Latest news with #betaBlockers
Daily Mail
26-05-2025
- Health
- Daily Mail
Experts warn against anxiety drug prescribed to millions due to little-known risk of 'toxic overdose'
Experts have issued a safety warning over a popular anxiety medication that can cause 'toxic' effects including seizures, depression and even cardiac arrest in high doses. Beta blockers, such as propranolol, have traditionally been prescribed for heart problems, but are increasingly offered by doctors to treat episodes of anxiety—as they slow the heart rate, supposedly reducing the physical symptoms of panic. Recent British research showed the number of prescriptions for propananol to treat anxiety doubled between 2003 and 2018. Roughly 7million prescriptions for the drug—which is also given for high blood pressure—are dispensed in the UK every year, according to official data. But now, experts say not only is there 'no evidence' to prove the drugs work for anxiety, too few patients, who are typically given large numbers of pills, are warned of the risk of overdose. In a recent letter to The Guardian, pharmacist Christopher Sullivan warned that the drug 'is associated with significant adverse outcomes' and urged GPs to exercise 'extreme caution when prescribing these medicines for anxiety'. 'Prescribing these medicines for anxiety is not recommended in national evidence-based guidelines,' he added. It followed comments from GP Dr Amir Khan, who told the newspaper that propananol had been linked to 'higher rates of depression' and warned GPs not to prescribe it to anxious patients who also suffer low mood. 'If you are taking them long term, you can't suddenly stop them,' he added. 'You need to be weaned off them.' The risks are not thought to pertain to those taking the medicine for heart problems and other physical issues like migraine—but experts say patients with mental health troubles are vulnerable to either accidentally or purposefully taking an overdose. The pharmacist's warning comes amid two high profile deaths related to the drug including accidental overdoses. In 2019, an inquest heard a mother-of-two, who was an NHS manager, accidentally overdosed on propranolol which she was initially prescribed for anxiety in 2018. Philippa Hulme, 46, died less than two hours after taking the lethal dose, with tests showing toxic levels in her system. A statement from Mrs Hulme's GP surgery said: 'Pippa had a history anxiety and depression and was well known to the practice. 'In July 2018 she was prescribed anxiety medication— propranolol and was given 60 tablets to take—one a day a maximum of two in 24 hours.' The coroner concluded that her death was most likely explained by an 'exacerbation' of anxiety that led her to 'consider it would be beneficial if she took more tablets to help her with the anxiety. 'I do not consider that she knew how toxic propranolol can be.' Another heartbreaking case is that of a mother-of-five who is thought to have accidentally killed herself with propranolol. A 2015 inquest heard how Janine Southwell, 37, a former beauty therapist was prescribed the drug, which she was 'reckless' about taking. She was found dead in bed, in August in 2015, with almost five times the potentially fatal level of the medication in her blood after a meal and glass of wine with her cousin. Her mother Janet Southwell said: 'She didn't take tablets when she was supposed to so she could have had a stockpile.' The coroner, Alan Walsh, concluded Ms Southwell did not intend to end her life. The fresh warnings follow guidance published by the General Pharmaceutical Council in October last year that warned about the 'wide variation' in individuals' response to toxic levels of propanolol. 'Peak plasma concentrations of propranolol occur 1-2 hours after ingestion, so symptoms of overdose will not be seen immediately,' the warning read. 'Rapid deterioration can occur following a propranolol overdose, this can include confusion and loss of consciousness as well as cardiovascular complications including cardiac arrest. 'As propranolol can cross the blood brain barrier, the risk of convulsions is higher than with other beta blockers. 'Delay in treatment increases the risk of fatality, therefore it is important to seek emergency help as soon as possible following overdose.' The danger of toxic propranolol overdose was a subject of the healthcare safety investigation report in 2020. This report revealed that vulnerable patients with existing migraines, anxiety and depression were at risk of using propranolol for self-harm. In 2022 to 2023, the National Poisons Information Service (NPIS) received 358 enquiries involving intentional propranolol overdose.
The Guardian
25-05-2025
- Health
- The Guardian
Dangers of using beta blockers to treat anxiety
Your article (I'm taking beta blockers for my anxiety – and so are many of my friends. Is that a problem?, 20 May) highlights the increasing use of beta blockers, especially to manage situational anxiety. These medicines are the subject of a healthcare safety investigation report in 2020, specifically the toxicity of propranolol in overdose. In October 2024, the General Pharmaceutical Council published advice for pharmacy professionals also highlighting the risk of toxicity. GPs must exercise extreme caution when prescribing these medicines for anxiety, which is not recommended in national evidence-based guidelines for the treatment of anxiety and is associated with significant adverse outcomes. Christopher Sullivan Pharmacist, Newton Abbot, Devon After being diagnosed with atrial fibrillation in 2020, I was prescribed beta blockers to lower my heart rate. I hated taking them as they made my symptoms – tiredness and brain fog – much worse. I stopped taking them and now have a pacemaker. I'm astounded to read that they are routinely prescribed for anxiety. I understand the need for a quick fix, but long term there have to be better coping strategies than taking medication for which there is 'no conclusive evidence' for its effectiveness and might be linked to higher rates of Richardson London Have an opinion on anything you've read in the Guardian today? Please email us your letter and it will be considered for publication in our letters section.
Yahoo
22-05-2025
- Health
- Yahoo
Everything You Might Want to Know About Beta Blockers for Anxiety, According to Doctors
"Hearst Magazines and Yahoo may earn commission or revenue on some items through these links." Not sure about you, but nervous energy comes at me like a bat out of hell. And, of course, it's always at the literal worst moments. Big job interview? My heart races like it's at the Olympics. Stressful meeting with a boss? My skin gets all flushed and hot. If you've been there, then you know that all these pesky physical symptoms only make you feel even more out of control. But what if I told you there could be a secret weapon found in the most unlikely of places? That place would be beta blockers. Okay, okay, if you're thinking, Aren't beta blockers for, like, my dad? You're not wrong. Beta blockers are a type of medication used to treat heart conditions and cardiovascular diseases, like congestive heart failure, heart attacks, coronary artery disease (aka when a bunch of gunk builds up in an artery and blocks regular blood flow to the heart), to name a few. But in some instances, doctors can prescribe them for migraines, certain shakes and tremors, and off-label for situational anxiety. For those of you with regulated nervous systems (how does it feel to be God's favorite?), situational anxiety is when you feel anxious before an event, like performing in a play or giving a speech, says Scott Breitinger, MD, a psychiatrist at the Mayo Clinic. Some people are able to work through these feelings and still do their thing without missing a step, while others feel like their body is betraying them *raises hand*. Celebrities like Khloé Kardashian and Robert Downey Jr. have said they take beta blockers before red carpets and other Hollywood moments, and reality star Paige DeSorbo has been open about how life-changing they've been for her on her podcast, Giggly Squad. Situational anxiety shouldn't be confused with generalized anxiety, though, which is way more persistent, can become dysfunctional, and impairs day-to-day function, says Dr. Breitinger. So basically, if you're anxious all the time, even when everything's chill, it's probably not situational anxiety. But! If you feel nearly paralyzed from nerves before big moments, that could be situational anxiety, and a beta blocker could be a useful tool to help it out. If you have been toying with the idea of starting a beta blocker or are now suddenly intrigued to learn more, keep on reading for everything you need to know about taking them for those moments when you're freaking the hell out. In short, it's a medication that helps slow your heart rate. Without getting too deep into it, there are two different kinds: selective, which are focused on the heart only, and non-selective, which work on your whole body, heart included. For context, selective beta blockers are typically used for things like when chest pains start after the heart doesn't get enough blood. On the other hand, non-selective beta blockers may be preferred by doctors for preventing things like migraines, and these are the ones prescribed for situational anxiety. Remember all those pesky symptoms like sweating, shaking, and shortness of breath? Well, these bad boys are caused by a spike in adrenaline, the hormone known to make you feel amped up, says Sanjiv Shah, MD, a professor of cardiology at Northwestern University's Feinberg School of Medicine. Beta blockers work by blocking the effects of adrenaline, slowing your heart rate and reducing those physical signs and symptoms of nervousness and anxiety, he explains. Essentially, think of using beta blockers like turning down the volume on your fight or flight response. Unlike antidepressants or other SSRIs, beta blockers don't directly aid in quieting worries or nervous thoughts—this is a heart medication, lest we forget. But for some people, they do help you to feel more in control of your body, especially since they can also help increase blood flow to the brain to allow it to function at its best, explains cardiologist Nishant Shah, MD, an associate professor at Duke University School of Medicine. If you're taking beta blockers for situational anxiety, the dosage is typically one or two pills about an hour ahead of the specific event. Of course, your doctor who prescribed them should give you clear instructions too! Your doctor will also tell you to take the beta blockers for a test-drive first—say, during a normal working day or when you don't have a high-pressure situation on the horizon—just to see how your body responds. Raw dogging a dose before a major moment (be it a date, family event, or stressful work presentation) and having a bad reaction is definitely not the vibe, so this part is pretty crucial. It's important to note that beta blockers should be more of a tool in your kit for navigating situational anxiety, rather than a long-term solution. To really get in control of your situational anxiety, you likely need a full-blown arsenal, including a therapist or psychiatrist (ideally in your insurance network). They'll likely use a variety of techniques to help, like exposure therapy, which means continuing to put yourself in the situations that make you nervous. Yes. Like most meds, beta blockers come with a list of potential side effects, such as low blood pressure, low heart rate, fatigue, reduced libido, and sleep disturbances, according to Dr. Breitinger. Dr. Nishant adds some people may experience hair loss, weight gain, and erectile dysfunction for patients with penises. I know, I know, that sounds like a lot, but Dr. Nishant also says most people tolerate beta blockers just fine, and some never feel side effects at all. Just be sure to keep a super close eye on how you feel, and make sure you keep your doctor up to date on your medical history. There are also certain people who shouldn't take beta blockers, including people who already have low blood pressure or anyone with diabetes, says Dr. Breitinger. That's because beta blockers can mask the symptoms in those patients, he explains. Before you do anything, talk to your therapist, psychiatrist, or doctor—they'll help you determine if you have situational anxiety or generalized anxiety. Start by describing how you feel and what triggers your symptoms. If your physician agrees that what you're experiencing seems like situational anxiety, mention that you'd like to give beta blockers a try. After that, the next step would be to get a prescription and take it for a test drive. Again, just make sure your physician knows your full medical history (no, seriously—tell them all the things) because beta blockers may affect people on certain medications and those with asthma or chronic lung diseases differently, Dr. Sanjiv explains. And remember that while beta blockers may serve as a sort of Band-Aid for getting through stressful events, they're not a cure. 'When we work to confront the things we're fearful of, that fear gradually extinguishes itself,' Dr. Breitinger said. 'The role of the medication is just to get the patient to the point where they feel like they can confront the fear.' Always consult your health care provider, dietitian, or other medical professional before taking a new medication or supplement. You Might Also Like Here's What NOT to Wear to a Wedding Meet the Laziest, Easiest Acne Routine You'll Ever Try
The Guardian
20-05-2025
- Health
- The Guardian
I'm taking beta blockers for my anxiety – and so are many of my friends. Is that a problem?
I first took beta blockers two years ago, when I was asked to give a eulogy. Terrible at public speaking on a good day, let alone at a funeral, my first instinct was to refuse to do it. I had made a speech at a friend's wedding 15 years before and my legs shook so violently throughout that I thought I would collapse. This isn't a case of being overcritical or dramatic: I find it almost impossible to stand up in front of a crowd and talk. It is an ordeal, for all involved – or it was before I took beta blockers. Beta blockers are a prescription medication that blocks adrenaline and therefore temporarily reduces the body's reaction to stress. Routinely given to patients with heart and circulatory conditions, including angina, atrial fibrillation and high blood pressure, as well as to prevent migraines, they are also prescribed for some kinds of anxiety. Some doctors will suggest taking them regularly, at certain times of the day. Others will suggest taking a specified dose when you feel you need it. 'They work by reducing the effects of adrenaline on the heart, so you don't get that heart-racing feeling, you may not get short of breath or sweaty, and they can reduce the symptoms of a full-blown panic attack,' says doctor and broadcaster Amir Khan, who has been a GP in Bradford for 16 years. Prescriptions for anti-anxiety medication have soared in recent years – driven mainly by increases among women and young people. According to a 2022 study by the University of Bristol's medical school, which looked at prescriptions issued for anxiety between 2003 and 2018, for every man prescribed beta blockers, there were 2.33 women. The reasons for the uptick in prescriptions are complex – but GPs interviewed for the study suggested that women and young people tend to be more open about anxiety. Also, beta blockers are generally considered lower risk and quicker-acting than other anxiety medications such as benzodiazepines, which are known to be addictive, and antidepressants, which can come with side effects. Patients did not consider beta blockers as 'mental health drugs', the study found, and therefore perceived them as 'less stigmatising'. There has also been a cultural shift – celebrities including the actor Kristen Bell, Khloé Kardashian and cook Prue Leith have all spoken about taking beta blockers. When Robert Downey Jr went to collect his Golden Globe for Oppenheimer, he told the audience: 'I took a beta blocker so this will be a breeze.' The writer and actor Sharon Horgan told Louis Theroux on his podcast recently: 'They do something very practical, physically, but I think the sort of mental stuff that goes with it … has had a real calming effect on me, and in situations that would normally kind of terrify me.' It was a friend who suggested I try beta blockers for the funeral. She had been taking them on and off for years, although this was the first I had heard about it. 'I'm not ashamed that I take them, but I also don't need to advertise it,' she says. 'I suppose I'm worried people would think it meant I'm not coping with life. I don't know. But most people largely keep their medications to themselves, don't they? It's private.' Well, yes, but once I told a few people that I was thinking of taking beta blockers, it was like a domino effect, with more and more of them revealing they had taken them, either for specific events or just now and then. 'I never leave home without them,' another friend tells me. 'I bet I'm far from the only frazzled mum at the school gates who has them.' Someone else I know takes them for perimenopausal anxiety, instead of upping her HRT, which could be another way to remedy the symptom. She says: 'I'm also trying wild swimming, yoga and meditation. I'm really being proactive, not just leaping to drugs. But beta blockers work well for me.' Despite the anecdotal evidence, the University of Bristol study says there is 'no conclusive evidence' for the effectiveness of beta blockers for anxiety. They do not feature in guidance from the National Institute for Health and Care Excellence (Nice) on treating anxiety. So why do doctors prescribe them? 'Although beta blockers can help with some of the physical symptoms of anxiety, they don't treat the biology behind it,' says Khan. Instead, he says, Nice recommends a type of antidepressant called selective serotonin reuptake inhibitors (SSRIs), which work by boosting levels of serotonin – known as the 'happy hormone' – in the brain, alongside talking therapy, especially for those with generalised anxiety disorder. 'Saying this, many GPs and prescribers use beta blockers for situational anxiety – when you know you are going to be in a situation where you are likely to become anxious,' says Khan. 'So, 'if and when' rather than long term.' When I spoke to my GP, she said she prescribed beta blockers relatively often, to people who had to do big presentations at work, or lawyers about to make their closing speech in a trial. She advised me to have a practice run rather than trying them for the first time on the day of the funeral. Within 10 minutes of taking them, I felt like me, but calm. When I gave the eulogy, I was as fine as anyone could be in those circumstances. Like most medications, beta blockers are not suitable for everyone. Dr Adrian Hayter, medical director for clinical policy at the Royal College of General Practitioners, says: 'GPs take a holistic approach to assessing their patients and proposing treatment plans, in conversation with them. This will take into account a patient's unique circumstances, the severity of their symptoms and their medical history, as well as possible side-effects and other medication they may be taking.' Side-effects of beta blockers include tiredness, dizziness and difficulties sleeping and they are not suitable for people with asthma. Taking more than your prescribed dose can be dangerous and you could end up in need of urgent treatment in A&E. Khan says: 'Beta blockers are not addictive, but if you are taking them long term, you can't suddenly stop them.' You need to be weaned off them. And he adds: 'Interestingly, they have been linked to higher rates of depression, so I wouldn't prescribe them for anyone who has depression alongside their anxiety.' Khan says that in the broader picture of more and more patients being in contact with mental health services, he is seeing a rise in the number of patients with anxiety, and in particular work-related anxiety. 'I don't think I am specifically prescribing more beta blockers, but I am certainly treating more people for anxiety overall … I think life is becoming harder and harder for so many people that this is manifesting as anxiety.' Last November, I lost the job I had been doing for 20 years, because of budget cuts. As I worked as a freelance, there was no redundancy pay out, just thank you, have a lovely Christmas. From the moment the bombshell was dropped, I felt constantly on the verge of a panic attack, as if sheer blind terror instead of blood was coursing through my veins. As an already anxious person, a phone call out of the blue that shattered my family's financial security in an instant did not improve my mindset. After a discussion with my doctor, I now take beta blockers three times a day. They are helping to make my life manageable as I navigate my new normal. We did talk about antidepressants instead, which I have taken in the past, but they didn't feel like the right way to go at this time. The anxiety I was feeling was a reaction to my situation, to circumstances beyond my control, rather than a longer term issue. And while they are working for me at the moment, I hope that I won't need to take them indefinitely. Hayter says: 'Wherever possible, GPs don't want patients to have to rely on medication long term, and most patients don't want that either. Best practice is for medication reviews to be held at regular intervals, where GPs and patients discuss whether there are opportunities to reduce the dosage or stop taking medication altogether.' At some point, I'm sure I will feel able to stop taking beta blockers as regularly. But if another stressful public speaking event came up again, I can see myself heading back to my doctor.
