could most likely benefit from a higher level of calmness and mental focus when you have to perform under pressure.

Here are the ingredients in PerformZen that promote calmness, focus, and even better cognitive function:

GABA

GABA, or Gamma-aminobutyric acid, is an amino acid that has been shown to reduce activity levels of neurons in the nervous system. As a result, GABA promotes relaxation and calmness [10]. Studies show that GABA works as a natural relaxant in stressful situations.

GABA also promotes alpha wave activity in the brain, which is a brain frequency that is linked to a state of wakeful alertness and creativity [11]. This state is often referred to as the “flow state”, which is where performers like musicians and athletes perform at their best.

L-theanine

L-theanine is another amino acid that boosts GABA levels in the body to promote relaxation and calmness [12]. It works as an adaptogen, which is a substance that helps balance mood and reduces stress. Additionally, L-theanine also increases alpha waves in the brain to improve alertness and creativity.

Magnesium

Magnesium can be beneficial to those with performance anxiety in a couple of different ways.

Magnesium makes GABA more bioavailable to your body.

PerformZen boosts GABA through its ingredients like GABA and L-theanine. Then, magnesium facilitates better absorption of GABA by stimulating receptors in your body to absorb GABA better [13]. As a result, you may experience a more potent effect of GABA.

Magnesium also works synergistically with vitamin B6, which is another ingredient in PerformZen.

Vitamin B6

Vitamin B6 combines with magnesium to improve focus and attention. One study also showed that magnesium, when combined with vitamin B6, improved behavioral disorder in children with ADHD syndrome (attention deficit hyperactivity disorder) [14].

Although the study was focused on kids with ADHD, the findings suggest that the combination of magnesium and B6 would benefit those with performance anxiety. When you’re focused on the task at hand (performing, writing, playing a sport), your attention will shift away from the negative thought patterns responsible for your anxiety.

Additionally, vitamin B6 also helps naturally synthesize GABA within your body, and low levels of B6 has been linked with increased stress levels [15].

Ginkgo Biloba

Ginkgo Biloba has been traditionally used for healing purposes in Chinese medicine. It is a herb rich in antioxidants that has various benefits for brain health.

One of the benefits of Ginkgo Biloba is that it reduces stress hormone levels [16]. Since stress response is what causes the physical symptoms of performance anxiety, managing stress hormones will prevent stage fright symptoms from manifesting.

Theacrine

Theacrine is a natural substance that is similar to caffeine. It is often described as caffeine without the fluctuations in energy levels [17]. Theacrine will enhance mental clarity and elevate your mood just like caffeine, and provide a steady boost in energy. It’s the perfect “pick-me-up” before a performance, exam, or a date.

Should I take Metoprolol or PerformZen?

Both supplements and beta-blockers can help you with performance anxiety, but they work in different ways.

What makes PerformZen a powerful natural alternative to Metoprolol is that all of it’s ingredients work synergistically to boost your brain’s capacity to reduce stress and promote a feeling of calm confidence, so you can go out there and perform at an optimal level.

When you consistently support your brain with ingredients like GABA, L-theanine, vitamin B6, and magnesium, over time it becomes more resilient, and better equipped to help you in your fight against anxiety.

PerformZen also doesn’t come with any side effects, and it doesn’t require a prescription, since it’s a dietary supplement.

Beta-blockers, on the other hand, work by blocking the effects of adrenaline within your body. Like all medications, they may address and block the symptoms at the moment, but they’re not able to provide you with any long-term health benefits.

Final thoughts on Metoprolol for performance anxiety

For many performers, stage fright can be debilitating to the point where it becomes impossible to perform. For others, it prevents them from performing at their highest level.

And for a countless number of people, performance anxiety might hold them back from landing their dream job, closing a sale, or getting a second date.

If you’re someone that suffers from a severe case of the jitters, beta-blockers like Metoprolol can provide a much-needed relief from the physical symptoms so you can get through what you need to do.

If you’re considering Metoprolol, be sure to consult with your doctor to make sure it is right for you. Otherwise, if you’d rather go with a natural supplement, consider giving PerformZen a try.


Agnit is a performance expert and the lead writer for PerformZen. As an avid health and fitness enthusiast, he is passionate about helping people take control of their health to live happier, more productive lives. Someday, he plans to listen to his own advice and drink less coffee.

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