FROM DAILY MAIL: A decades-old cheap medication prescribed to millions of Americans is being hailed as a ‘miracle pill’ for anxiety and nerves.
Nearly 10 million Americans a year are prescribed propranolol, a beta-blocker approved in the 1960s for high blood pressure.
But over the years, the 30-cent pill has become a drug of all trades, treating irregular heartbeats, migraines and kidney issues.
Now swathes of young women have started popping it before presentations, speeches and even walking down the aisle, claiming it helps calm them down.
What is propranolol?
Propranolol is a nonselective beta-blocker medication used to treat and prevent conditions related to the heart and circulation, such as high blood pressure and angina.
What does it treat?
Cardiovascular issues: High blood pressure (hypertension), irregular heartbeats (arrhythmias), angina (chest pain), and to improve survival after a heart attack.
Neurological conditions: Migraine prevention and essential tremor.
Endocrine disorders: Pheochromocytoma (an adrenal gland tumor) and certain thyroid conditions.
How does it work?
It works by blocking the effects of adrenaline and other stress hormones throughout the body. Propranolol works by binding to and blocking beta-adrenergic receptors, which are found in the heart, blood vessels, and other tissues. This action reduces the body’s response to the stress hormones adrenaline and noradrenaline. By blocking these receptors, propranolol can achieve the following effects:
Heart rate: It slows down the heart rate and reduces the force of the heart’s contractions.
Blood pressure: It relaxes blood vessels, which lowers overall blood pressure.
Circulation: It reduces blood flow to the extremities, which is why cold hands and feet can be a side effect.
What’s this about anxiety?
Off-label, propranolol can also be used to treat anxiety. It is used to manage the physical symptoms of anxiety, particularly performance anxiety. In anxiety, propranolol blocks the physical symptoms of the “fight-or-flight” response, such as a rapid heart rate, sweating, and tremors.
According to Daily Mail, one influencer said she keeps the drug in her purse for big events and presentations to “prevent that racing heart and jittery feeling.”
A healthcare worker in Texas said it helps alleviate symptoms associated with her panic disorder and anxiety, calling it a “miracle medication” and “healthy alternative” to anti-anxiety drugs.
The report goes on to note that A-lister Robert Downey Jr said at the 2024 Golden Globes that he took a beta-blocker beforehand, while at this year’s Oscars, actress Rachel Sennott touted the fix, saying, “Take that beta-blocker, girl. Swallow it down and lock in.”
Are there any risks?
The associated side effects could include the following:
- Dizziness, weakness, or fatigue
- Cold hands and feet
- Stomach upset, such as nausea or diarrhea
- Headaches
More serious side effects could include:
- Slow or irregular heartbeat
- Shortness of breath, swelling, or sudden weight gain (signs of heart failure)
- Severe dizziness or fainting
- Allergic reactions, such as hives or swelling of the face and throat
Patients are also warned not to abruptly stop taking propranolol because that can cause serious heart issues. Your doctor would help you gradually reduce the dose.
Other considerations are listed for people with diabetes and an overactive thyroid, as the drug can mask the symptoms of low blood sugar. It can also be a problem for people with asthma and COPD, as it can cause the airways in the lungs to constrict.
What do doctors say?
Doctors told the Daily Mail that there is a rise in requests for propranolol, especially from women, as people are seeking fast-acting anxiety relief without lasting side effects.
Dr Haiyan Wang, medical director and psychiatrist at Neuro Wellness Spa, told the Daily Mail, “I see this constantly now. Young women are drawn to it because it works differently. Instead of targeting brain chemistry, it interrupts the physical feedback loop.
“When your heart isn’t pounding, your brain doesn’t read the situation as dangerous.”
But they caution that it won’t actually treat anxiety.
It won’t “replace selective serotonin reuptake inhibitors (SSRIs) and sedatives that rewire brain chemistry and hormone levels,” the Mail reports. “It may work for a big speech, but it likely will not treat anxiety on its own.”
Dr Parth Bhavasar, a family medicine physician and founder of TeleDirectMD, told the Mail that propranolol “doesn’t treat the anxiety per se, but it just blunts the physical manifestations of it.”
Still, Dr Gaby Cora, a psychiatrist and CEO at CoraLG, Inc, in Miami, told the Mail she has been prescribing propranolol with great success, mentioning instances such as musicians needing to alleviate anxious tremors before they step on stage and academics before tests.
“We’ve been prescribing beta blockers for anxiety for decades,” she told the outlet. “They work.”
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