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Thread: beta blockers for social anxiety

  1. Default beta blockers for social anxiety

    ok, so i have social anxiety and im currently taking 200 mgs of zoloft and 150 mgs of seroquel.

    i was doing some research and read about beta blockers, and how they help as an as needed basis for situations where you know you will have social anxiety.


    my anxiety is virtually gone- except for when im around my boyfriends parents/family/ at his house. when there, it gets pretty severe and i am unable to speak to anyone and i pretty much sit there staring at my feet.

    i have to deal with this situation once a week.




    so my question is, has anyone used beta blockers for anxiety?

    did it work?

    does it seem like it would be a good choice for me, and my situation?

    should i ask my psychiatrist about it? btw she wont prescribe me any anxiety medications like xanax, so maybe this would be a better alternative?

    thanks in advance<3


  2. #2
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    Hi. There's a similar inquiry about beta blockers for social anxiety. You can check this link: do beta blockers work for social anxiety...

    You can always ask you doctor about it--that would be the best. Guide to what things you should ask: side effects, dosage, what to do in case side effects affect you functionally and contraindications to medications you're already taking & activities (i.e. exercise).
    Helpful riverstyx Rated helpful

  3. This is my problem as well. I found this forum trying to research these. In order for me to see the link above, I need to make 3 posts. This is the first.

    My apologies.

    This is the second.

    Interesting, it lumped my second in with my first...I wonder what it will do with this one.

  4. An article awhile back in the medical journal American Family Physician maintained that treatment studies of beta blockers for social phobia show mixed results. It did say that Beta blockers such as propranolol (Inderal) appear to be clinically effective when used in low doses (10 to 40 mg for propranolol) on an as-needed basis for mild to moderate circumscribed performance anxiety, but the doctors couldn't find any "consistent empiric support" to recommend them as a first-line treatment for generalized social anxiety.
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  5. I was prescribed bbs for a short time as an alternative to my occasional use of 2mg valium for mild anxiety in performance situations like doing big presentations at work. The doc I then had was situated right across from a major theatre in the city i live in, and he told me that actors often used them for 'stage fright'

    I'm afraid it did nothing for me .. so back to the benzos, which I only take occasionally and have yet to find a decent, honest online supplier of.

    *This post was auto-merged. The following text was added 7 minutes after the last post:*

    Incidentally, does anyone else have a prob even discussing social anxiety (and making oneself understood) with a doc? In a world where to be ''loud and proud' is more less required for social, occupational and other 'success' I find it increasingly hard to do - hence turning to OLP's as an alternative.
    Last edited by malex; 04-15-2011 at 04:14 PM.
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  6. I asked my doc for Valium when I had to do a major presentation and speech to a multinational client conference. I was crapping myself and knew that when I got up on stage, I might choke if I was too uptight. He happily gave me 5mg Valium, but also BB's as well. They did work well, didn't get the sweaty hands or rapid heartbeat associated with anxiety, and unlike Diazepam, they didn't interfere with motivation or ability to think. Good option if you need to keep functioning - but they don't seem to get to the heart of social anxiety like zoloft or paxil.

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    @annaruby "they don't seem to get to the heart of social anxiety like zoloft or paxil"

    You're exactly right. Benzodiazepines are only meant to be a temporary stop-gap measure for social anxiety until the SSRI's kick in, which can take 4-6 weeks. But as someone who's taken beta blockers for social anxiety (propranolol 20mg) I don't believe they work worth a crap. At least they didn't in my case. The only thing that seemed to work was the benzos.
    Helpful riverstyx Rated helpful
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  8. I used to take atenolol for social anxiety and it was awesome, really did the trick. The only problem was I would get lightheaded when I tried to workout afterwards.
    Helpful crucibelle Rated helpful

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    Back a couple years ago I had high blood pressure ( I don't know why it came back down after a year without meds).

    Toprol-XL is a beta-blocker and did have some calming effects. The biggest problem was my friends started to tell me I looked and seemed depressed. I didn't notice it because it came on slowly .

    I did stop taking it and the feeling of fatuige, and no energy did go away after a few days. So this may be a good option for some to help with anxiety, but I'd watch for the side effects. Your results may vary!
    Helpful riverstyx, DaneV Rated helpful

  10. #10
    i was prescribed inderal for tremor made worse by anxiety. cant say it didnt work at all, but i wasnt real happy. it also made me wheezy and seriously crimped anything athletic, which was my main complaint with it.

  11. i think they help with the physical symptoms of anxiety such as rapid heartbeat, shaking, tremors and not the psychological things and i'm not sure if they are supposed to help blushing and sweating. i have heard the name of Propranolol a lot for social anxiety, i think it's because it's easy to get it, you can buy it without prescription in my country so i bought some too and it's very cheap but i didn't feel anything (but i didn't try them in a high anxiety inducing situation like presentation or something) and didn't want to try a higher dose.

  12. #12
    In my experience use of beta blockers, like propranolol, doesn't get rid of the anxiety per se. Actually, it just numbs the effects of the anxiety by blocking adrenaline from going to you your brain. Hence, if you have situational/performance anxiety you'll be better able to get through situations you feel uncomfortable with by taking it.
    Last edited by dlman62; 05-27-2011 at 04:58 PM.
    Helpful crucibelle, TobyFlenderson Rated helpful

  13. #13
    Yeah, although it doesn't do much to me mentally it pretty much got rid of my issue with facial flushing, and it was that worry which prevented me from many social activities.
    Helpful dlman62 Rated helpful

  14. #14
    the blocking the adrenaline part is what made it suck for me. i have seasonal asthma and inderal blocked it, which asthmatics need...i was so wheezy after taking it for one day of stress, i couldnt effectively excercise for days. where does it become a fair trade off? of course benzos dont do much for vitality and excercise, but at least asthmatics still can get access to air with them, even if they no longer care...thats a joke son...kinda. in any case, even without asthma complications, it wasnt near potent enough to be of much use for me. alcohol is actually the best remedy for my problem, essential tremor, but you can only go so far with that....or else. the next step is a brain implant, i aint got the nerve for that yet.
    Last edited by DB Dicey; 05-28-2011 at 01:51 AM.

  15. I have actually used this drug for flying, and I can say that its effect was minimal. As others have pointed out, the drug only works to mask the outer signs that anything is wrong. If you are worried about the sluggishness created by a heavier type of drug, then it may be worth it to give it a shot. My experience has not been favorable with it.

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    Beta-blockers have commonly been used for many years by people who have to "perform" in a public arena - musicians, concert pianists, public speakers etc. Beta-blockers do a few things really well in reducing the physical manifestation of anxiety and/or stage-fright.

    1) They significantly reduce heart rate and the force of the heart's contractions. A pounding heart is distressing and one tends to focus on it, which in turn can make it worse.

    2) They reduce shaking, tremor and "jitters". Clearly, it would be hard for a concert pianist to play with the high level of accuracy required for many pieces if his/her hands were shaking. Beta-blockers can reduce this effect considerably

    3) They diminish the effects of epinephrine (aka adrenaline) and other stress hormones. This in turn reduces spectrum of symptoms associated with the fight or flight response, such as cold/clammy hands, increased sweating and respiration. This can enable people to function more successfully in social situations and to be better able to focus on the task in hand.

    Beta-blockers are not, however, psychotropic medications. They work purely on the adrenal/hormone/vascular biosystem. Patients who initially approach their doctor suffering with an anxiety disorder of some type are often given beta-blockers, and are told that "these will help to calm you down". This is only half-true. They will calm down the uncomfortable physical sensations associated with anxiety, but they will have scant effect on mental or psychological symptoms (which, after all are causing the physical symptoms through a vastly distorted response to stress).

    As all of us Peeps on PharmacyReviewer know, doctors these days think that they are much more clued up about the prescribing of benzodiazepines. These drugs have been given a terrible press over the past twenty years, which in some ways, is a bit misplaced. In my humble opinion, benzodiazepines do have a valid role to play in the treatment (both short and long term) of anxiety disorders, which includes Social Anxiety Disorder. The trend has turned very much toward the use of new-generation antidepressants or even anti-psychotics in the treatment of anxiety disorders, and the success rates of these newer drugs isn't always as fantastic as pharmaceutical companies, and doctors would have you believe. A bit of digging around on the internet would reveal that many of the older tricyclic antidepressants show superior efficacy for the treatment of anxiety disorders and/or depression.

    A deeply cynical motive lays behind the use of these new-fangled wonder-drugs, such as the newer antidepressants (from Prozac onward) and anti-psychotics (Quetiapine, Olanzapine etc). The big pharmaceuticals push these drugs on to the market in a very aggressive manner, and target your local doctor's surgeries and hospitals. Doctors are busy people who have different medications promoted to them continuously, so it's understandable that if a new medication is (questionably) touted as some kind of panacea, it might follow that said doctors will treat it thus. This has been especially relevant for the drug you mention taking, Seroquel (Quetiapine). Seroquel has only been officially approved for the treatment of bi-polar disorder and schizophrenia. However, doctors have become comfortable prescribing this drug "off-label" for complaints ranging from Social Anxiety Disorder, insomnia, Panic Disorder, G.A.D and also eating disorders. The most compelling reason that a drug like Seroquel is being prescribed in this manner (remember this is not a "mild" medication, it is a first line treatment for severe paranoid schizophrenia and fast-onset manic psychosis) is that it has a much lower abuse profile when compared to diazepam, for example. The next bit is critical though: Seroquel has never been officially sanctioned for use in anxiety-spectrum disorders. Further, there is absolutely no proof, empirical or otherwise that Seroquel (and many of it's brethren) is superior to benzodiazepines for the treatment of anxiety disorders. Most disturbing to me, though, is the wide range of severe and sometimes life-threatening side-effects that accompany the use of atypical antipsychotics, even at relatively low doses. Here's a few: Tardive Dykinesia, which is an incurable and debilitating neurological disorder. Neuroleptic Malignant Syndrome: this condition has certain similarities with Serotonin Syndrome and can be life threatening. A recent comparative study of anti-psychotic drugs showed that Quetiapine therapy was associated with increased risk of death relative to the other analysed treatments.

    It is not wise or appropriate for me to suggest what medications might be helpful to you. I have an interest in these things because I have a panic disorder myself and I come from a family that work in several medical fields. What I would say however, is that your relationship with your psychiatrist should be one of a client and service provider. If I was in your situation (which I'm not), I would be very inclined to ask her reasoning behind not prescribing a benzodiazepine. Contrary to what many people think, benzodiazepine therapy can be enormously successful for many anxiety disorders (which include social anxiety) if it is managed and supervised correctly. What most people hear is the horror stories of people who have become dependent on gigantic doses of benzodiazepines and end up hospitalised after succumbing to tonic-clonic seizures. Holistically, benzodiazepines are much safer and less toxic than antipsychotic drugs. I feel very strongly that you don't need a a sledgehammer to crack a nut, and part of me feels that prescribing an antipsychotic because your psychiatrist "doesn't want" to prescribe Xanax fits that analogy well.

    You may well find that beta-blockers are useful to you, and they are safe drug used by millions. I use them every day for my panic disorder and they do keep my heart steady when I am having a panic attack.

    Finally, I apologise if I have gone off on a wild tangent on the issues around your medication. I feel very strongly that anti-psychotic medications should be only be prescribed for the illnesses they have been officially licensed for: bipolar disorder and schizophrenia.

    Of course, all of what I have said is simply my subjective viewpoint, and I do not recommend for a moment taking any different medications or making important decisions about your health without properly discussing with a qualified healthcare professional.

  17. #17
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    My job involves regular stressful public performances and I find propranolol very helpful with the anxiety that accompanies this. I take 20mg about 30 minutes before the event and it eliminates the unpleasant physical symptoms like the sick feeling in the stomach, nervous voice, shaking hands and blushing.

    While it does not have any psychotropic effect I find the knowledge that I will not appear stressed and nervous reduces my anxiety considerably because a large part of what makes me anxious is worrying that other people will see that I am anxious so its a sort of evil feedback loop. The propranolol breaks this loop and I feel calm and collected.

    I like also that it has no sedating effects whatsoever so that you do not lose your mental sharpness at all.
    Helpful riverstyx, trevor_wood Rated helpful

  18. it helped with the typical "spinal tickling" that comes with stress and anxiety for me.

  19. When I first went to my current doctor he put me on atenolol. I had to go through the dreaded spiel with all my other doctors putting me on zoloft (which was terrible if I missed a dose or two), Paxil (which increased my anxiety ), Trazadone ( which caused me to be so messed up I wrecked my car twice in one day while taking it) and effexor (which had no effect on me at all except to make me feel like my mind wasn't mine).

    He listened and then said well lets do this. He put me on atenolol, elavil,celexa, and klonopin. The combinations seems to help some but not enough for me to even remotely normal. The klonopin help me when I have to go outside to do any errands. The others don't make me feel like I am anybody but me; just a little calmer. Anyway, this post says to me what I finally found from a caring doctor after 8 years of others.

    Thanks
    Lulu
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  20. #20
    I am prescribed beta blockers (atenolol) for hypertension, and I can say for sure that they do NOT do a thing for my social anxiety. Beta blockers are supposed to suppress the release of cortisol in the body, which prevents some of the physiological effects of stress. But anxiety attacks have a way of punching right through anyway, which tells me that enormous amounts of stress hormone are secreted during panic attacks.

    I will typically get attacks right before, and at the start of certain situations, like parties, professional meetings and the like. They become very acute if the situation involves any attention on myself (for example, having to lead a meeting or talk to a group of people). Even if I can keep my voice under control, the sweating becomes acute and is a dead give-away.

    However, when I first started using opiates for chronic nerve and muscle pain I discovered, to my surprise, that they knocked out my panic attacks and anxiety beautifully. The trick for me is to take them about 45 minutes before any anxiety-provoking situation, so that I feel the drug come on right at the outset of the situation - timing is critical. If I can get through the first few minutes of a social situation panic-free, I am good to go and can usually handle myself fine for the duration.
    Last edited by GreenThumb; 09-20-2011 at 06:43 PM.


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