AARP Hearing Center
Beta-Blockers for Anxiety: What Older Adults Should Know
Doctors explain how the medications work, when they’re most useful and why they’re not the right fit for everyone
Getty Images
Key takeaways
- Beta-blockers may help reduce physical symptoms of anxiety such as tremors, sweating, palpitations and a racing heart.
- Experts say these medications are most useful for situational anxiety and are not recommended for chronic conditions such as generalized anxiety disorder, panic disorders or PTSD.
- Older adults should discuss risks, side effects and possible drug interactions with a doctor before considering beta-blockers for anxiety.
Beta-blockers have long been used to treat high blood pressure and other heart-related conditions that are common in older adults. But more recently, they’re drawing attention for a different reason: their potential to help ease symptoms of anxiety, which affects as many as 1 in 5 older adults.
Here’s what you need to know about beta-blockers for anxiety, including the questions you should ask your doctor.
More Ways to Benefit
- Related Benefit 1
- Related Benefit 2
- Related Benefit 3
- Related Benefit 4
- Related Benefit 5
What are beta-blockers?
Beta-blockers, also called beta-adrenergic blocking agents or beta-adrenergic receptor antagonists, are medicines that block the effects of epinephrine, a hormone commonly known as adrenaline.
Some of the most common beta-blockers are metoprolol, propranolol, bisoprolol and atenolol. These medications can slow your heart rate and relax your blood vessels, which can lower your blood pressure and provide other cardiac and circulatory benefits. They have been traditionally prescribed to treat a wide range of heart and circulatory conditions, including arrhythmia, high blood pressure and congestive heart failure.
How can beta-blockers help with anxiety?
Although beta-blockers have been primarily prescribed for the kind of heart and circulatory conditions mentioned above, patients and health professionals noticed that these drugs can also help with some physical symptoms of anxiety.
Dr. Andrew Leuchter, a professor of psychiatry at the UCLA Semel Institute for Neuroscience and Human Behavior, says these symptoms — which can include tremors, increased perspiration and a racing heart — are often triggered by our natural “fight or flight” response in stressful situations.
“By blocking those adrenergic receptors in the periphery, it helps to reduce physical symptoms or somatic symptoms of anxiety,” says Dr. Nathalie D. Murphy, a board-certified psychiatrist at Cedars-Sinai Medical Center in Los Angeles. “For example, if you have tremors, if you have sweating, if you have palpitations, if you have increased heart rates, the beta-blockers essentially target that and dull that down.”
This off-label use of beta-blockers provides an alternative to traditional anxiety treatments for those seeking something to help with occasional anxiety issues.
“They’re kind of a different class of medications compared to other, more classical treatments we have for anxiety and depression,” Murphy says. “They’re not SSRIs, they’re not antidepressants, they’re not benzodiazepines.”
It’s helpful to have this additional tool to consider, Murphy says, especially because some people can’t tolerate — or may not be a good candidate for — benzodiazepines like Xanax or Valium or other anxiety medications.
Beta-blockers don’t replace mental health treatment
Leuchter says beta-blockers are most effective for “situational anxiety,” a sporadic or short-term type of anxiety triggered by stressful circumstances, such as giving an important speech or presentation or accepting an award. They are not, however, recommended to treat chronic or more serious mental health conditions such as post-traumatic stress disorder (PTSD), panic disorders or generalized anxiety disorder.
“If somebody is suffering from depression, or they’re having they have what we call generalized anxiety disorder — where they have a lot of anxiety all the time — those are medical conditions that might require specific treatment with an antidepressant or some other kind of anti-anxiety agent,” Leuchter says.
Things to consider before taking beta-blockers for anxiety
As with any medication, it’s important to consider potential risks and side effects. The most common side effects of beta-blockers are lightheadedness and dizziness, especially when standing or sitting up too quickly, as well as fatigue and cold hands or feet.
The biggest concern is that beta-blockers can slow your heart rate and lower your blood pressure, which can be dangerous for people who already have a slow heartbeat, low blood pressure or certain heart conditions.
Murphy says beta-blockers are generally not recommended for those with certain heart conditions, including a heart block or sick sinus syndrome, or for people with certain circulation issues. There’s also a risk that these medications can trigger asthma attacks in people with that condition or mask the symptoms of low blood sugar.
If you’re looking to beta-blockers as a possible solution to help with stage fright or performance anxiety, it’s a good idea to give the medication a trial run in a low-stakes situation to gauge any potential side effects.
“You don’t want the first time that you take the pill to be when you’re getting up in front of 1,000 people,” Leuchter says.
Talking to your doctor about beta-blockers
As with any medication, it’s important to consult your health care provider before deciding if beta-blockers are a good option for you. Murphy says you need to have a thorough medical exam, review your medical history and think about what might be causing your anxiety to determine if you should seek treatment from a mental health professional.
Be sure to ask your doctor whether beta-blockers could negatively interfere with any other medications you take, including over-the-counter meds, and if potential side effects could be a concern, especially if you have any other medical conditions, like asthma or diabetes.
If you are prescribed beta-blockers for anxiety, be alert for any side effects. And inform your doctor or seek medical treatment right away if you experience any significant problems or issues of concern.
The key takeaways were created with the assistance of generative AI. An AARP editor reviewed and refined the content for accuracy and clarity.
AARP Membership
Join AARP for only $15 per year with automatic renewal. Get instant access to members-only products and hundreds of benefits, a free second membership, and a subscription to AARP The Magazine.
More From AARP
Medications That May Harm Your Eyes
Some drugs can affect vision or raise eye pressure
What Are Statins — and Who Needs Them?
A closer look at new cholesterol guidelines and a common medication
What to Know About Peptides
Doctors say many popular peptides lack human studies and clear safety data, especially for older adults