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Propranolol for Anxiety: What to Know About This “Performance Pill”

Medically Reviewed by
Nzinga Harrison, MD
October 2, 2025

Why Is Propranolol in the Spotlight Right Now?

In the past year, propranolol – a decades-old medication – has been making headlines far outside of medical journals. From Wall Street Journal coverage to red carpet shout-outs and even podcast merch, propranolol has become something of a cultural talking point. Influencers, performers, and everyday people are sharing how the medication helps them manage stage fright, social anxiety, or big life moments like weddings.

At Eleanor Health, we think it’s important to join this conversation. When a medication starts trending in popular culture, prescriptions often rise. That can be a good thing when stigma is reduced and more people feel comfortable asking for help.

What Is Propranolol?

Propranolol is a beta blocker first approved by the FDA in 1967 to treat heart conditions and high blood pressure. Today, many clinicians also prescribe it off-label for short-term, situational anxiety because it calms the body’s stress response.

How Does Propranolol Help With Anxiety?

When anxiety surges, your body’s “fight-or-flight” system kicks in – heart racing, hands shaking, chest tightening. Propranolol works by calming these symptoms, slowing the heart rate and lowering blood pressure.

That relief can make it easier to get through moments like:

  • Public speaking or big presentations
  • Performances, interviews, or auditions
  • High-stakes life events, like weddings or important meetings

By quieting the body’s fear signals, propranolol often helps quiet the mind too, creating a positive cycle of calm and confidence.

Why We’re Enthusiastic About Propranolol

Unlike benzodiazepines and other short-acting anxiety medications, propranolol is non-addictive and not a controlled substance. This makes it a safer, more sustainable situational option for many people. For those who only need relief during specific events, propranolol can be a game-changer, as this is a good alternative to riskier medications like Xanax, Klonopin and Valium which are often used for in the moment anxiety control.

Who Should Check With Their Clinician First?

Propranolol isn’t right for everyone. People with certain heart, blood pressure, or breathing conditions should use caution, which is why a quick health history and vitals check with your provider is important.

Where Propranolol Fits in Whole-Person Care

At Eleanor Health, we see propranolol as a valuable “in the moment” tool — one that works best when paired with a broader approach to healing, including:

  • Therapy and skills for managing stress and thought patterns
  • Peer and community support for connection and encouragement
  • Lifestyle care like sleep, movement, and nutrition
  • Other medications when appropriate, tailored to each person’s needs

The Takeaway: Relief in the Moment, Healing for a Lifetime

It’s encouraging to see mental health tools like propranolol being talked about openly in mainstream media and even pop culture. That kind of visibility helps reduce stigma and makes it easier for people to ask for support.

It’s not a cure-all, no single pill ever is, but it can provide the immediate relief that helps people show up as their best selves in life’s big moments.

At Eleanor Health, our mission is to help people find the tools that work for them – whether that’s propranolol, therapy, peer support, or a combination – so they can feel better today and build recovery for a lifetime.

Nzinga Harrison, MD

Dr. Harrison serves as the Chief Medical Officer and Co-founder for Eleanor Health. With more than 15 years experience practicing medicine, she is a double-board certified physician with specialties in general adult psychiatry and addiction medicine. Dr. Harrison has spent her career as a physician treating individuals from marginalized communities with substance use and other psychiatric disorders. As a physician executive, she has served as Senior Vice President and Chief Medical Officer roles committed to creating and improving systems-based delivery of psychiatric and substance abuse care. She is a vocal advocate for stigma reduction, and is passionate about the necessity for whole-person care as individuals and communities seek to recover from and prevent substance use disorders. She authored the book Un-Addiction: 6 Mind-Changing Conversations That Could Change a Life to change how we talk about substance use disorder and help fix the broken system of care.

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