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How to stop taking propranolol for anxiety

Propranolol should be gradually stopped under supervision from your healthcare provider - here’s why
Leandra Beabout
By | Jan. 6, 2025 Medically reviewed by Leslie Greenberg, MD
Rx bottle: How to stop taking propranolol for anxiety

Key takeaways

  • Propranolol is a beta blocker sometimes prescribed off-label for anxiety.

  • Abruptly discontinuing propranolol can cause withdrawal side effects such as rebound anxiety and heart problems.

  • Even low doses of propranolol should be weaned under the guidance of a healthcare professional.

  • If propranolol is not effectively treating your anxiety, talk to your healthcare provider about trying one of the many other anxiety treatments available.

In this article:

Propranolol is a generic beta blocker also sold under the brand names Inderal, InnoPran, and Hemangeol. It is approved by the Food and Drug Administration (FDA) to treat high blood pressure, fast heartbeats, and essential tremor (ET). Because it suppresses the central nervous system’s “fight or flight hormones,” propranolol is sometimes prescribed off-label for anxiety, especially performance anxiety, social anxiety, panic attacks, and situational anxiety, such as fear of flying. 

Of course, people on propranolol to treat anxiety might wonder when and how to stop taking it. The best way to quit propranolol is to work with your healthcare provider to plan how to taper dosage and prevent potential withdrawal symptoms.

What happens if you stop taking propranolol?

The primary outcome of stopping propranolol for anxiety is that you will no longer experience the beneficial effects of the medication. When propranolol is prescribed for anxiety, it is intended to reduce physical symptoms such as tremors, a racing heart, and elevated blood pressure. 

People on propranolol for anxiety are generally not prescribed high doses. However, it’s still a good idea to taper dosage to avoid unpleasant withdrawal-like side effects, says Sid Khurana, MD, a board-certified psychiatrist and co-founder of Nevada Mental Health in Las Vegas. 

Side effects of propranolol discontinuation may include:

The good news is that gradually decreasing the dose for a couple of weeks has been shown to prevent these withdrawal effects.

Exactly when to stop taking propranolol for anxiety depends on the person, according to Dr. Khurana. Seek medical advice from a primary care provider or mental health professional who knows your medical history. For some people, propranolol discontinuation is recommended when the underlying cause of anxiety has been addressed or removed. In other cases, a person might stop taking propranolol because there is a better anxiety treatment available to them or because propranolol is not reducing their anxiety symptoms. “Someone’s anxiety may actually be cured, too, and it may be time to wean them off,” Dr. Khurana says. 

Can you stop taking propranolol cold turkey?

It is not recommended to stop taking propranolol cold turkey. Beta blockers like propranolol dampen the body’s “fight-or-flight” hormone surges so that the heart beats more gently and slowly. Abruptly removing propranolol can cause increased blood pressure, rapid or irregular heartbeat, and agitation or irritability, per Dr. Khurana.

Stopping propranolol abruptly can also cause withdrawals, says Inna Melamed, Pharm.D., a functional medicine practitioner and author of Digestive Reset. “Withdrawal symptoms include an increase in blood pressure, chest pains, fast heartbeat, more anxiety and even heart attacks.”

Propranolol dosage should be weaned, not discontinued abruptly. The consequences of quitting propranolol cold turkey include a risk of hypertension, heart issues, and rebound anxiety. 

How to stop taking propranolol for anxiety

Remember, propranolol dosage should be tapered under the guidance of a healthcare provider. The good news is that weaning patients off propranolol doesn’t take long. “I can typically do it in two weeks,” says Dr. Khurana. “Generally, I will reduce the dose by one-half for one week. If they are tolerating it well, I will reduce it another quarter the next week, then take the last part off at the end of that second week.”

For example, a patient taking 100 milligrams (mg) of propranolol daily would reduce their dose to 50 mg daily for one week and 25 mg the following week. The drug would be entirely discontinued in the third week. 

It’s important to understand that the exact tapering schedule varies from person to person. Dr. Khurana suggests that the dosage also varies based on a person’s other medications and the severity of their anxiety symptoms. 

What to know about rebound anxiety

Not everyone experiences rebound anxiety, or a resurgence of anxiety symptoms, after quitting propranolol. Some people discontinue anti-anxiety medication because they no longer need it or because they are switching to a different anxiety treatment or their other anti-anxiety medication can work effectively alone.

To people who do experience a return of anxiety symptoms, Dr. Khurana says it’s important to consult a mental health provider about managing your anxiety and planning out your next steps. “Crisis sometimes gives an opportunity to take a slightly deeper look at what is bringing on the anxiety and how, this time around, you might be able to create a treatment plan that goes more to the root of the problem,” he says.

Propranolol alternatives for anxiety

Propranolol isn’t the only drug used to treat anxiety. It’s not even the most common anxiety treatment.

Alternative anxiety medications

Common anxiety medications include:

These medications have different side effect profiles, contraindications, and warnings. They may be more appropriate than propranolol depending on a person’s other medical conditions (certain heart conditions or low blood pressure, for instance) and individual situations (being pregnant or breastfeeding, for example). 

Non-pharmacological alternatives

There are also non-pharmacological options such as cognitive behavior therapies (CBTs), hypnotherapy, and “nutraceuticals including valerian root, kava kava, GABA with l-theanine, and more,” says Dr. Melamed. She adds that magnesium — specifically magnesium l-threonate and magnesium glycinate — can also have a calming effect similar to propranolol.

CBT is considered a first-line therapy for anxiety because sessions are focused on identifying and systematically restructuring negative thoughts and behaviors. CBT treatments might also involve controlled exposure therapy for people with specific triggers for panic attacks.

As for supplements, placebo-controlled studies on over-the-counter remedies and herbs for anxiety are limited. Supplements don’t work like propranolol, and their quality and efficacy might vary from brand to brand. It’s a good idea to consult a healthcare provider before taking any new anxiety medication, even an over-the-counter supplement, especially if you are also taking other medications. 

The bottom line

Propranolol is sometimes prescribed to treat the physical symptoms of anxiety: tremors, rapid heart rate, and high blood pressure. People taking propranolol for anxiety should consult their healthcare provider before discontinuing this medication. Quitting propranolol cold turkey can cause rebound anxiety and withdrawal symptoms. In most cases, propranolol can be successfully tapered and then discontinued in a matter of weeks. Communicating regularly with your healthcare provider throughout the weaning process is essential.