Primary source desk

Propranolol hydrochloride tablets prescribing information ↗

Drugs@FDA: Inderal (propranolol hydrochloride) application overview ↗

FDA: understanding unapproved use of approved drugs (off label) ↗

NIMH: mental health medications ↗

NIMH: social anxiety disorder ↗

A systematic review and meta-analysis of beta-blockers for anxiety disorders concluded that the quality of evidence for the efficacy of propranolol at present is insufficient to support the routine use of propranolol in the treatment of any of the anxiety disorders.

A systematic review and meta-analysis of placebo-controlled randomized trials of pharmacotherapy for social anxiety disorder states that evidence for the efficacy of beta-blockers in treating performance anxiety was lacking.

NIMH says beta-blockers are commonly the medication of choice for the “performance anxiety” type of social anxiety disorder.

In a randomized, double-masked, crossover study of 5 ophthalmology residents who took propranolol 40 mg or placebo 1 hour before microsurgery, the residents' own ratings showed a highly significant effect of propranolol in decreasing anxiety (P = .0058) and surgical tremor (P < .0001); the abstract states it is unknown whether decreased tremor and anxiety improved surgical outcome.

A double-blind pilot study of propranolol 40 mg (n = 40) or placebo (n = 20) before a speech task reports that self-reported speech distress and questionnaire measures of public speaking anxiety showed clear reductions following treatment, but propranolol did not reliably outperform placebo regardless of speech duration at treatment.

A study of beta blockers and speakers' performance and memory reports that propranolol impaired recall of difficult items in the memory of anxious subjects.

A laboratory stress study states that prior findings are surprisingly mixed about whether beta-blockade (e.g., propranolol) blunts subjective stress, with many studies reporting no effects.