Sometimes, if the anxiety is not caused by cognitive dysfunction (including fatigue). It may be the physical response people find uncomfortable, the effects of trembling hands and breaking out in sweat. Propranolol can be bought to use off label to reduce tremors. Musicians famously used it to do live gigs, but they also said the reduction in physical anxiety made their performance “flat”. Basically – well worth a shot, but don’t expect anything strong. Propranolol does nothing for anxiety and panic’s psychological effects.


– Khemcorp

What are Beta Blockers?

Beta blockers are beta-adrenergic blocking agents which prevent the stimulation of the adrenergic receptors responsible for increased cardiac action. The resulting action of beta blockers is the vasodilation effects on blood vessels. This is the property that makes this drug suitable to treat conditions such as high blood pressure, irregular heart rhythm, congestive heart failure, angina, glaucoma, and migraines.

“Brianna is a 22 year old aspiring actress whose talent was discovered from the young age of 10. She imitated her favorite cartoon characters and would dance and sing to the delight of her family, teachers and friends. It was no surprise at all when she went off to acting school at a college for the Performing Arts. Brianna’s coach however noted that she did not audition well for leading roles. The extroverted, vivacious acting student would become shy, nervous and hesitant. In an attempt to understand why this was happening he scheduled a meeting with Brianna. In the conversation with Brianna her coach shared his observation with her and Brianna broke down in tears. She explained that she was trying her best but did indeed feel nervous before auditions. She further explained that her hands would shake, heart pound and palms sweat. Relieved that he was right about the diagnosis he reassured Brianna that what was happening to her is called “stage fright” also called “performance anxiety”. This type of anxiety is actually not unusual among aspiring actors and performers and could be treated with therapy. He then refers Brianna to a therapist and after a few sessions and a short course of medication called propranolol (a beta blocker) the star qualities in Brianna begin to emerge to the delight of her acting coach. The new Brianna is confident and composed. Her future as an actress looks bright.”

Propranolol a Popular Beta Blocker

Propranolol is a well-known beta blocker used for the treatment of high blood pressure. There are newer beta blockers that have entered the market and these have more selective actions and, in general, are more efficacious. Propranolol is still however widely prescribed by doctors for the treatment of the conditions previously listed. Propranolol has been gaining popularity for the treatment of physical symptoms which result from anxiety.

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Stage Fright – Beta Blockers for Social Anxiety

Stage fright is a type of social anxiety disorder. It is an uncontrollable nervousness which happens before or during an appearance before an audience. Public speaking has been named by some adults as their most dreaded fear. The symptoms of stage fright can be paralyzing thereby ruining a performance. The actor with performance anxiety experiences:

  • Tremors
  • Shaking
  • Sweating
  • Difficulty with movement
  • In extreme cases, persons can become violently sick with nausea and vomiting

Experiences of Those Who Use Propranolol for Stage Fright

Reviews have been mostly positive from persons who prescribe propranolol for their patients or from persons who have used propranolol for performance anxiety. In reviews on propranolol used for performance anxiety the calming of the jitters and “butterflies” is dramatic. Confidence grows before performances once the physical symptoms of anxiety are controlled

For adults, the suggested starting dose is 10 mg an hour before the speaking engagement or the performance. Some performers need much higher doses, but this must be done in conjunction with their doctor.

Many reviewers reported that propranolol was very effective and they had no or minimal side effects Mild side effects included lightheadedness.

A Word of Caution

Propranolol should not be used by asthmatics, persons with known allergy to propranolol or by persons who have a very slow heart rate (bradycardia). We also do not recommend that you take propranolol if you are pregnant or breast feeding your baby.

Alcohol can increase the blood levels of propranolol and so you should avoid drinking alcohol. Propranolol can decrease blood pressure and so when sitting up or standing don’t do so abruptly.

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Tips for Reducing Stage Fright

  1. Cognitive-behavior therapy is very helpful to overcome the fear of public speaking or performance. Persons are coached to:
    1. Affirm your talent and preparedness for the public speaking engagement or the performance. “I can do this!” and “I will get this done!” are great affirmations.
    2. Recognize negative self-talk of “what if I am not good” or “what if they don’t like the performance” and gently replace those thoughts with affirmations.
    3. Utilize deep breathing techniques to help you relax. Inhale through the nostril and exhale slowly through the mouth.
    4. Be well prepared and the only way is to practice, practice and more practice. Use a mirror to assist you as you practice.
    5. Visualize the end. See how please you are at the end of the speech or performance. Hear the accolades that are given to you. Feel the energy of your audience.
    6. Acceptance that even the most accomplished artist/performer still gets jitters occasionally. Also, accept that not every performance will be brilliant.
    7. Connect with the audience to feel grounded. Make eye contact with persons in the audience.
    8. Avoid caffeine and alcohol before a performance. Do not drink cold beverages just before a speaking engagement or singing performance as the vocal cords can tighten up.
    9. Eat well and have a balanced meal 2-3 hours before the event. Keep it light so you are not sluggish or too full for comfort.
    10. A good night’s rest before an event is always a good practice for clarity of thought and better physical performance.


  1. Natural remedies

There are herbal teas that have a calming effect such as chamomile. Omega 3 fatty acids and L-lysine are supplements which can help.

  1. Medication
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Ask your doctor about using beta blockers such as propranolol to reduce nervousness and tremors. It is important to use the medication exactly as your doctor has prescribed it. Your doctor will ensure that there are no contraindications that would make you excluded from using the drug. It may become necessary for you to take anxiolytic medications such as diazepam. Never self-medicate and always be under the care of a physician.


Even for the worst case of performance anxiety medication and relaxation therapy should result in improvement over time. Do not hesitate to get help for stage fright as your future depends on the action you take now.

– Third Party Writer, Not from Khemcorp