Quote from julia_girl:

Hi there,
anyone know of the side effects of using small dosages of beta blockers for anxiety relief? I have an intense fear of public speaking that I cannot seem to lose. Meditation, natural supplements, etc. have not worked. I do not have any anxiety except for this, so I only need it occasionally. It is starting to affect my career choices etc because I am always avoiding it and cant anymore. I think I worry more about my voice shaking etc than the actual presentation.
Thanks for any advice!

Beta Blockers (IE: Metoprolol, Atenolol, Propranolol) are not FDA approved to be given for the relief of anxiety.

The list of complications and side effects for Beta Blockers is long. The following are the list of side effects that have been reported with all of the various Beta Blocker Medications; that is not to say that all are present for each medication, just that these are the side effects for the entire catagory. Some Beta Blockers might have more or less of the below than others:

Side Effects and Adverse Reactions
agranulocytosis
alopecia
angina
arthralgias
asthenia
AV block
bronchospasm
cardiac arrest
depression
diaphoresis
diarrhea
dizziness
dyspepsia
dyspnea
edema
ejaculation dysfunction
elevated hepatic enzymes
exfoliative dermatitis
fatigue
hallucinations
headache
heart failure
hepatic necrosis
hyperglycemia
hypoglycemia
hypotension
impotence
insomnia
jaundice
lacrimation
libido decrease
myalgia
nausea/vomiting
nightmares
ocular irritation
orthostatic hypotension
paresthesias
peripheral vasoconstriction
peripheral edema
pharyngitis
priapism
pruritus
QT prolongation
sinus bradycardia
skin hyperpigmentation
syncope
torsade de pointes
urinary retention
ventricular fibrillation
ventricular tachycardia
wheezing
xerosis

If you have anxiety over public speaking (social anxiety disorder), speak to your doctor about Paxil. It's FDA approved for exactly that.

Having been on both benzos (Xanax) and beta blockers, specifically propranolol, I would say that the longer term side effects for the beta blocker is less. I have weaned off the Xanax (but still suffer its occasional withdrawal side effects which can be quite unpleasant) and in the process of (trying very hard!) weaning off the propranolol!

Beta blockers are prescribed in small doses (typically 10mg of propranolol) for "stage fright". At these small and infrequent doses, it is unlikely that you will have many (if any) of the side effects listed, which affect differrent people in different ways. Propranolol works fast (typically within 20-90 minutes) and is "washed out" of our system quickly as well (in medical terms, it has a short "half life"). You will feel less jittery and your heart will beat slower (thereby indirectly making you feel "calmer").

This of course is not a recommendation for you to take propranolol or benzos to manage your "stage fright". You'll need to discuss with your doctor what's the best option for you as taking medication is never desirable (unless to control an existing permanent medical condition) and getting hooked on them is the last thing you want to happen.

Good luck in furthering your career!

I just wanted to point out that physicians can (and do) prescribe things all the time without an FDA indication. A lack of an indication (propranolol for public speaking, for example) just prevents the drug manufacturer from marketing the drug as such. Most drugs have dozens of additional actions (AKA "side effects") that are not indicated but are potentially useful.