Anxiety disorder is one of the most commonly diagnosed mental health disorders in the world. Anxiety is when you experience a type of fear often associated with feeling threatened or something going wrong. This can be around future worries, but also from fear about something happening right now.
Many people with anxiety experience a combination of physiological and psychological symptoms. Physiological symptoms of anxiety are part of a natural bodily reaction to stress, commonly known as the fight or flight response.
Psychological Symptoms of anxiety may include:
- Palpitations or, and an increased in heart rate (Tachycardia)
- Excessive sweating
- Dry mouth
- Difficulty breathing
- Feeling of choking
- Shakiness and trembling
- Chest pain or discomfort
- Nausea or abdominal distress
- Feeling dizzy
- Derealisation or depersonalization
- Fear of losing control, passing out, or dying
- Hot flushes or cold chills
- Numbness or tingling sensations
Psychological symptoms can include significant worry, feelings of apprehension about daily occurrences and events. These symptoms together can sometimes lead to general aches and pains, reduced sex drive, sleep difficulties and headaches. Many individuals can experience these symptoms without knowing that they are suffering from anxiety.
There are several treatment options available:
- Self-Guided options, such as engaging in relaxation techniques, mindfulness, yoga, balanced lifestyle or engaging in self guided therapy online.
- Psychological intervention, such as professional led cognitive behavioural therapy, interpersonal therapy, and psychodynamic psychotherapy.
- Pharmacological intervention, such as Propranolol or antidepressants (ie. Sertraline, Escitalopram etc.).
Evidence based psychological interventions are first line treatment for anxiety and are usually recommended in preference of pharmacological treatment.
It is likely that you may have tried self guided support and/or psychological therapy but you continue to experience ongoing physiological symptoms of anxiety before your healthcare worker prescribes you medication.
PROPRANOLOL
Propranolol hydrochloride is a medication belonging to a group of medicines called beta blockers. In the UK, you can only get Propranolol on prescription.
The medication works by slowing down your heart rate and lowering blood pressure.
Propranolol comes in two forms - normal standard release and prolonged release.
Standard release Propranolol tablets are sometimes prescribed for those experiencing physiological symptoms of anxiety because it is distributed into your body quickly to help relieve symptoms.
Propranolol after oral administration, is completely absorbed within 1-2 hours (3). Many individuals can start to benefit from the relief of symptoms from an hour after taking the medication.
The liver starts the process of elimination and can remove the medication from the body within 3-6 hours (this is known as the elimination half life).
The usual recommended daily dosages for an adult is 40mg to 120mg for anxiety. A dose of 40mg a day may help provide short term relief of acute situational anxiety/panic attack. You may require it throughout the day, or as required. This would depend on the level of symptoms you experience.
The treatment should be regularly reviewed, and can be continued or adjusted according to response and potential side effects.
Similar to other medications, you may experience some side effects when starting Propranolol. After taking the first few doses you may experience dizziness, cold hands/feet, difficulty with sleep and nightmares. Please note that these side effects are often mild, and usually subside within the first few days of taking the medication.
It is important to note, that if you have any concerns about the medication or the side effects you experience to discuss with your local pharmacist or book an appointment with your prescribing clinician.
Read more: How to take care of your mental health
- Anxiety UK. Retrieved from https://www.anxietyuk.org.uk/
- NHS. Anxiety: feelings and symptoms. Retrieved from https://www.nhs.uk/mental-health/feelings-symptoms-behaviours/feelings-and-symptoms/anxiety-fear-panic/
- Mind. Treatment for anxiety and panic attacks. Retrieved from https://www.mind.org.uk/information-support/types-of-mental-health-problems/anxiety-and-panic-attacks/treatment/
- NHS. Propranolol medication information for patients. Retrieved from https://www.nhs.uk/medicines/propranolol/
- Drugs.com. Propranolol: Patient tips. Retrieved from https://www.drugs.com/tips/propranolol-patient-tips
Additional references not directly related to URLs provided:
- Thibaut F. Anxiety disorders: a review of current literature. Dialogues Clin Neurosci. 2017;19(2):87-88.
- ICD Anxiety F41.1
- EMC https://www.medicines.org.uk/emc/product/11812/smpc
