If you’ve taken medication for heart conditions or high blood pressure, there’s a good chance you may have been prescribed Propranolol.
Like with any drug, there are some side effects of Propranolol you should be aware of. Each person may experience different side effects, with varying intensity; ranging from none at all, to significant discomfort.
In this article we’re going to give you all you need to know about the possible side effects of Propranolol, and anything you should be aware of before taking it. We’ll also share some alternatives to Propranolol, which are less likely to have undesirable side effects or dangers.
What is Propranolol?
Propranolol is a prescription drug used in the treatment of heart conditions or problems with circulation, such as high blood pressure.
Propranolol may also be known by brand names such as Hemangeol, Inderal, Inderal LA, Inderal XL and InnoPran XL.
It belongs to a class of drugs known as beta-blockers. Beta-blockers (short for beta-adrenergic blocking agents) treat heart and circulation conditions by blocking the release of the hormone epinephrine (also known as adrenaline), which makes the heart beat faster.
By regulating adrenaline, beta-blockers reduce stress on the heart and lower blood pressure, which provides relief for some common heart conditions, as well as some off-script conditions, like anxiety.
Propranolol is most commonly used to treat the following :
- High blood pressure (hypertension)
- Irregular or uneven heartbeat (arrhythmia)
- Angina (chest pain)
- Heart attacks
It’s also used sometimes to treat the symptoms of social anxiety disorders and performance anxiety.
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Propranolol for Anxiety
Beta-blockers like Propranolol are not specifically designed to treat anxiety, however the symptoms of anxiety overlap significantly with those of conditions beta-blockers are regularly prescribed for.
Anxiety disorders like performance anxiety are characterized by an increase in stress hormones, caused by the body’s “fight or flight” response. This is left over from our ancestors, who regularly had to face dangerous situations, in which we would either fight or run away in order to survive.
When these situations arose, the body would release high levels of adrenaline, which makes the heart beat faster, pumping more blood to the muscles in preparation for a fight, or a fast escape.
Today, actual danger is very rare. However, our brain sometimes interprets stressful situations the same way. It’s not uncommon to experience the same stress response before a performance, or a high-pressure social situation.
When this happens, we can experience physical symptoms such as an elevated heart rate, sweating, high blood pressure and rapid breathing, which can cause significant discomfort.
That’s where beta-blockers come in. While they don’t treat the underlying cause of anxiety, they treat its symptoms, by slowing the release of adrenaline, and the symptoms that come with it.
Propranolol and other beta-blockers are somewhat popular with professionals, for whom performance anxiety can be a threat to one’s livelihood. And this is not a new phenomenon. A 1987 survey of orchestral musicians showed 27% of American respondents took Propranolol or other beta-blockers to treat performance anxiety .
Common Propranolol side effects
While Propranolol is a commonly prescribed drug, and shows efficacy for a number of conditions (including anxiety), it does come with side effects.
These side effects may vary in intensity from person to person. Depending on the severity of the condition Propranolol is prescribed for, the side effects may be worth it. In other cases, these side effects may be enough to make you want to consider an alternative treatment.
- Dizziness or feeling lightheaded
- Fatigue or weakness
- Dry eyes
- Cold fingers and toes
- Stomach pain
- Diarrhea or constipation
- Low heart rate
- Low blood pressure
- Trouble sleeping or vivid dreams
- Decreased sex drive
- Mood changes or depression
- Memory loss
- Anaphylaxis (allergic reaction)
It’s estimated that at least 1 in 100 people experience some form of side effect when taking Propranolol .
You may experience lightheadedness and fatigue, due to the way that Propranolol reduces heart rate and blood pressure. This also slows circulation, which can lead to coldness in the fingers, hands, toes and feet in more serious cases.
Additionally, side effects such as personality or mood changes, and memory issues can happen because Propranolol slows the release of certain hormones, such as epinephrine.
These hormones, released as part of the body’s fight or flight response, also act as neurotransmitters . Thus, when you alter the release of these hormones, you may encounter neurological issues.
These side effects are rare, but do occur in some cases.
When to be concerned about side effects from Propranolol
Oftentimes, side effects go away after a number of days, as they tend to be a sign of the body adjusting to the drug.
Many side effects are mild, and thus manageable. However, you should seek medical advice if side effects remain longer than a few days.
Other situations where you may want to tell your doctor include:
- Side effects of higher or rising severity
- Neurological side-effects such as mood changes, depression, memory issues or hallucinations
- Chest pain, irregular heartbeat, dizziness or feeling faint
- Signs of an allergic reaction, such as wheezing, trouble breathing, rashes or swelling
You should seek immediate medical attention if you start to show the signs of an allergic reaction to Propranolol.
Is there a risk of addiction, dependence or withdrawal with Propranolol?
Propranolol is not considered to be a physically addictive substance. Yet there is still a risk of developing a psychological dependence to this drug.
The risk is likely to be greater for someone taking Propranolol for anxiety, particularly professionals who rely on Propranolol’s calming effect on a regular basis.
While it’s not a widely discussed issue, there are cases reported of Propranolol abuse, most commonly due to the positive effect it can have on symptoms of anxiety .
Withdrawal symptoms are common when stopping Propranolol abruptly, or after taking Propranolol for a long time.
Studies have shown symptoms such as chest pain, headache, palpitations and sweating from Propranolol withdrawal . You may also experience a dangerous spike in blood pressure and/or heart rate when going off it all of a sudden .
If you do stop taking Propranolol, you should consult with your doctor first, to discuss a plan to safely get off your medication. A taper down period of four to seven days is often recommended to avoid any withdrawal issues .
Is long-term use of Propranolol safe?
Beta-blockers such as Propranolol are generally considered safe to take long-term. A small number of people experience long-term side effects, but the majority of adverse side effects are mild and manageable .
Some studies show Propranolol is beneficial long-term (up to 2 years) in treating the symptoms of heart conditions , and does not present any danger when taken for this length of time.
There may however be a risk of overuse with Propranolol.
One study presents a link between long-term beta-blocker use and a collection of neurological symptoms, including memory loss, disorientation of time and place and decreased cognitive ability . These effects are resolved when the drug is stopped.
The greatest risk long-term may be the risk of withdrawal, and the potential dangers of abruptly stopping Propranolol after an extended history of use.
Warnings and considerations when taking Propranolol
Some people should not take Propranolol, as it may present dangers for people with certain conditions, or have interactions with other drugs or medications.
- Asthma or lung disease
- Low heartbeat or low blood pressure
- Blood circulation problems
It’s also recommended to consult your doctor before taking Propranolol if you have the following conditions:
- Low blood sugar or diabetes
- Liver disease
- Thyroid disorders
- Muscle disorders
- Bronchitis or breathing disorders
Propranolol may have interactions with some drugs, including medicines for blood pressure or irregular heartbeat, allergy medications, non-steroidal anti-inflammatories (such as ibuprofen), and anything else that lowers blood pressure.
There is also a risk of overdose with Propranolol. The NHS in 2017 recorded 52 deaths linked to Propranolol overdose, a 33% increase over the previous 5 years . One fatality referenced involved the use of both Propranolol and the antidepressant citalopram, indicating the dangers of mixing Propranolol with other medications.
In any case, it’s highly recommended you consult with your doctor before taking Propranolol for any reason, including for anxiety.
Propranolol alternatives for Anxiety
Propranolol is one of many potential solutions for people who suffer performance anxiety or similar bouts of social anxiety. And while Propranolol 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 Propranolol, in regards to slowing the release of adrenaline and lessening the physiological symptoms of anxiety. These include:
You may have better luck with the side effects from these drugs. However, as they all come under the same umbrella, it’s likely that any problems you have with Propranolol will persist with another beta-blocker.
Otherwise, you may want to consider a natural alternative, to treat anxiety symptoms with a lower risk of side effects, dependence or complications, and without the need for a prescription.
Natural alternatives to Propranolol for anxiety
When we understand what Propranolol does and how it treats the symptoms of anxiety, we can find natural alternatives that achieve the same goal. By supplementing with vitamins or minerals that the body naturally produces, you drastically lower the risk of a bad reaction or dangerous side effects.
Here are a few natural Propranolol alternatives:
L-theanine & GABA
When we experience social anxiety or performance anxiety, the main causes are overactive neurotransmitters, signaling to the body that we’re in danger, and it needs to pump adrenaline at a high rate.
GABA (or gamma-aminobutyric acid) is a neurotransmitter that is naturally produced by the body. GABA is an inhibitory neurotransmitter, meaning it suppresses certain brain signals, and is well-known for producing a calming effect.
L-theanine is another naturally-produced compound that shows effectiveness for anxiety. It works in synergy with GABA; L-theanine boosts production of several neurotransmitters, including GABA . This means it produces very similar effects.
Both GABA and L-theanine are widely found in supplement form, while L-theanine is also present in some food sources, most notably green, black and oolong teas.
Magnesium is a mineral abundant in many food sources, and vital for a large number of bodily functions. What’s most relevant to our topic of conversation is that magnesium appears to have powerful effects on stress and anxiety.
The best thing about magnesium is that it has a wide range of additional health benefits, and as a naturally occurring, beneficial mineral, there is very little risk of side effects or negative interactions.
If you’re looking for a way to benefit from the positive effects of GABA, L-theanine, Magnesium and several other natural tools to treat performance anxiety, PerformZen is for you.
This natural supplement is designed specifically with performance anxiety, stage fright and similar social anxiety disorders in mind. It contains a mixture of natural ingredients that have been shown to have positive effects on anxiety, nerves and excitability.
Along with the three mentioned above, PerformZen contains vitamin B6, theacrine and ginkgo biloba, which help in a number of ways to regulate stress and induce mental clarity.
Being formulated from natural ingredients, there is very little risk of the negative side effects, dependency or withdrawal symptoms that come with pharmaceutical beta-blockers like Propranolol.
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Final thoughts on Propranolol, potential side effects, and natural alternatives
Propranolol is generally considered safe, and often prescribed in confidence by doctors who know what they’re doing. However, like any drug, there are some interactions to watch out for, and a small number of people may experience negative side effects, ranging from minor to severe.
If you decide to take Propranolol for anxiety, be sure to get medical advice first, disclose why you’re taking it, what other medications you may be taking, and any conditions that may be affected by Propranolol. Also, closely monitor your 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.
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