Low-dose propanolol

[gabafan]

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I was wondering what others thought about using low-dose propanolol for anxiety (not just for performance anxiety, but daily). Is the side-effect profile worth the risk, compared with other anxiety meds?

I had a patient develop complete heart block, but she was on high doses, for HTN. (Now pacer dependant).

Thanks for your input.

 

[birchswing]

While I've been advised that I cannot offer the benefit of my experience, and the benefit of my experience has been deleted, it is my opinion, as a student interested in psychiatry, that Inderal can be effective for the physical symptoms of panic attacks. It is also my opinion that it carries a better side effects profile than benzodiazepines. However, it is my opinion that it carries the caveats that: 1) It does not change the psychological nature of a person's anxiety (which could be beneficial). It seems to only affect the physical symptoms of anxiety. 2) It is probably better to prescribe prn as taking it long-term would lead to the need to discontinue the medication slowly.

Also, it is my opinion that it can be effective for panic at far lower doses than ordinarily prescribed (5 mg, for example).

I hope that is helpful.

 

[michaelrack]

I was wondering what others thought about using low-dose propanolol for anxiety (not just for performance anxiety, but daily). Is the side-effect profile worth the risk, compared with other anxiety meds?

I had a patient develop complete heart block, but she was on high doses, for HTN. (Now pacer dependant).

Thanks for your input.

I don't think that propanolol can cause permanent heart block (it should go away if propanolol is discontinued)- if you want to know for sure you can ask in the IM/cards forum.

 

[notdeadyet]

OP- did this patient fail trials of SSRIs?

 

[gabafan]

Yes.

 

[gabafan]

I saw your original reply, birchswing. Thank you for sharing your experience!

 

[vistaril]

I was wondering what others thought about using low-dose propanolol for anxiety (not just for performance anxiety, but daily). Is the side-effect profile worth the risk, compared with other anxiety meds?

I had a patient develop complete heart block, but she was on high doses, for HTN. (Now pacer dependant).

Thanks for your input.

Propranolol as a daily anxiolytic is fairly useless....

 

[digitlnoize]

I'm still wondering about the efficacy of nebivolol vs propranolol if anyone wants a research topic...