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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by jparsell82 on September 9, 2003, at 7:57:19
Hi, I'd like to know about the effects of Propranolol for anxiety symptoms, particularly for Social Anxiety. If anyone has tried it please share. Also, can it be used daily or is it more of a situational type of treatment. Thanks!
Posted by djmmm on September 9, 2003, at 8:33:48
In reply to Inderal(Propranolol) - Good for Anxiety???, posted by jparsell82 on September 9, 2003, at 7:57:19
> Hi, I'd like to know about the effects of Propranolol for anxiety symptoms, particularly for Social Anxiety. If anyone has tried it please share. Also, can it be used daily or is it more of a situational type of treatment. Thanks!
It works very well for the physical symptoms of anxiety disorders (blushing, sweating, shaking, palpitations, etc)
Inderal, specifically, seems to be more effective than other beta-blockers, or newer beta-blockers, for anxiety...
Inderal does not typically help with the psychological symptoms of anxiety (racing thoughts, etc)...but, It can help stop the "cycle" of social anxiety if blushing, trembling, are contributing factors to your social anxiety
Posted by Ed O`Flaherty on September 9, 2003, at 11:26:11
In reply to Re: Inderal(Propranolol) - Good for Anxiety???, posted by djmmm on September 9, 2003, at 8:33:48
Some people find Inderal (propranolol) to be quite good for physical symptoms of anxiety such as palpitations.It is not a benzodiazepine (unlike e.g.Valium).It is a beta-blocker and as a result it is not suitable for asthmatics.It appears to be quite safe to stay on it long-term,although it increases cholesterol marginally.
Posted by Ame Sans Vie on September 9, 2003, at 11:57:42
In reply to Re: Inderal(Propranolol) - Good for Anxiety???, posted by djmmm on September 9, 2003, at 8:33:48
I pretty much just would like to echo what djmmm said, having used propranolol on and off over the past year for SP. Just a couple things I'd like to add.
Propranolol *can* be taken on a regular basis, but there really isn't much point to it (for most people). Its purpose is really just to stifle the physical symtpoms of SP on an as-needed basis.
Some people, however, have extremely troublesome problems with sweating, blushing, etc. For these people the best option may be to take the drug on a regular basis. The most attractive option for these people seems, at first glance, to be the once-daily dosage formulations (i.e. Inderal LA [long-acting]). Unfortunately, the lowest dose in which these capsules are available is 60mg, which is more than enough to cause a truly horrible depression, fatigue, and malaise for many people. I had developed these symptoms at only 40mg/day (10mg four times daily of immediate-release propranolol), and they were just awful. I'd never encountered the horrific symptoms of melancholic depression prior to this, but I strongly feel that's what I was experiencing while under the influence of this drug. Upon discontinuation, my symptoms cleared up 100%.
Your best option, generally speaking, is to try a dose of 10-20mg about 30 minutes in anticipation of an experience wherein the physical symptoms of your social anxiety are most prevalent. Very few doctors will have any qualms about prescribing this drug (or any beta-blocker, for that matter) unless, of course, the drug is contraindicated in your particular case.
One final thing to keep in mind is that propranolol increases the effects of clonazepam, which is, generally speaking, the social anxiety treatment of choice (especially amongst patients). Thus, if you are taking clonazepam, it would be wise to discuss with your prescribing physician whether a dosage reduction may be necessary solely on those occasions that require you to take propranolol comcomitantly.
Posted by jparsell82 on September 10, 2003, at 4:29:50
In reply to Re: Inderal(Propranolol) - Good for Anxiety??? » djmmm, posted by Ame Sans Vie on September 9, 2003, at 11:57:42
Thanks for the informations guys. So would you have any suggestions on meds for the psychological part of social anxiety? Such as racing or irrational thoughts. I've tried benzos but couldn't handle them. Also, ssri's didn't help me a bit.
Posted by Ame Sans Vie on September 10, 2003, at 5:03:16
In reply to Re: Inderal(Propranolol) - Good for Anxiety???, posted by jparsell82 on September 10, 2003, at 4:29:50
A mild mood stabilizer (Neurontin and Trileptal spring to mind) could help quite a bit... but I have to ask, what was it about the benzos that you couldn't handle? If it was the drowsiness/dizziness, that does subside after a week or two... maybe you didn't give them enough of a chance? Just wondering because benzos are by far your best bet when it comes to treating the psychological symptoms of social anxiety (or just about any anxiety disorder for that matter).
I totally understand about the SSRIs, though -- I hate those things with a passion. I've tried all six of 'em... plus a bunch of tricyclics, Nardil, five or six antipsychotics, all the atypical antidepressants, all the mood-stabilizers, most of the benzos, several barbiturates, beta-blockers, and all the stimulants but Cylert. I know what a pain in the *ss it can be.
Posted by jparsell82 on September 11, 2003, at 6:52:07
In reply to Re: Inderal(Propranolol) - Good for Anxiety??? » jparsell82, posted by Ame Sans Vie on September 10, 2003, at 5:03:16
I took Klonopin for about 1-2 weeks and felt constantly tired and demotivated. Also, my concentration and memory were poor. I don't want to take anything that will lower my cognitive abilities.
Posted by Ame Sans Vie on September 11, 2003, at 10:19:59
In reply to Re: Inderal(Propranolol) - Good for Anxiety???, posted by jparsell82 on September 11, 2003, at 6:52:07
Perhaps your dose was too high? Or Klonopin isn't the right benzo for you? Maybe you'd respond more favorably to Xanax, Valium, or Ativan. As I mentioned in my last post though, it is almost guaranteed that the side effects from any benzodiazepine will disappear within a few weeks of regular use, leaving behind only the beneficial effects.
Posted by gabbix2 on September 13, 2003, at 4:43:08
In reply to Re: Inderal(Propranolol) - Good for Anxiety???, posted by jparsell82 on September 11, 2003, at 6:52:07
I think its **quite** a generalization to say its almost guaranteed that the side effects of a benzo will go away after several weeks of regular use.
I'm not a benzophope by any stretch of the imagination, but clonazepam makes me literally suicidally depressed, even at low doses. This is something I learned by trial and error and 2 emergency hospital trips.Regular xanax is so short acting it gives me rebound panic attacks that are worse than the original problem.
Ativan has been a god- send when used judiciously but it adds to my depression
if I use it regularly, the same goes for valium.I also know from speaking to others that my reactions are not unusual. I most definitely believe benzodiazepines have a very important function, and their demonization makes me furious
but for many with depression their regular use just isn't a good idea.
Posted by sassyveg on September 13, 2003, at 11:07:14
In reply to Re: Inderal(Propranolol) - Good for Anxiety??? » jparsell82, posted by gabbix2 on September 13, 2003, at 4:43:08
I've been on a combo of Inderal LA and Lexapro for about 5 months and it works out pretty well for me. I don't have any se's from the Inderal, which my doc gave me for migraines. She also said that it helps with the physical symptoms of anxiety, which it has, particularly the racy heart feeling. But it doesn't do anything for the psychological symptoms - that's where the Lexapro comes in for me. You have to be careful with something like Inderal though, because it does lower your blood pressure - you have to make sure it doesn't get to be too low.
Posted by jparsell82 on September 15, 2003, at 7:22:07
In reply to Re: Inderal(Propranolol) - Good for Anxiety???, posted by sassyveg on September 13, 2003, at 11:07:14
Is Inderal LA an extended release form of Inderal? I get the heart palpitations, shakiness, and stuttering really bad. I'll soon be going to the doctor, I'll have to check into trying this Inderal LA or Xanax XR.
Posted by Ame Sans Vie on September 15, 2003, at 8:40:21
In reply to Re: Inderal(Propranolol) - Good for Anxiety??? » jparsell82, posted by gabbix2 on September 13, 2003, at 4:43:08
> I think its **quite** a generalization to say its almost guaranteed that the side effects of a benzo will go away after several weeks of regular use.
Sorry, that was an over-generalization on my part. I was just considering that every one of the dozens of people I know personally who are on long-term benzos became accustomed to any side effects rather quickly. I realize there are those who do not, but it seems that, *in those with a primary anxiety disorder* (i.e. not a primary mood disorder), benzos are almost invariably effective and tolerable.
Posted by Carmen Jones on January 8, 2004, at 10:43:51
In reply to Re: Inderal(Propranolol) - Good for Anxiety??? » gabbix2, posted by Ame Sans Vie on September 15, 2003, at 8:40:21
I've just been prescribed Inderal for a long-standing anxiety condition about driving, but am concerned to read that it doesn't really help with the psychological symtoms of anxiety. I don't want to take more drugs, so can anyone recommend anything else for the neagative/panicky thoughts thay might work well with the Inderal?
Posted by Kon on January 9, 2004, at 18:32:05
In reply to Re: Inderal(Propranolol) - Good for Anxiety???, posted by Carmen Jones on January 8, 2004, at 10:43:51
I have severe public speaking anxiety and mild social anxiety (with no depression). I've compared the following drugs during anxiety-provoking situations:
1. Beta-blocker (atenolol) plus clonazepam.
2. Clonazepam alone.
3. Beta-blocker alone.With the beta-blocker my heart rate drops significantly and yet I found no noticeable relief from anxiety. In fact, I didn't notice much of a difference wrt anxiety relief when comparing 1 and 2 so the beta-blocker didn't seem to add any anxiety relief to the clonazepam. If it did, it was pretty minor. With the clonazepam or other benzos my heart rate is not affected significantly and yet relief from anxiety is significant. For myself, benzos were much more effective than the beta-blocker.
Posted by John brown on February 28, 2006, at 13:52:38
In reply to Re: Inderal(Propranolol) - Good for Anxiety???, posted by djmmm on September 9, 2003, at 8:33:48
Hi,I occasionally work with the Royal Household at Buckingham Palace and Windsor Castle and had a real problem with the physical effects of anxiety,sweating,shakes,dry mouth and generally in the fight or flight state,not good when you are serving the good and the great.
Have tried herbal remedies,no good they let you down,now my GP has prescribed Half Inderal which work a treat,keep body calm which in turn lowers anxiety,and I can enjoy the occasion.
Posted by ed_uk on February 28, 2006, at 14:27:29
In reply to Re: Inderal(Propranolol) - Good for Anxiety???, posted by John brown on February 28, 2006, at 13:52:38
Hi John
>when you are serving
Are you a waitor? Just curious.
Which of your symptoms respond best to Half Inderal LA?
Ed
Posted by jean-marc on March 7, 2006, at 19:29:03
In reply to Re: Inderal(Propranolol) - Good for Anxiety???, posted by djmmm on September 9, 2003, at 8:33:48
I have just started using inderal to treat situational anxiety (public speaking, certain stressful social situations). My main symptoms are extreme flushing (always) and sweating (less often, but always associated with social situations). I have found that low doses of inderal work well for the flushing but not the sweating. I only take 5mg or 10mg. Has anyone else observed a similar thing with this drug? Would increasing the dose for the 'sweat-related' events help?
Posted by ed_uk on March 8, 2006, at 14:37:10
In reply to Re: Inderal(Propranolol) - Good for Anxiety???, posted by jean-marc on March 7, 2006, at 19:29:03
Hi
As far as I know, Inderal is not effective for sweating.
Regards
Ed
Posted by KarenRB53 on March 30, 2006, at 20:00:36
In reply to Re: Inderal(Propranolol) - Good for Anxiety??? » jean-marc, posted by ed_uk on March 8, 2006, at 14:37:10
My doctor wants me to use Propranolol regularly, at least once a day for anxiety and tremors. Does anyone else use it on a regular basis?
Posted by Franz on April 17, 2007, at 19:28:42
In reply to Re: Inderal(Propranolol) - Good for Anxiety???, posted by Ed O`Flaherty on September 9, 2003, at 11:26:11
> Some people find Inderal (propranolol) to be quite good for physical symptoms of anxiety such as palpitations.It is not a benzodiazepine (unlike e.g.Valium).It is a beta-blocker and as a result it is not suitable for asthmatics.It appears to be quite safe to stay on it long-term,although it increases cholesterol marginally.
There are some risks it seems:
While once first-line treatment for hypertension, the role for beta-blockers was downgraded in June 2006 in the United Kingdom to fourth-line as they perform less well than other drugs, particularly in the elderly, and evidence is increasing that the most frequently used beta-blockers at usual doses carry an unacceptable risk of provoking type 2 diabetes.
http://en.wikipedia.org/wiki/Propranolol
I hope not in low doses. I take it from time to time and it works, plus it is ceap and not classiffied as a psychotropic. But cardiologist do not recommned to start using it if you don´t need it.
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