Comment by thepasswordis | Hacker News Reader

Comment by thepasswordis | Hacker News Reader

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Propanolol is a fantastic anxiety treatment. In some ways better than xanax, at least for me.

Highly, highly recommend trying it. They say it's for "stage fright", which can be offputting because "stage fright" (at least to me) seems almost wholly unrelated to the type of anxiety I suffer from.

It's a miracle from my perspective. If you suffer from generalized anxiety, please ask your doctor about it.

Just to really hammer this home: I had doctors recommend this drug to me for years, and I always more or less ignored them. I have taken xanax for quite some time, and took this recommendation as them being apprehensive about prescribing it (which i understand, since many people abuse it).

Propanolol seems to have the same type of calming effect, but with none of tired/disassociative feelings that xanax gives (which I don't like). The first time I took it I almost wanted to cry. It really was just like a switch that turned the anxiety off. It does take about 60-90 minutes to fully kick in, though.

I feel that propanolol helps with physical effects of anxiety (which are not much of a problem for me), but doesn't affect the mental side of anxiety the same way benzos do. It's much less addictive than benzos of course, and preferable for that reason if it works.

I only get the physical effects, which is why it works so well for me.

+ 1 for propranolol. Its a beta blocker. It binds to receptor sites for adrenaline so adrenaline doesnt have effect. Usually anxiety attack is a loop where brain panics, triggers body reaction like increased heart rate etc and that causes brain to panic further and this loop escalates. Propranolol blocks this loop in the body, as in, heart rate wont increase.

Personally I found it useful.

I'm a hobbyist musician with IBS-D, which is often triggered by general anxiety. I've been asked to play with the pros several times, and every time I have to say 'no' several hours beforehand b/c I'm chained to the toilet. Do you think that propranolol would negate those issues? I have also tried CBT with a therapist and it was only marginally helpful

I think the drug is often prescribed for this exact scenario (stage fright, essentially).

This is not medical advice. However propranolol is prescribed off label for “performance anxiety” so it may be worth discussing with your PCP. It is not an anxiety medication per se, it is a non selective beta blocker, it blocks some of the effects of (nor)adrenaline. How this can help isn’t entirely understood but part of performance anxiety is a positive feedback cycle where your physical feelings of anxiety provoke more anxiety.

The good thing about propranolol is that since it does not have meaningful addiction or tolerance potential it’s reasonable to take long term. It’s relatively safe in otherwise healthy people, so it’s overall low risk, with depressed heart rate and BP leading to syncope the main one. It historically was a blood pressure medication, but oral beta blockers are poor first line BP meds. Few PCPs have qualms prescribing it if there are no contraindications.

Thanks for the suggestion; I appreciate it. Is this something you take daily or as you need it?

As needed, but it's fine to take daily with no negative downsides.

I'll take it before I need to go do something which might have triggered an attack, but the long term benefit here is that doing those activities without getting triggered lessens the sensitivity to the trigger (if that make sense).

So lately I haven't taken any in weeks, but when I was first prescribed it I took it every day.

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