{"id":632433,"date":"2025-06-04T12:37:57","date_gmt":"2025-06-04T16:37:57","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=632433"},"modified":"2025-06-05T10:58:39","modified_gmt":"2025-06-05T14:58:39","slug":"atenolol-vs-propranolol-for-anxiety","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/atenolol-vs-propranolol-for-anxiety\/","title":{"rendered":"Atenolol vs. propranolol: Which is better for anxiety?"},"content":{"rendered":"

Atenolol<\/span><\/a> and <\/span>propranolol<\/span><\/a> aren\u2019t traditional anxiety meds like SSRIs\u2014rather, they\u2019re blood pressure medications called beta blockers\u2014but they prevent the action of epinephrine (adrenaline), reducing anxiety\u2019s physical symptoms.\u00a0<\/span><\/p>\n

Which one is better? It all depends on the patient’s condition, medical history, and other medications. Read on for a thorough examination of atenolol and propranolol\u2019s key similarities and differences.\u00a0<\/span><\/p>\n

What is atenolol?<\/span><\/h2>\n

Atenolol (brand name: <\/span>Tenormin<\/span><\/a>) is a cardioselective beta blocker, which means it blocks the body\u2019s beta-1 receptors, primarily around the heart. This prevents chemicals like epinephrine from binding to the receptors and taking effect. Atenolol\u2019s main benefits are cardiovascular, like relaxing the blood vessels and slowing the heart rate, so it\u2019s only FDA approved to treat high blood pressure (hypertension), heart attacks (acute myocardial infarction), and chest pain related to cardiovascular conditions (angina pectoris).\u00a0<\/span><\/p>\n

However, atenolol\u2019s adrenaline-blocking action can also curb the body\u2019s fight-or-flight symptoms, like a racing heart or tremors. That\u2019s why doctors may prescribe it off-label for anxiety. In <\/span>one 2020 study<\/span><\/a>, 86% of patients with anxiety disorders, trauma-related disorders, and post-traumatic stress disorder reported positive effects while taking atenolol. The typical dose of atenolol for anxiety is 10\u201340 mg, three times per day.\u00a0<\/span><\/p>\n

What is propranolol?<\/span><\/h2>\n

Propranolol <\/span><\/a>(brand names: Inderal, InnoPran XL, Hemangeol) is also a beta blocker, so it functions much like atenolol in the body. However, it\u2019s a non-cardioselective beta blocker. While cardioselective beta blockers like atenolol target the beta-1 receptors, which are mainly around the heart, <\/span>non-cardioselective ones<\/span><\/a> like propranolol target beta-2 receptors as well. Beta-2 receptors are found in tissues throughout the body, rather than just the heart and blood vessels.\u00a0<\/span><\/p>\n

Like atenolol, propranolol is FDA-approved to treat hypertension, heart attack, and chest pain. It\u2019s also approved for essential tremors, migraine prevention, hypertrophic subaortic stenosis, and an adrenal gland tumor called pheochromocytoma. Doctors may prescribe it<\/span> off-label for performance anxiety<\/span><\/a> or stage fright, and although there is some evidence to support this use, <\/span>researchers have concluded<\/span><\/a> that it\u2019s insufficient to make an official determination on its effectiveness.\u00a0<\/span><\/p>\n

For anxiety, propranolol\u2019s starting dosage is typically 10\u201340 mg, but this depends on the patient\u2019s health, conditions, other medications, and more.\u00a0<\/span><\/p>\n

How do they compare?<\/span><\/h2>\n

Both of these drugs can treat the physical anxiety symptoms of anxiety, but it\u2019s important to note that they don\u2019t treat the psychological or emotional symptoms, like racing thoughts, dread, or agitation. So they might not be the best option for someone whose anxiety manifests primarily in the mind.\u00a0<\/span><\/p>\n

When it comes to adverse effects, \u201cboth medications carry potential, often dose-associated, side effects, such as dizziness and bradycardia,\u201d says Dr. Jake Johnson, MD, founder of <\/span>Integral Psychiatry<\/span><\/a>. However, \u201cpropranolol crosses the blood-brain barrier more readily, potentially offering more central nervous system effects,\u201d such as fatigue, dizziness, or sleep disturbances.\u00a0<\/span><\/p>\n

Because of its effects on both the brain and the body, \u201cfor someone who wants something that eases both mental and physical symptoms, propranolol may be a better option,\u201d says <\/span>Dr. Randall Turner, DO<\/span><\/a>, board-certified psychiatrist and medical director at <\/span>Able To Change Recovery<\/span><\/a>. \u201cAtenolol might be preferred for people who want to avoid central side effects like fatigue or fogginess. Propranolol also has a shorter acting, which can be helpful if you only need relief for a few hours.\u201d<\/span><\/p>\n

Neither drug is exceptionally pricey, though. The average retail price for atenolol is $35 for 30, 25 mg tablets, while propranolol typically costs $40 for 60, 10 mg tablets. Health insurance may cover some of these costs if the doctor deems the medication medically necessary. But because anxiety is an off-label use, some plans might not cover it, or require prior authorization first.\u00a0<\/span><\/p>\n\n\n\n\n\n\n
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Side effects of atenolol vs propranolol<\/h3>\n<\/th>\n<\/tr>\n<\/thead>\n

Atenolol<\/span><\/td>\nPropranolol<\/span><\/td>\n<\/tr>\n
\n
    \n
  • Tiredness<\/span><\/li>\n
  • Dizziness<\/span><\/li>\n
  • Cold fingers, toes, hands, and feet<\/span><\/li>\n
  • Depression<\/span><\/li>\n
  • Fatigue<\/span><\/li>\n
  • Shortness of breath<\/span><\/li>\n
  • Nausea<\/span><\/li>\n
  • Diarrhea<\/span><\/li>\n
  • Feeling faint when standing up<\/span><\/li>\n
  • Vivid dreams<\/span><\/li>\n
  • Low blood sugar<\/span><\/li>\n<\/ul>\n<\/td>\n
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