Propranolol for Anxiety and Stage Fright: Everything You Need to Know

The beta-blocker Propranolol is commonly used off-script for anxiety & stage fright by professional performers of all sorts: from singers to CEOs, orchestra musicians and anyone who is experiencing severe anxiety in the run up to a large, high-stakes event. Here we look at how and why propranolol works to help with anxiety & stage fright, as well as analyzing the side-effects and diving into natural and equally effective alternatives. Keep reading if you are interested in using propranolol to help with your performance anxiety.

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Are you considering Propranolol for performance anxiety because you get a bad case of the jitters every time you have to go and stage and perform in front of an audience?

Maybe your heart starts racing, your hands start trembling, and you start sweating profusely, to the point where it affects your ability to perform at an optimal level.

Or perhaps you’re not a “performer”, as in a musician, public speaker, or a comedian, but you still get the jitters in high-pressure situations, whether it’s an interview, an exam, or in a social event like at a party or on a date.

If any of that sounds familiar, you’re not alone. Performance anxiety, also known as stage fright, is a common phenomenon that affects millions of people around the world. It stems from the fear of being judged negatively because of your performance, even if it is irrational and there’s no real evidence to justify the fear.

Stage fright is prevalent, especially among professional musicians, public speakers, and even stand-up comedians. And many of them turn to Propranolol and beta-blocker drugs to deal with performance anxiety.

Propranolol is popular with many performers

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 [1]. Experts estimate that number is much higher today.

And a quick search on the internet will reveal many anecdotal stories of performers, and people from various other walks of life, who have used beta-blockers at some point to deal with social anxiety.

But what is Propranolol, and does it really help you overcome performance anxiety? And are there any alternatives?

Here, we’ll discuss what Propranolol is, how it works within the body, and why some performers use it to deal with stage fright. We’ll also discuss some natural alternatives to beta-blockers that can also help you remain calm and focused during your performance.

But before we delve into why Propranolol may help some performers, let’s take a look at why you experience performance anxiety.

Knowing why you get the jitters will help you better understand why beta-blockers, or other natural alternatives, may be effective against your stage fright symptoms.

Why do I experience performance anxiety?

You experience performance anxiety due to an exaggerated stress response.

Performing in front of an audience is somewhat of a stressful experience for most people. Almost everyone experiences elevated heart rate and maybe even some slight sweating.

But for many, the slight stress response is no big deal, and they carry on with their performance, speech, interview, or exam.

Some people even use the adrenaline rush to their advantage, and it helps them raise the intensity of their performance.

But for those who experience performance anxiety, the stress response goes too far.

Your body thinks that you’re in actual danger and your fight-or-flight response kicks in, resulting in exaggerated symptoms of stage fright like excessive sweating, high blood pressure, dizziness, nausea, and more [2].

One thing to note in the context of why Propranolol may help with symptoms of stage fright, is the role of adrenaline.

Adrenaline is a stress hormone, and it shoots up when you’re in the fight-or-flight mode, and it is linked with many of the physical symptoms of performance anxiety [3].

It is also the reason why beta-blockers are effective in dealing with symptoms of performance anxiety

What is Propranolol and why do performers take it?

Now that we have some understanding about why you experience performance anxiety, let’s take a look at how it is related to beta-blockers, and more specifically, Propranolol.

Why do performers take beta-blockers?

Let’s look at how beta-blockers work to give you a better grasp of why it can help with stage fright symptoms.

Beta-blockers are also known as beta-adrenergic blocking agents. They block the effects of adrenaline and prevent it from binding to the beta receptors in the heart. This has a calming effect on the heart and the force with which it has to pump blood. Consequently, the heart can return to its regular workload, and your blood pressure can remain steady [4].

As we explained in the previous section, an exaggerated stress response like when you experience performance anxiety, is associated with a dramatic spike in adrenaline.

So, by blocking the effects of adrenaline, you’re preventing it from binding to the beta receptors in the heart. So, beta-blockers essentially block the physical symptoms of performance anxiety.

When you take a beta-blocker, it can slow your heart rate, reduce the trembling and sweating, and regulate your breathing and blood pressure. It can help you feel relaxed, essentially negating the stress response to help you get through the performance.

We should make a note that each individual is different, especially when it comes to causes of anxiety. We also vary widely in symptoms, the severity of those symptoms, and how we react to specific medications. So, how you respond to a beta-blocker can be different from someone else.

What is Propranolol?

Propranolol is one of the most popular and commonly prescribed beta-blockers. Doctors typically prescribe beta-blockers to treat cardiovascular conditions like high blood pressure, chest pains (angina), irregular heartbeats, and at times, even migraines [5].

Another condition that Propranolol is sometimes used for is benign essential tremors, a disorder that can cause uncontrolled shaking in the arms, hands, or your torso.

Beta-blockers work by influencing how your heart pumps blood and how it flows through your arteries and veins.

Drugs like Propranolol often aren’t the first line of treatment against something like high blood pressure. Doctors may first recommend lifestyle changes like eating less sodium-rich foods, exercising, managing stress, etc.

Propranolol may be prescribed if lifestyle changes fail, or if your doctor thinks a beta-blocker may be a good complement to the lifestyle adjustments.

Doctors may also prescribe Propranolol to increase someone’s chances of survival after a heart attack or heart failure.

A common prescription beta blocker alternative to propranolol is metoprolol.

Propranolol and performance anxiety

Propranolol is one of the most commonly used beta-blockers among performers.

It works as an effective short term relief from the physical symptoms of stage fright. If a musician takes Propranolol before going on stage, he or she might still feel the stress, but not the symptoms like trembling hands, racing heart rate, or nausea.

So, when people talk about taking beta-blockers for performance anxiety, it is important to note that they’re not talking about addressing the root causes of the fear, or a long-term solution.

They’re talking about a short-term fix. But it’s a short-term fix that can be the difference between whether someone gets to keep pursuing a career in performing, or give up on their passion and move on to something else.

But useful as they may be, you shouldn’t expect beta-blockers to cure your performance anxiety if you do choose to take them.,

What is the recommended dosage for Propranolol?

Propranolol is a prescription drug in the United States. So, if you’re considering Propranolol for performance anxiety, you’ll have to ask your doctor if it may be an option for you.

If your doctor decides to prescribe beta-blockers for you, then he or she will also let you know your daily dosage.

You must stick to the recommendations of your doctor. They know your medical history and all your other current medications and health issues. Going beyond what your doctor prescribes can have severe health consequences.

For most adults, an effective dose is between 40-80 mg per day [6].

For most people who use beta-blockers for stage fright, the best time to take it some time before they’re about to go on stage. You want to give it enough time for the effects to kick in, but not so early that it is no longer useful. Again, consult with your doctor for when and how much Propranolol you should take before you have to perform.

Are there any downsides to using Propranolol for performance anxiety?

Propranolol, and beta-blockers in general, are considered to be safe, especially if you only take them occasionally before a big performance, speech, exam, or job interview.

But if you start performing more frequently, and you find that Propranolol is really helping you get a handle on the jitteriness, you might start using it more regularly.

And if you’re going to use Propranolol regularly, then you should be aware of the potential downsides of Propranolol, and beta-blockers in general.

Potential side effects

Severe side effects aren’t very common in people that use Propranolol for stage fright. But you should still know the potential side effects, so you can notify your doctor if you experience any of them. Your doctor can then evaluate if you should continue taking them.

Here are some of the potential side effects of Propranolol [7]:

  • Dryness in the eyes
  • Below normal heart rate
  • Tiredness or feeling weak
  • Nausea

Severe side effects are rare, but if you experience any of the following, be sure to notify your doctor immediately.

  • Allergic reactions like skin rash or hives
  • Swollen face, lips, or tongue
  • Trouble breathing

Drowsiness may affect your performance

The benefit of beta-blockers could also be a potential downside for some people.

For most people that experience severe stage fright, a beta-blocker will help them avoid the symptoms in a way that calms them down enough to be able to get through a performance.

But for some people, the calming effect may go too far. If Propranolol relaxes you to the point where you start feeling drowsy, that’s obviously not good for your performance.

What you ideally want is to remain calm, but also mentally sharp and focused so you can perform at your best.

The good news is that there are ways to do just that, as we’ll discuss below.

Interactions with other medications

If you’re taking any medications, or even any herbs or supplements on a regular basis, you should let your doctor know when discussing whether Propranolol might be right for you.

Propranolol may interact with other medications or supplements in a harmful way. It may also impact how well another drug works.

Your doctor knows the entire picture of your health, as well as your medications. So you must follow your doctor’s guidance on whether you should take Propranolol for performance anxiety.

Here are some of the common medications that may interact with beta-blockers, and you might be advised to avoid Propranolol if you’re currently taking any of them [7].

  • Arrhythmia (irregular heartbeat) medications
  • Other blood pressure medications
  • Asthma medications
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Blood thinners
  • Stomach ulcer medications

Propranolol requires a prescription

Assuming your doctor approves of you taking Propranolol for stage fright, and writes a prescription, you’ll have to refill that prescription every time you run out.

This will not be an issue if you only plan on using Propranolol occasionally. But if you start using them more often, then it could become a significant inconvenience.

Potential dependence on beta-blockers

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 Propranolol 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 Propranolol regularly, talk to your doctor if you want to stop the medication.

Always a short-term solution

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 clearly do. 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.

To overcome performance anxiety in the long-term, you’ll need to focus on solutions that address the root causes of the issue, whether it’s emotional, mental, or physiological.

Why do some people experience performance anxiety and others don’t?

Performance anxiety is a complex issue. It can be a combination of environmental and biological factors.

Anxiety issues often run in the family, but it isn’t clear whether that is due to genetics or because of learned behavior from parents. Evidence also suggests that being bullied as a child, or having overprotective parents, can make someone more susceptible to social anxiety as an adult [2].

Often, it is a self-fulfilling prophecy. You may have had a traumatic experience during a performance that didn’t go well at a young age, or early in your career.

This bad experience then creates stress and fear around the very idea of performing, which results in a stress response every time you have to go on stage, and it affects your performance.

You then think your negative expectations are warranted, making it more likely that you experience stage fright again in the future.

Another potential cause why some people experience more severe performance anxiety is a neurotransmitter imbalance in the brain.

The neurotransmitter GABA and performance anxiety

Gamma-aminobutyric acid (GABA) is a neurotransmitter that limits and reduces nervous activity in the brain.

According to an article published in the Journal of Neuropsychiatric Disease and Treatment, when GABA levels are out of balance in your body, you might be more susceptible to more severe symptoms of depression, PTSD, and social anxiety disorders (SAD) [8].

Performance anxiety falls within the umbrella of social anxiety disorders (SAD). It is possible that if your GABA levels are disrupted, the part of the brain that handles stress may be overactive, and you’re more susceptible to severe symptoms of stage fright.

Are there any natural alternatives to Propranolol

If you’re not too excited about becoming dependent on a beta-blocker every time you want to perform, or having to get a prescription whenever you run out, you may be wondering if there are natural alternatives to Propranolol.

A natural alternative 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 mind and body in a way that, over time, makes you 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 remedies to performance anxiety.

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 for you.

The goal of CBT is to take something you find overwhelming (like performing in front of an audience), break it down into smaller parts, and to replace any negative patterns with more positive and productive ones [9][10].

Your therapist will 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.

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

Yoga

If you could train your body to learn how to better deal with stress, then you’d have a less severe stress-response, and your symptoms of stage fright would be less severe.

And that’s precisely what you can accomplish with yoga.

According to an article in Harvard Health, yoga can work as a natural anxiety relief by reducing the impact of an exaggerated stress response, which is what causes stage fright [11].

Yoga trains your body to operate more in a state of calm. So, when there’s a stressful situation, you’re 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 [12]. A higher HRV indicates your body’s increased ability to deal with stress.

PerformZen calm performance formula

PerformZen is a natural supplement designed to help performers remain calm and relaxed when it’s time to get on stage and deliver for an audience.

Besides promoting calmness to reduce anxiety symptoms, PerfomZen also helps with mental focus so you can have the best of both worlds. You remain relaxed, but at the same time, you’re also mentally sharp so you can perform at the highest level.

GABA to promote calmness

PerformZen works primarily by boosting GABA levels in your brain.

As we explained above, GABA is a neurotransmitter that reduces anxiety and promotes calmness. GABA also increases alpha brain wave activity, which is a brain frequency where you are in a wakeful state of alertness, and you’re also most creative [13].

But PerformZen does more than just boost GABA.

It combines other critical ingredients that work synergistically to make GABA more bioavailable, so your body can absorb and utilize it better.

That means, you feel a more potent effect of GABA when it matters most, as you’re walking on stage to perform for an audience.

One of the things that make PerformZen a better solution than beta-blockers is that it also improves your cognitive performance.

Instead of only getting rid of the negative symptoms, PerformZen also helps you focus on the task at hand, which is to deliver a great performance or speech or to crush your exam or interview.

Let’s take a look at the different ingredients in PerformZen that promote calmness during a performance, while at the same time helps you maintain your focus.

L-theanine boosts GABA and promotes relaxation

L-theanine is an amino acid that is most commonly found in green, black, and oolong teas.

Evidence shows that L-theanine promotes relaxation without making you tired. It is responsible for the soothing effects of green tea.

One of the benefits of L-theanine in PerformZen is that it increases GABA levels in the brain. It also increases alpha brain waves to promote relaxation, and it reduces beta waves, which have been linked with stress [14].

Magnesium to increase absorption of GABA

Besides being a natural relaxant that will also promote calmness during a performance [15], one of the benefits of magnesium in PerformZen is that it facilitates better absorption of GABA.

GABA and L-theanine in PerformZen will increase GABA levels in your body. But for GABA to be most effective, your body needs to absorb it efficiently. Magnesium stimulates certain receptors which makes it easier to absorb GABA, so you can feel a more potent effect when it matters most [16].

But that’s not all. There’s another role that magnesium plays in PerformZen when it combines with a separate ingredient, vitamin B6.

Vitamin B6 and magnesium to improve focus

When combined together, vitamin B6 and magnesium can help you focus more on the task at hand, which is your performance, instead of getting distracted by counterproductive thoughts.

Evidence shows that vitamin B6 and magnesium can help children with ADHD improve their behavior. Although the research was conducted with kids with ADHD, the improvement in focus would also benefit those with stage fright [17].

Additionally, vitamin B6 helps naturally synthesize GABA within your body, and low levels of B6 has been linked with increased stress levels [18].

Theacrine, the benefits of coffee without the jitters

Theacrine is a naturally occurring substance found in a Chinese tea known as Kucha.

When you take PerformZen before you’re about to go on stage, Theacrine will provide a clean energy boost. It may feel similar to caffeine but without the jittery ups and downs.

Along with GABA, L-theanine, and the combination of magnesium and B6, theacrine is another ingredient in PerformZen that will improve cognitive performance to help you perform at your best.

Ginkgo Biloba

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

Evidence shows that Ginkgo Biloba can help you manage your stress hormone levels, which keeps your fight-or-flight response under control and prevents the symptoms of performance anxiety.

All combined, PerformZen is a potent formula when it comes to fighting performance anxiety. As a natural supplement, it promotes calmness, focus, and optimal cognitive performance.

Final thoughts on Propranolol for performance anxiety

You don’t have to let performance anxiety control you and prevent you from doing the thing you love, which is performing for an audience. Or perhaps getting jittery has been affecting your professional or personal life.

Beta-blockers like Propranolol can provide a much-needed relief from the physical symptoms so you can get through what you need to do.

But a beta-blocker, or any other drug, will never be the solution you’re really looking for, which is to not be fearful about performing in front of an audience in the first place.

To overcome performance anxiety in the long term, consider natural alternatives like cognitive behavioral therapy (CBT), yoga, and a natural supplement like PerformZen.

In the meantime, If you’re considering Propranolol for a quick-fix, be sure to consult with your doctor to make sure it is right for you.


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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