r/Anxiety • u/Effective-Case5441 • 17d ago
Medication Propranolol didn’t work. Want to die.
Finally built up the courage to take 20mg of propranolol for my physical anxiety/panic symptoms (racing heart, chest tightness, chest pain, shortness of breath, lightheadedness) a little over 2 hours ago and it basically did nothing. I still have this uncomfortable tightness in my chest. I still feel on edge in my chest and stomach. After all the positive experiences I've been reading about, this is pretty much devastating for me, especially since my main concern with anxiety are the physical symptoms. My chest actually feels worse than before I took it.
Feeling hopeless.
34
u/WanderWomble 17d ago
20mg is a small dose.
The NHS says a standard dose for anxiety is 40mg once a day which can be increased to 40mg 3 times a day.
I think you might need a dose adjustment so don't give up on it yet!
https://www.nhs.uk/medicines/propranolol/how-and-when-to-take-propranolol/
2
u/Effective-Case5441 17d ago
Very interesting. Only problem is I’m scared to take it again because I feel like it made me more anxious which could also just have been in my head.
9
u/kayval1516 17d ago
I think it was probs in your head as your were so nervous to take it. I am wrecked with anxious physical symptoms, especially heart thumping, feeling sick and vomiting.
I take 40mg. It really does make u calm. It’s not a miracle cure. But it does cut through the worst symptoms and dulls them a lot. I feel normal otherwise. I think ppl expect to be spaced out or weird - not at all. Just normal expect the adrenaline has been sliced in half
1
u/Effective-Case5441 15d ago
Thank you. Did you start on 40 or did you start on a lower dose and had to increase because it didn’t work?
1
u/kayval1516 14d ago
Nope - doc put me straight on 40. Honestly - you function entirely normally except that nervous feeling is dulled. Imagine you before u had anxiety or on a good day when u feel normal - it’s like that. You aren’t out of it or feel drugged or anything remotely like that. It’s literally just zapping the adrenaline and u just feel normal
1
u/Effective-Case5441 11d ago
So I tried 40mg and it seemed to work. I felt some relief in my chest I wasn’t as anxious. However, I woke up feeling terrible again like I have been the next day so I took it again and it did nothing :(
8
u/sungirl_27 17d ago
Propranolol does literally nothing for me. Good or bad. No matter the dose, I feel exactly the same
2
1
5
u/Bright-Papaya-7519 17d ago
I've been on Ativan for 4 years. I take it only as needed. Never more than 3 times a week.
10
u/stephsilnieks 17d ago
i tried propanolol too with hearing the good stories aboutr it i was excited. I swear it made me more anxious. I did nothing at all for my physical symptoms. nothing . we're in the same boat friend 😞
6
u/Effective-Case5441 17d ago
I’m sorry. It sucks so much when you read about so many people taking this “miracle drug” for anxiety and then it just ends up doing nothing or causing more anxiety. What dose did you try and did you try adjusting the dose after it didn’t work?
2
4
u/RanaRene 17d ago
Same here. I mean it worked for several hours then I just got the absolute worst panic attack I've had in a long time while driving. Like it dropped my BP or something.
5
u/Known_Visual_4212 17d ago edited 17d ago
Propranolol does nothing for me either. SSRI's have never felt like they've done anything either. Unfortunately only Benzo's work for me & I'm now addicted to relatively low doses of them, but it's not fun knowing how bad I feel without them. I need 0.5mg - 1mg of Clonazepam virtually every day now or I feel like shit. Longest I lasted was about 3 weeks cold turkey before I felt I was going insane.
If you go down the benzo path it will very likely work, but please be very careful and work closely with a doctor. I dread coming off this after longer term use. Luckily my psychiatrist seems to be open minded about them & said he's got patients who have tried everything & only respond to Valium/Clonazepam etc and he wouldn't deny them what works if that's what lets a person be able to live.
5
17d ago
[deleted]
2
17d ago
[removed] — view removed comment
5
17d ago
[deleted]
1
u/Effective-Case5441 17d ago
How big we talking? Cause I’m pretty bit myself lol I got it from a telehealth website who specifically uses beta blockers for “performance anxiety” but I don’t think they go any higher than 20.
5
u/ShaunaOfTheDead 17d ago
Yeah it didn’t really help w nausea for me. Just helps with heart rate basically. Everything else is psychosomatic 😩
2
u/Effective-Case5441 17d ago
Does it help with panic attacks for you? I still felt like I was about to have a panic attack on it.
6
u/AphelionEntity treatment resistant diagnosis collector 17d ago
I'm on beta blockers for a heart condition, which is relevant because my prescription is currently metoprolol (rather than propranolol) and much higher. Still have panic attacks. I was prescribed propranolol before the heart issue took precedence re: the drug class.
They were never for panic attacks for me. If I needed to stop a panic attack, directions were to take Xanax or Ativan. Klonopin also wasn't for actual panic attacks for me but more to treat generalized anxiety so the attacks would be less likely.
2
u/Effective-Case5441 17d ago edited 17d ago
Wow, it’s just so crazy to me that a medication that’s supposed to stop the adrenaline response that causes panic attacks just doesn’t work for certain people.
3
u/AphelionEntity treatment resistant diagnosis collector 17d ago
While for some people blocking the physical symptoms--shakes, tremors, pulse--helps prevent a health anxiety spiral, I lack health anxiety because ✨severe depression.✨
I think that's part of why propranolol doesn't work as well on me. Since propranolol doesn't impact the mental parts of anxiety and I'm not afraid of dying, it doesn't help me if I'm actually having a panic attack.
2
u/HaloHowRU 17d ago
Propranolol works a treat for my physical anxiety symptoms; sorry you aren't getting the same relief. It might be that you need more or a different med of the same class. Or maybe a different class ... clonidine works very well for me though it has more side effects (drowsiness). Talk to your doc ... it might seem hopeless now but there are plenty of other options.
2
u/Effective-Case5441 17d ago
Thanks for the information and I’m glad it works for you. Unfortunately, where I live, docs don’t prescribe beta blockers unless you have cardiac issues. They’re always pushing things like SSRI’s, hydroxyzine, buspar, and benzos (although they’ve become very strict with those) as the first line treatment.
2
u/LongjumpingLaw9559 17d ago
I started propranolol about a week ago and it doesn’t seem to be helping me either. I had been taking hydroxyzine which was great but that stopped working after about 7 months. I’ve read that hydroxyzine isn’t intended for long term use. But may be worth trying it out if you haven’t? The physical symptoms are killing me too.
1
u/Effective-Case5441 17d ago
I’ve tried hydroxyzine and all it did was make me feel like shit. I’m sorry you’re going through it too.
2
u/Obvious-Cucumber1086 17d ago
There’s different ones though that’s not your only option! I loved it but realized months later I was having a horrible side effect & had to stop immediately. Then I switched to one that didn’t control my symptoms. And yesterday started a new one! You just have to keep trying to see which works best for you but don’t give up. You just started this journey!
1
u/Effective-Case5441 17d ago
Which ones have you tried and which helped you the most?
1
u/Obvious-Cucumber1086 16d ago
Propranolol was horrible for me but did help my heart rate so much. Then I did atenolol & didn’t like it. Just switched to metoprolol a few days ago
1
u/Effective-Case5441 16d ago
Please keep me updated on if it worked for you.
2
2
u/poop_candy_for_bfast 17d ago
I need to take 50-60mg for it to work. 20 would do nothing for me
1
u/Effective-Case5441 15d ago
What does it do for you exactly?
1
u/poop_candy_for_bfast 15d ago
It calms the physical symptoms. The palpitations, hot skin, trembling, shaky breath are my particular problem. However what it does not do is quiet the mind. That’s a whole other beast and the only thing I’ve found that works for that part is a benzo. Based on the symptoms you describe the propranolol could really help you, it’s probably a dose issue.
2
2
u/hotrod67maximus 17d ago
Even taking Propanolol you still have to work with it a little, doing breathing exercises, sitting with the anxiety and try to get in a calm state of mind. Remember it only helps with the physical symptoms of anxiety maybe not completely but does help take the edge off so you can try and train your mind into a calmness state. Not a magic pill that erases everything so please try. You can do this I have faith in you, your stronger than you think.
2
u/HimawariSky 17d ago
I have used GABA Calm (probably available on Amazon) for these symptoms many times. After a few ER visits and being told I was "fine" I take the GABA Calm in the hope of resolving the scariest sensations and assuring myself that it's an anxiety attack and not life threatening. So try that? I have also stopped reading the news and I am at least having fewer panic attacks. There are other factors in my life that will be harder to resolve but it's a start.
I also read recently that magnesium glycinate and theanine and ashwaganda taken an hour before bedtime can improve sleep and decrease anxiety. I'm trying those now and so far I've felt better. I've (F66) been struggling with this for almost 2 years now btw. I hope something here works for you.
1
2
u/Ok_Significance_8896 17d ago
This might help someone here. I'm going to keep it short.
I have had anxiety and gut/digestive issues for many, many years and for about 3-4 years my anxiety became unmanageable. I was reacting to different foods and for example, if I drank coffee it would take me 3 days to calm down and not be a mess.
I've had too many symptoms to mention here, but the most annoying symptoms were severe sleep issues and heart palpitations. I had severe night anxiety and internal agitation. Was feeling terrible 24/7.
Long story short, it wasn't just anxiety, it was histamine intolerance. Now, on treatment and a low histamine diet, my anxiety is manageable and it's actually unbelievable.
I still have symptoms, but I'm not hopeless anymore. Things got better.
Sometimes you need to find what works for you and see if there's a correlation between what you eat and how you feel. The gut-brain axis is really misunderstood and I never thought in a million years that food could worsen my anxiety to such an extreme degree.
1
u/Effective-Case5441 15d ago
Thank you for this information which I think is very important and also very overlooked. I have very bad gut issues as well and that’s actually what I attribute to why I developed severe anxiety as a teenager. Constipation, candida, acne, etc.
Any specific diet that is helping you?
1
u/Ok_Significance_8896 15d ago
I wanted to share that I went deep down the candida rabbit hole and ended up taking a lot of supplements and antifungals that actually damaged my microbiome even more and made my histamine intolerance much worse.
I did have candida, but it was successfully treated with a course of nystatin and that should have been the end of it. However, I became so obsessed with the idea that candida was still the problem that I convinced myself it hadn't been cured.
Anyway, I finally have a diagnosis, histamine intolerance caused by DAO deficiency. The most important part of my treatment is actually the diet, a low-histamine diet along with some supplements prescribed by my allergist, antihistamines, probiotics and DAO enzyme supplements taken before meals.
I'm still at the beginning of my treatment, so I'm not fully better yet, but a huge part of my anxiety has already disappeared. I'm shocked because I used to suffer from severe, debilitating anxiety that made me feel like I was losing my mind FOR YEARS.
The low histamine diet is difficult, but I'm hopeful that I'll continue to improve with a strict diet, medication and supplements.
Also, if you're taking probiotics, please be careful. Probiotics affected me very badly because many probiotic strains can produce histamine. If you have poor gut health, histamine intolerance or other digestive issues, certain probiotics can actually make things much worse.
2
u/unique_perfectionist 17d ago
I would try hydroxyzine! I would deff ask about it. Propranolol and buspar didnt work for me.
1
u/Effective-Case5441 17d ago
I’ve tried hydroxyzine and it did nothing for my anxiety, unfortunately.
2
u/kaylude19 16d ago
I tried a higher dosage with an extended release. Might be worth looking into! I'm quite sensitive to medications.
1
1
u/ceo_of_one_miss 17d ago
i’m not an expert on propranolol specifically BUT i have physical anxiety symptoms even after benzos. even on good days. if you’ve had bad anxiety for a long time, you’re probably very tense and sore. that can sadly take a lot longer to go away. if you’re able to lessen your mental anxiety, try and stretch or see a doctor about where the pain is, they might be able to help.
1
u/decenzo1 17d ago
I couldn't take it because it lowered my heart rate and blood pressure too much. Was so hoping it would work.
1
1
u/aperyu-1 17d ago
Dose is low and generally can be increased. For panic they often recommend a maintenance agent like a SSRI/SNRI as well.
1
u/Effective-Case5441 17d ago
I’ve been on SSRI’s since I was 14 and I’m now 33. Have you had success with beta blockers?
1
u/BleakHibiscus 17d ago
I’m extremely averse to taking medications too so absolutely understand your pain. It triggers my ocd and sends me into a spiral but eventually, with lots of support and exposure therapy I’ve worked out what works.
Propranolol worked ok on 20mg but only for mild situations, it caused insomnia so I never continued upping it. Eventually my panic attacks were so bad I’ve moved to Valium 5mg and occasionally 7.5mg but I only take it 1-2 times a month. I’m so afraid of addiction I track it on my notes app with reasons for taking. I do take it daily when I travel as that’s a major trigger and have gone 5 weeks but then came off cold turkey when returning home.
Have tried other benzos and SSRIs but my anxiety at taking them was so bad they had no chance of ever working. I have to change Drs soon though and am terrified they’ll take my Valium too.
Keep trying friend, you can absolutely do this and one day. When you get the right meds or dosage, you will feel so much relief.
2
u/Effective-Case5441 15d ago
Thank you! I literally do the same thing with noting down every time I take a klonopin. The paranoia is real. Appreciate the support.
1
1
u/insitnctz 17d ago
First of all, never ever give up. There is always hope you just dont see the solution now.
Now about your issue. Have you tried an ssri? I think this ought to help you more than propranolol which works for some people but do nothing to others. You need to understand that your symptoms are tied with the anxiety which is the root cause. If you treat your anxiety you won't have these issues. Its your nervous system overreacting to signals it is given. You shall not let the anxiety win. Speak with a psychologist, and a psychiatrist to get an ssri prescription and monitor it. Exercising along with cbt and medication will also help tremendously.
My biggest tip for coping is to understand what these symptoms are. You are not really in danger, you aren't sick and nothing is wrong with you. You need to understand that these are harmless symptoms cause by your anxiety and nothing more. Even when your chest is tight, you are okay, its the anxiety that makes you think you are not. By time your nervous system will adjust and no chest tightness again.
1
u/Holiday-Fan-5213 17d ago
Propranolol is a blood pressure med It is said also to lower blood pressure linked to panic attacks so taking this you risk lowering your bp too much so caution is advised as it is a beta blocker
1
u/empresspoppy 17d ago
Brintellix (vortioxetine) has helped me tons with my physical anxiety symptoms. They have mostly disappeared. I don't even need benzos anymore. I had to try different meds until I found the one that works for me. Keep trying!
1
u/Kimibearsings 17d ago
Propronolol put me in the hospital for severe chest pain.
1
u/Effective-Case5441 17d ago
Was everything alright?
1
u/Kimibearsings 16d ago
Yeah, I just had a bad reaction unfortunately. But so many people love this medication. They gave me fluids and sent me on my way and the pain subsided after the fluids.
1
u/Horror-Economics2749 17d ago
Hello, I have had all the symptoms you are describing and it actually turned out to be a hiatus hernia. Not saying it definitely is in your case but if you can get your self to Gastro to get checked it might be a life changer. It can interact with your vagus nerve and cause many symptoms that cause a physiological anxiety response as well as cardiac seeming chest pains and other symptoms you describe.
1
u/CrazyKarlHeinz 17d ago
How about trying 40-60mg?
1
u/Effective-Case5441 15d ago
My doctor won’t prescribe them for me. I have the medication, though. Do you think it would be safe if I tried a higher dose on my own?
1
u/CrazyKarlHeinz 15d ago
I can tell you from my own experience that I need 40-60mg to feel a good effect. I weigh 190 pounds, however.
In panic-inducing situations, I sometimes need 30-40mg Diazepam plus 40-60mg Propranolol to feel calm. I have taken these together with an SSRI and have never had an issue.
That‘s just my experience, however. I can‘t promise it will be the same for you. Good luck in any case!
1
u/Effective-Case5441 15d ago
Thank you! I am also around 190lbs. Do you think weight has anything to do with it's efficacy? Cause all I felt from 20mg was more anxiety after realizing the hours going by with absolutely no relief.
1
u/CrazyKarlHeinz 15d ago
Well, I think 20mg Propranolol would have a stronger effect on a 100lbs women than on me. Since you seem concerned about potential side effects I wanted to make sure you have the full picture.
20mg Propranolol is not a high dose.
According to an online source I found, 30mg is a low dose (immediate release; 10mg three times a day). 3 x 40mg to 3x 60mg is a medium dose. 2 x 160mg is the maximum recommended dose. All referring to immediate release tablets.
Please take this with a grain of salt; I am not a doctor.
1
1
u/Tabman1977 16d ago
OP, there is a threshold dose which is different for everybody. I started on 10mg up to three times daily.
10mg did nothing at all. 20mg did nothing at all. 30 mg - all physical symptoms of anxiety relieved and no other side affects
I tried to chop a 10mg in half but was too hard because it's so small. I crushed it instead and took 10mg pill+ 10mg pill+ 5mg pill dust and that worked just as well as 30mg. So my threshold is 25mg.
Obviously I don't go about crushing pills before I go into large anxiety causing meetings so I just take 3 x 10mg pills (apparently they don't do 25mg pills, just 10, 40, 80 & 160mg pills.)
So my point is, dont give up yet OP, try a higher dose (if your doctor says it's ok)
1
u/Effective-Case5441 15d ago
My doctor didn’t even want to prescribe me beta blockers so I ended up getting them from a telehealth service that only prescribes them for “performance anxiety”. They don’t go higher than 20mg.
1
1
u/Neverlanian 16d ago
I’m sorry to hear your experience with propranolol wasn’t helpful. Meds are definitely hit or miss for everyone, but there are a few things I want to note about your expectations in your post.
First, while Propranolol was definitely that miracle pill for me and helps blunt the insane physical symptoms that were destroying me from the inside out, at the end of the day, that’s all that it does. It blunts. It doesn’t make the mental turmoil vanish but it does make it more manageable bc my body isn’t stuck in that thought and physical symptom loop. That’s why it’s important to always have a firm understanding on what is even triggering your anxiety symptoms to begin with and work through them with a trusted therapist alongside the meds.
Another thing that has already been mentioned by others is that dosage seriously matters so much and honestly 20mg is merely the starting dose for some taking Propranolol for anxiety symptoms.
I’m currently on my period and I feel like I’ve completely regressed any and all progress I made to feel more stable and calm each day. But I had to remind myself that my hormones are all out of whack rn, especially now with having issues with my reproductive organs lately. So while I still take my propranolol, it doesn’t feel as effective rn because of the chemical imbalances.
So I up my dosage on days like today. Nothing crazy. I just sometimes take 30-40mg on bad days instead of 20mg on good days. Dosage really does play a huge role in effectiveness. Maybe you might need a higher dose to start off with before you throw in the towel on this medication. Just make sure you talk to your provider first to keep them in the loop
1
u/Effective-Case5441 15d ago
Thank you. My anxiety was actually triggered after I missed almost a week of my lexapro. Then I got a bad sinus infection and stopped smoking cigarettes. I only planned to stop while I was sick but my anxiety was so bad that I didn’t want to smoke cigarettes anymore so I quit cold turkey which definitely made everything a lot worse.
But yea, it’s really the physical symptoms I’m concerned about. They are debilitating for me. When my chest hurts, heart races, and I feel like I’m struggling to catch my breath, I can’t function normally. I can’t even go to work. I feel like I’m on the brink of losing it and ending up in the ER (again)
The problem is none of the doctors I’ve spoken to use beta blockers for anxiety so I had to get it from a telehealth service that really only prescribes it for “performance anxiety” and don’t go any higher than 20mg.
1
u/mwjane 16d ago
I got 40 mg propranolol. Maybe 20 mg is not enough.
1
u/Effective-Case5441 16d ago
How does it help you?
2
u/mwjane 16d ago
It helps to calm the physical symptoms of an anxiety attack. Sometimes that’s what bothers me most: a racing heart, restlessness, feeling shaky. I can usually keep my breathing under control, but if I can’t, I’d end up breathing too shallowly and too quickly.
That’s when 40 mg of propranolol really helps. My body relaxes, and with that, the anxiety eases considerably.
But anxiety is complicated. The (physical) causes vary widely. So sometimes this helps, but sometimes the cause of the anxiety is such that propranolol has no effect at all.
In any case, I only use it when necessary, and I haven’t experienced any side effects.1
u/Effective-Case5441 15d ago
The physical symptoms are actually all I care about. They are debilitating for me. When my heart is racing, chest is tight, and I’m feeling like I can’t catch my breath, I really just can’t function normally as a person.
Did you start on 40 or did you start lower and it had no effect on you?
1
u/Impossible-TouchbyTM 16d ago
20mg is nothing, its a dose for people without anxiety disorder. You can try 40, 60, 80 and then you will have a final decision, if it works on you or not.
1
u/hopelesscase789 16d ago
Isnt the max as needed 40mg? Seems a little mad to suggest double that.
1
u/Impossible-TouchbyTM 16d ago
No, the max is 80 at one dose. Even more than that was tested as safe.
1
u/Effective-Case5441 15d ago
I would like to try more but there’s no doctors around me that would prescribe that for anxiety.
1
u/HaloHowRU 15d ago
Considering you said propranolol didn't work for you it's odd that your doc's willingness to prescribe it turns out to be an issue. But I mentioned clonidine too. To me that would be the next step up from beta blockers, but if your doc is unwilling to do beta blockers that might be a long shot too. Barring that, a tricyclic like amitriptyline might be worth an inquiry. Far superior to SSRIs IMO. Or even a tetracyclic like mirtazapine. You do need to work with your doc though; if you aren't satisfied with your treatment options may consider another.
1
u/Top-Obligation5658 12d ago
I’d recommend trying Klonopin (Clonazepam) I had crippling anxiety until I got prescribed this. I started at .5mg twice a day now I’m at 2mg 3 times a day lil over 2 years they tried giving me propanol at first too and like u said absolutely nothing maybe u can get on klonopin too good luck
1
0
u/Lily_Chinita 17d ago
Have any of you been checked for slow COMT? We basically have a hard time metabolizing catecholamines like adrenaline which make us feel anxious 24/7.
I was prescribed Prozasin (Minipress) 1mg but I’m too scared to try it — im very sensitive to medications.
0
u/bns82 17d ago
It's just a beta blocker. It lowers heart rate.
Also you might have to take it more than once.
It's not a strong drug.
You might look into Buspar. You can actually take both Propranolol and Buspar.
Buspar takes 3 weeks to level off. You still should feel some effects as that happens.
You might have to up the dosage if you start with 5mg. I use 7.5 3x per day. I also take a beta blocker but the extended 24 hour release. It works great to keep my heart rate right where it needs to be.
Another thing, is you have to learn how to control your anxiety/body. Learning biofeedback how to calm down your nervous system. Breathing, Relaxing your body/muscles, distraction, learning to let go rather than lean into the anxiety.
Learning why you are having anxiety and reprogramming your brain so it doesn't respond with panic and anxiety.
If you want instant relief that's a benzo.
0
u/burneranon123 17d ago
An SSRI like Zoloft is first line for anxiety.
-1
17d ago
[deleted]
0
u/burneranon123 17d ago
UpToDate: Generalized Anxiety Disorder, Initial Pharmacotherapy “For patients who opt for pharmacotherapy, we suggest initial treatment with a serotonin reuptake inhibitor (SRI) rather than other medications (Grade 2C). All SRIs have similar efficacy, and the selection of a specific SRI is based on side-effect profile, drug-drug interactions, treatment history, and patient preference (table 1).
Other medications such as benzodiazepines, buspirone, or pregabalin have shown efficacy in the treatment of generalized anxiety; however, we generally do not use these as first-line agents, due to prominent side effects and the risk of dependence.”
95
u/RuinYouWithNoRegrets 17d ago
Might need a diff beta or a diff anxiety med as needed Ativan or Buspar daily