Best Propranolol (Inderal) Natural Alternatives for Anxiety

Propranolol, a non-selective beta blocker commonly prescribed to help with heart-related conditions, is used by many to help with performance anxiety (often referred to as ‘stage fright’) symptoms.

Propranolol is actually one of the most popular and commonly prescribed beta blockers amongst the alternatives. Typically prescribed to treat cardiovascular conditions like high blood pressure, chest pains, irregular heartbeats, and sometimes migraines ^[1]; Propranolol can also offer short term relief from the physical symptoms of stage fright and anxiety, which is why many performers like public speakers, actors, singers and other facing high-anxiety situations regularly use Propranolol ‘off-script’ to help them get through the most stressful parts of their performances.

As with most prescription medications, there are some side effects with Propranolol that you should be aware of. Here, we are going to look into how Propranolol works, what the side-effects and risks of Propranolol are when using the drug specifically for treating anxiety symptoms and, finally, we’ll take a look at some natural alternatives to Propranolol that are less likely to have undesirable side effects and/or dangers while still offering the same anti-anxiety characteristics that a performer (or anyone looking at an upcoming high-anxiety scenario) might be seeking.

What is Propranolol?

Propranolol is one of the most commonly prescribed beta-blocker medications in the US ^[2]. Beta-adrenergic blocking agents (the full medical name of beta blockers) such as Propranolol work by blocking the effects of adrenergic hormones, like adrenaline, on the heart.

This can moderate heart rate and the accompanying symptoms that might result with elevated heart rate and blood pressure. And this explains why medical professionals typically prescribe beta-blockers like Propranolol to treat various heart conditions, if lifestyle adjustments fail to do the job. Typical conditions for which your doctor might recommend Propranolol include ^[3]:

• High blood pressure
• Irregular heartbeat
• Angina (chest pain)

Beta-blockers were originally created to help those with cardiovascular issues by influencing the force with which your heart pumps blood. Sometimes, however, beta blockers like Propranolol are also prescribed for conditions like migraines, and harmless tremors of the arms, hands, etc ^[4].

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Propranolol OTC Brand Names

Propranolol is sold OTC (over the counter) under the following brand names:

• Inderal
• Inderal LA
• Hemangeol
• Inderal XL

Propranolol is a prescription medication, and therefore requires a prescription from your doctor to obtain, whether you need it for a heart condition or are considering propranolol beta-blockers for performance anxiety.

Is Propranolol a Beta Blocker?

The short answer to this question is yes, Propranolol is a beta blocker. More specifically, Propranolol is a non-selective β-adrenergic receptor antagonist, or just ‘beta blocker’ for short. This means that Propranolol blocks the action of epinephrine (adrenaline) and norepinephrine (noradrenaline) at both β1- and β2-adrenergic receptors ^[5].

How Propranolol works for Anxiety

As explained above, Propranolol is part of a class of drugs known as beta-blockers and beta-blockers are, first and foremost, a form of heart medication, typically prescribed to treat conditions like irregular heartbeat and high blood pressure/hypertension.

Propranolol slows the heartbeat and lowers blood pressure through a mechanism of blocking the release of the hormone epinephrine (commonly known as adrenaline), which has the opposite effect. When adrenaline is released, the heart beats faster, more blood gets pumped around the body, and for some people, undue stress is caused to the heart and cardiovascular system.

It just so happens, adrenaline is also the cause of many of the physical symptoms of anxiety and stage fright. The reason we experience high blood pressure, sweating and rapid breathing before a performance or social setting is our body’s “fight or flight” response, a natural process of the nervous system designed to help us survive dangerous or threatening situations.

Whenever our brain interprets that we’re in danger, it typically kicks the fight or flight response into action, releasing a surge of adrenaline into the bloodstream ^[6].

When experiencing anxiety, our system incorrectly interprets a situation as life-threatening, and starts to release adrenaline into the bloodstream. This results in symptoms synonymous with anxiety; such as trembling, sweating, and high blood pressure.

Propranolol counters this process by slowing the rate at which adrenaline is released into the bloodstream, providing relief from many of the unwanted and unnecessary physical symptoms of anxiety.

So, while Propranolol may not completely eradicate the root causes of any anxiety, it can be effective in treating and reducing the major symptoms, which can get in the way of a performance or produce a degree of discomfort in social settings.

Here’s a video explanation of how Propranolol works for anxiety:

A fast yet accurate video description of Propranolol & it’s uses for anxiety

Propranolol Side Effects

For the most part, Propranolol has been found to be a relatively safe medication by most users, including for long-term use ^[3]. While taking beta-blockers for anxiety is often done “off-script”, meaning that the drug is being used for something other than the original purpose, doctors do sometimes prescribe Propranolol to treat anxiety.

What are the downsides of Propranolol?

While there aren’t too many major risks, there are definitely some side-effects and downsides that come with Propranolol. It’s common to feel slight dizziness or light-headedness by many people using a course of propranolol, due to how the drug lowers blood pressure.

Propranolol can also have interactions with other medicines, and may not be suitable for people who already have low blood pressure, or people taking other medicine for high blood pressure.

There is also a risk of withdrawal if taken for a long time and abruptly stopped. The symptoms of withdrawal are consistent with a spike in blood pressure, and can be serious ^[7]. For this reason, it’s recommended to taper off over a period of four to seven days after long-term use ^[8].

Is Propranolol ototoxic?

Ototoxicity is what happens when toxins from medications damage your ears. There are hundreds of medications available on the market that might cause damage to the ears. Some of these drugs are used to treat severe infections of illnesses and for some people, an unfortunate side effect is ototoxicity ^[9]. Because ototoxicity impacts the inner ear, the symptoms are primarily related to hearing and balance and include:

• Ringing in the ears (also known as tinnitus)
• Dizziness
• Hearing loss in one or both ears
• Loss of balance
• Blurred vision
• Bouncing vision

Ototoxic Medications that can cause hearing loss include antibiotics such as Gentamicin, Streptomycin & Erythromycin; Loop diuretics like Furosemide; Chemotherapeutic agents like Cisplatin & Carboplatin; and even simple Aspirin ^[9].

Tinnitus, a symptom of ototoxicity where there is ringing in the ear, is rare with Propranolol, and appears to be slightly more common with bisoprolol and nebivolol (Bystolic) beta-blockers ^[10].

There are a lot of anecdotal accounts where peoples hearing has been affected by Propranolol usage, so it would definitely help to discuss an alternative in the same medication class (perhaps Metoprolol, but keep your options open) with a healthcare provider if you notice tinnitus or any change in your hearing when using Propranolol ^[11].

One last thing to keep in mind is that having high blood pressure is also considered a possible cause of tinnitus. Blood pressure regulation is one of the main uses of Propranolol, so in some cases tinnitus symptoms could be from high blood pressure — rather than the Propranolol medication.

Natural Propranolol Alternatives for Anxiety

We’ve had to answer the question here at PerformZen HQ many times: “Is Propranolol the best way to deal with anxiety?” – and the answer is never straightforward! The answer is complicated by the fact that Propranolol does show efficacy in treating the physical symptoms of anxiety, particularly performance anxiety and stage fright. Doctors even prescribe Propranolol for this use, and it’s quite commonly used by classical musicians to help with anxiety issues during a performance ^[12].

But maybe you’re not overly excited about the idea of becoming dependent on a beta-blocker like Propranolol every time you want to perform, or having to renew a prescription whenever you run out. If this sounds like you, then I’m guessing you want to find a natural alternative to Propranolol.

Any natural alternative to a prescription drug should achieve the same end-result as the original medication, which in this case is to provide relief from symptoms of performance anxiety. But a good natural alternative should do so by supporting your mind and body in a way that, over time, makes you more resilient to anxiety. Ideally, you would become better equipped to handle any stress response and you would learn to think about your performance in a way that makes it less stressful, to begin with ^[2].

Here are some of the most effective natural remedies for performance anxiety that we’ve seen:

GABA

Gamma-Aminobutyric Acid, shortened as GABA, is a naturally-occurring amino acid that acts as a neurotransmitter within the body. GABA has been shown in numerous studies to have a calming effect, and GABA deficiency is believed to play a part in several anxiety disorders ^[8].

Studies that used GABA supplementation have found it may have a positive effect on stress and anxiety ^[13], which would help block the symptoms associated with performance anxiety.

If you’re looking for a natural alternative to beta blockers that reduces anxiety by boosting GABA levels, then we can recommend:

L-Theanine

L-Theanine is an amino acid that is popularly known for its relaxing properties ^[14]. Several studies have identified that L-theanine can sometimes decrease the severity of stress-related symptoms, while increasing cognitive performance ^[15].

For these reasons, it safe to say that taking L-theanine may help performers counteract the nerves that come with performance anxiety, as well as providing better focus during their performances. The singer Taylor Swift has even stated in interviews that she uses L-theanine to help her handle the stress of stage performances.

L-theanine is present in green, black and oolong teas, as well as some mushrooms. For the most efficient form of L-theanine, the compound can also be taken as a supplement. Our supplement (PerformZen) contains L-Theanine, which we will talk more about later. But if you’re looking for a concentrated dose of L-Theanine, then we recommend:

Silexan (Lavender)

Silexan is a branded extract of lavender oil created by Wilmar Schwabe GmbH, a German pharmaceutical company. Schwabe pharmaceuticals claim that silexan is “introducing a new therapeutic alternative in the field of anxiety disorder treatment” ^[16].

At its core, Silexan is a standardized essential oil of L. angustifolia (lavender) flowers prepared by steam distillation ^[17].

Research involving Silexan is showing that “pharmaceutical quality lavender oil” (potent silexan) can improve symptoms of mild anxiety. Two recent studies found lavender oil capsules to be just as effective as commonly prescribed benzodiazepine Lorazepam and the antidepressant Paroxetine ^[18].

The anxiolytic (anti-anxiety) properties of lavender/silexan seemingly come from the antagonization of NMDA and GABA-related receptors in the central nervous system that influence muscle contraction, as well as inhibition of the serotonin transporter.

This simply means that the mechanism of action for Silexan seems to be similar to anxiolytic and antidepressant drugs like SSRIs and Benzodiazepines ^[19].

The major upside to lavender/silexan over similar prescription anti-anxiety medications (like benzos) is the almost complete lack of abuse potential in healthy recreational users of the lavender extract ^[20].

Downsides can include the affectionately-titled “lavender burps” which are potential mild gastrointestinal issues, and recent studies showing that chemicals in lavender oil are potential endocrine disruptors with varying effects on receptors for two hormones — estrogen and androgen ^[21].

We have a whole page covering Silexan here, but if you’re interested in trying a potent Silexan supplement, then we recommend:

Garlic

Garlic can be a natural alternative to Propranolol, providing many of the same positive effects on cardiovascular health and blood pressure.

Studies have shown significant beneficial effects of garlic on hypertension ^[22]. Garlic works for anxiety mostly by stimulating the production of nitric oxide within the body, which has the effect of relaxing blood vessels ^[23].

One particular study showed that garlic can have an equal effect on blood pressure as atenolol, another commonly prescribed beta blocker ^[24].

Whether the antihypertensive benefits of garlic provide beneficial for performance anxiety is (as yet) unproven, however garlic’s ability to replicate the effects of prescription beta-blockers like Propranolol is very promising!

Garlic is best purchased in your nearest supermarket and added to your food when cooking; it’s the most delicious way we know of to add garlic to your diet.

Natural Anxiety Supplements (Like PerformZen)

If you’re looking for a more specialized all-natural alternative to anxiety medications that promotes overall relaxation, calmness, and improved cognitive function then you should consider PerformZen Calm Performance Formula.

PerformZen is a natural supplement designed to help public speakers overcome glossophobia symptoms, and maintain their composure and mental focus when they have to deliver a speech under pressure!

PerformZen works by boosting GABA, which is a neurotransmitter that promotes calmness ^[24]. It also contains magnesium and vitamin B6, which combine together to improve cognitive performance ^[25].

Additionally, PerformZen contains L-theanine, theacrine, and Ginkgo Biloba, which are natural ingredients that promote calmness and provide a boost in clean energy.

So does a natural alternative to Propranolol exist?

Performance anxiety and stage fright are not fun (at all) to deal with. It’s even worse when you’re consistently tasked with performing in high-pressure situations, especially when this is your profession.

While many people are using Propranolol off-script to help with their performance anxiety, there are many natural ways to treat those same symptoms, or even to prevent the cause of performance anxiety itself. With amino acids like GABA and L-theanine, simple ingredients like garlic, and cognitive-enhancing supplements like PerformZen, you can have a go-to natural option to fight off nerves and perform without anxiety, if you choose.