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The Dangers of Taking Unprescribed Beta-Blockers for Anxiety

Some see the heart medication as a miracle drug for public speaking fears, anxiety and panic attacks, but it’s not without its risks

While anxiety and panic attacks are considered ailments of the mind, their effects are mostly physical: Your heart races, you begin to sweat, maybe even shake. Rather than treat the anxiety itself, benzodiazepines treat the side effects, and while that works just fine for some, others are roped into a cycle of dependence — benzos are highly addictive and can essentially train someone into being incapable of handling their anxiety without them.

For that reason, psychologists and psychiatrists often prefer alternative treatments. Cognitive-behavioral therapy, traditional talk therapy and antidepressants like SSRIs can be effective, although they all require some dedication. But there’s an alternative both less addictive and less time-consuming: heart medication, in the form of beta-blockers. They offer some middle ground in that they work by making you physically less capable of panicking by controlling your heart rate. They’re typically prescribed for high-blood pressure and heart issues — by lowering one’s blood pressure, the heart doesn’t have to work as hard to circulate blood and is thus less likely to have a heart attack — but they’ve also long been prescribed for anxiety, despite that not being their intended function.

“Beta-blockers aren’t FDA approved for the treatment of anxiety disorders. However, they’ve frequently been used for the treatment of performance anxiety by students — those with a fear of public speaking and some with social anxiety,” says Charles Nemeroff, psychiatrist and medical director of the Anxiety and Depression Association of America. “They reduce the effects of epinephrine and norepinephrine, which are responsible for the increase in heart rate, sweating and other autonomic effects of stress and anxiety. However, they aren’t without side effects in some patients, including an increase in depression. The reduction in heart rate also will, for example, prevent runners from reaching peak heart rates needed when out on the track.”

Despite not being FDA-approved for anxiety, doctors are still legally allowed to prescribe them for the condition. But it doesn’t mean that someone should take beta-blockers without a prescription at all, which some people are attempting to do. Because of the drug’s ability to greatly reduce anxiety without any of the tranquilizing effects of benzos, some cite beta-blockers as the perfect drug for public speaking or other stressful situations where performance counts. There are even startups marketing beta-blockers for just this purpose, like Kick, a company that connects people with online doctors who can prescribe the medication through digital consultations. For $50, Kick will arrange a quick online appointment with a physician who can write a legitimate prescription, without you ever needing to leave the house. 

But Nemeroff reiterates that this is potentially dangerous: For those with low blood pressure, for instance, as the medication further reduces blood pressure, it would likely cause the recipient to faint. Beta-blockers also commonly come with side effects like dizziness, fatigue and diarrhea. They can potentially worsen depression (again, as Nemeroff pointed out) or trigger severe asthma attacks as well.

So just because they’re not addictive in the same way benzos are (although it’s certainly possible to form a dependence upon them), your doctor knows far more than you or I about what’s best for your body, so always talk to them first. 

After all, do you really trust anyone who advises you to skip the doctor consultation before taking heart medicine?