Propranolol Dosage for Anxiety | Does It Cause Weight Gain?

Have you ever felt anxious before any speech or social event? You know what the nerves feel like — your palms get sweaty, your heart starts racing, your mouth gets dry, and you feel like you will pass out at any minute.

Most of us have experienced performance anxiety once in a while.

Propranolol, a medication used to treat heart conditions, has been used off-label for many years to help with the anxiety symptoms you may experience. In addition, artists, public speakers, and students alike used Propranolol to help calm their nerves. 

I have already shared a post related to this topic: What Is Anxiety Disorder?. I hope you read this post.

What is Propranolol?

Propranolol is a non-selective beta-blocker, a medication that works by blocking beta receptors in various areas of your body. It’s one of the best and most used beta-blockers.

Propranolol was designed to treat high blood pressure or irregular heart rate — but its uses have expanded since it was approved. It’s available in a variety of forms, from injection to an oral tablet.

I had earlier shared: High Blood Pressure After Covid-19. I hope you read the post.

Table of Contents

Does propranolol reduce anxiety symptoms?

Yes, Propranolol can reduce your body’s physiological answer to anxiety under the circumstances. In other words.

The physical anxieties symptoms that Propranolol helps reduce include:

  • Racing heart
  • Chills
  • Sweating
  • Shaking
  • Lightheadedness

Because some of these physical reactions with anxiety can increase psychological response, reducing these symptoms can help you relax during anxiety-inducing events.

There are types of anxiety disorders, and Propranolol did not work for all of them. The research suggests the drug helps in cases of:

  • Anticipatory anxiety
  • Social anxiety disorder
  • Performance anxiety
  • Specific phobias

Propranolol is a prescription medicine, and only a health professional may recommend you use it for anxiety, depending on your situation.

I also wrote a tutorial on: Is Adjustment Disorder With Anxiety A Mental Illness?. That you can follow.

Did propranolol be used to treat performance anxiety?

Unlike medications like alprazolam or sertraline, Propranolol is not an anti-anxiety medication. Anti-anxiety medications work on specific brain areas, causing you to feel calm and relaxed. They help stop you from feeling the mental or physical effects of anxiety. Propranolol works a little bit differently — more on this next.

I recommend you to read following posts that will help you: Symptoms Of Post-Traumatic Stress Disorder

Does Propranolol cause weight gain?

Propranolol weight gain is down to 2 reasons. Firstly, Propranolol slightly reduces the body’s ability to burn fat. Secondly, Propranolol causes your body to hold more fluid than normal, leading to an increase in body weight.

This weight gain isn’t noticeable, and it is also far less likely at the dose used for anxiety treatment.

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How does propranolol work?

Propranolol can be prescribed off-label to treat particular anxiety types, such as social anxiety or performance anxiety. 

Some physical performance anxiety symptoms include:

  • Dry mouth
  • Dizziness
  • Nausea
  • Sweaty hands
  • Faster pulse
  • Shakiness in your hands
  • Sweaty hands

When you’re feeling nervous or stressed, your body produces stress hormones. These stress hormones attach to beta receptors during your body, which triggers some of the symptoms listed above. 

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propranolol dosage for anxiety

Propranolol is a prescription medicine, meaning you’ll need to talk with your healthcare provider before you use it. Propranolol dosage for anxiety is quite low. Most doctors recommend taking a small dose of 10–20 mg one hour before a moment, like a presentation, interview, job, or crucial exam.

Propranolol is prescribed off-label for performance anxiety. You can start to feel the effects of Propranolol within a few hours after one dose. However, keep in mind that people can react differently to medications, so you want to follow the guidance given to you by the healthcare provider.

Like all medicines, it can take some time to work out the best dose for you. So your provider starts you on a low dose and adjusts based on your level of symptom change and side effects.

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Side effects of Propranolol

What are the common side effects?

The common side effects for Propranolol for anxiety include:

  • Feeling tired
  • Slower heart rate
  • Diarrhea
  • Nausea
  • Dry eyes

What are the serious side effects?

If you are experiencing side effects, call your doctor right away. Serious side effects can include:

  • Serious allergic reactions (e.g., hives, swelling of face, itching, rash)
  • Hallucinations
  • Breathing problems
  • Muscle cramps or weakness

To learn more, you can read: All About Conversion Disorder

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What else is propranolol used for?

While Propranolol is prescribed off-label for performance anxiety, it has quite an approved use. Below are a few examples.

High blood pressure

Propranolol can be used alone or combined with other medicines, like a thiazide diuretic, to treat high blood pressure. 

An opening dose for high blood pressure is 40 mg taken twice per day. When getting started on Propranolol, it takes a few days to some weeks to see the medication’s effects.

Your provider will gradually raise your dose until you achieve target blood pressure control, typically 120 mg and 240 mg daily.

See this post for more info: High Blood Pressure After Covid-19

Migraine prevention

Propranolol is used daily for migraine prevention. However, it’s only approved for prevention and shouldn’t be used to stop a migraine that’s already started. 

A common starting dose for migraine prevention is 80 mg per day, broken up into smaller, equal size doses throughout the day. After that, your provider likely will slowly raise your dose until you’re taking 160 mg to 240 mg daily.

If the medication isn’t working for you after 4 to 6 weeks, your provider may have you stop taking it. In this case, they’ll have you slowly lower your dose over several weeks to avoid side effects from stopping too quickly

Must read: Tension Headache vs Migraine

Frequently Asked Question

Does Propranolol affect appetite?

Depression, confusion, hallucinations, liver problems- upper stomach pain, nausea, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, and jaundice.


How to stop taking Propranolol for anxiety?

If you want to stop taking Propranolol, you should ask your doctor for help. Stopping this medicine quickly, or reducing the dose too much at once, may cause withdrawal symptoms that are dangerous to your heart.


Can I take Propranolol everyday anxiety?

If you are using Propranolol for more general social anxiety during the day, you can take it at regular intervals. Start by taking one 10mg tablet three times per day. If you feel it is necessary, you can increase the dose to four tablets, but it’s good to speak to your doctor about this.


Will Propranolol help me sleep?

Propranolol and other beta-blockers have been shown in some analyses to decrease your body’s secretion of melatonin — an important hormone for optimal sleep. For a small percent of propranolol users, this can lead to difficulties falling and staying asleep.


If you need to help calm your nerves before a speech or performance, Propranolol can help. Propranolol works by beta-blockers receptors in the body to lessen anxiety symptoms, such as dizziness, fast pulse, or sweaty palms.

While Propranolol is used off-label to treat performance anxiety, it has approved uses, including high blood pressure, tremors, and migraine prevention.

Talk with the doctor or healthcare provider if you are experiencing anxiety and have questions about Propranolol might be able to help you.

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