Beta-blockers for anxiety: Do they really work?

Anxiety can be incredibly overwhelming, especially when physical symptoms start to take over. The pounding heart, anxiety chest pain, sweaty palms, and shaky hands can make everyday situations feel unmanageable.

For some people, beta-blockers offer short-term relief from these intense physical sensations, particularly before high-pressure moments like presentations, exams, or performances. But what role should they play in anxiety treatment?

In this guide, we’ll look at how beta-blockers work, when they might be helpful, who they suit best, and why therapy remains an important part of managing anxiety long term.

Understanding beta-blockers

Beta-blockers, also known as beta-adrenergic antagonists, are medications that reduce the effects of adrenaline on the heart and blood vessels. By slowing the heart rate and lowering blood pressure, they help reduce some of the physical symptoms associated with anxiety.

They're commonly used to treat medical conditions like high blood pressure, heart rhythm problems, and migraines. In recent years, some doctors have also prescribed them "off-label" to manage physical anxiety symptoms, especially in short-term situations like public speaking or performing.

A few crucial details you should know are:

• Beta-blockers do not treat the emotional or cognitive parts of anxiety. They work on the body, not the mind.

• In Australia, beta-blockers are prescription-only medications. That means they must be prescribed by a general practitioner (GP) or psychiatrist.

• People react differently to medications. While some find relief, others may not notice a significant effect, or they may experience unwanted side effects.

Common side effects

Most side effects are mild, especially at low doses used for anxiety. Still, it’s important to be aware of what to look out for:

• Feeling tired or low in energy

• Dizziness or light-headedness

• Cold hands or feet

• Nausea or stomach discomfort

• Headaches

• Feeling down or flat in mood

More serious effects can include a very slow heart rate, low blood sugar, or breathing difficulties, especially for those with asthma.

If you notice anything concerning, it's important to speak with your doctor before making changes to your medication.

What if I want to start using beta-blockers for anxiety?

In Australia, beta-blockers must be prescribed by a medical doctor. This is usually your GP, though in some cases, a psychiatrist might be involved.

A clinical psychologist cannot prescribe medications but can help you decide whether talking to your doctor about them makes sense for your situation.

Doctors will usually start with a low dose, especially if the medication is only being used for situational anxiety. For example, propranolol may be taken an hour or so before a high-stress event.

Why therapy should come first

Most people who experience anxiety benefit from psychological therapy. Clinical psychologists work with you to understand what triggers anxiety, how it shows up in your body and thoughts, and how to manage it more effectively.

While medications can help reduce the intensity of symptoms, therapy gives you tools that can support long-term recovery. In many cases, psychologists and GPs or psychiatrists work together, combining therapy with medication where appropriate.

Are beta-blockers suitable for everyone?

Who may benefit

Beta-blockers are sometimes helpful for people who experience strong physical symptoms during specific situations, like public speaking, performing, job interviews or exams, or while flying or during medical procedures.

They can also support therapy by making it easier to practise facing anxiety triggers.

Who should avoid beta-blockers

They're not the right choice for everyone. People with the following conditions should avoid beta-blockers or use them only under close medical supervision:

• Asthma or other breathing issues

• Low blood sugar or diabetes

• Very low blood pressure

• Certain heart conditions (such as bradycardia or advanced heart failure)

• Pregnancy or breastfeeding, unless advised by a doctor

Medications, supplements, and other health conditions can also interact with beta-blockers. Be sure to discuss your full health history with your doctor.

Final thoughts

Beta-blockers can offer relief from the physical symptoms of anxiety, especially when they're tied to specific events or triggers. They may help you feel more physically steady, which can be useful when you're building confidence or practising anxiety coping strategies.

But they’re not a stand-alone fix. To manage anxiety effectively and sustainably, therapy, lifestyle support, and good self-care are key. If you're finding anxiety hard to manage, speak with a clinical psychologist. They can help you work through what’s going on and collaborate with your GP or psychiatrist if medication is part of the plan.