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How long does it take for propranolol to work?

How long does it take for propranolol to work?

Propranolol for anxiety works within two hours. The extended-release propranolol takes slightly longer to kick in, but the effects will last longer.

Reviewed by:
Austin Lin, MD
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April 29, 2024
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Key takeaways

Propranolol is a beta-blocker that is sometimes prescribed to treat physical symptoms of anxiety. You may also hear propranolol called Inderal, which is its brand name. If you've been prescribed propranolol, you're likely curious about when you can expect it to take effect. The good news is that it typically starts working within a 1-2 hours if you take an immediate-release version.  

Read on to learn about what affects how quickly it works, when you’ll feel its full benefits, and more.


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Propranolol overview

Though beta-blockers like propranolol are primarily used to treat cardiovascular heart conditions like chest pain, hypertension, and irregular heartbeat, scientific studies have shown that propranolol can help relieve physical anxiety symptoms related to generalized anxiety disorder, social anxiety, performance anxiety, and phobias. It works by relaxing blood vessels so blood flows easier through your body, resulting in lowered blood pressure. When a medicine is being prescribed for something other than what it was originally approved for, it’s called an “off-label” use. Off-label use is common and safe as long as you’re taking the medication as prescribed by a health care professional.  

Propranolol is often used for as-needed like when you have performance anxiety or are working through phobia during exposure therapy. The effects are short-lived, so it can be ideal for this kind of situational anxiety. Antidepressants on the other hand, take several weeks to work and  have a more of a preventative effect.

Propranolol timing and effects

Propranolol does not act instantly, but it does kick in pretty quickly. You will likely start to feel the effects of propranolol within about an hour or so of taking it. That’s why doctors typically recommend taking a dose of propranolol long enough before your anxiety-inducing situation that it has time to kick in and make you feel calm. This way, you’ll be able to get through the event without being flooded by anxiety.  

Everyone reacts to medication differently, and it may take a few tries to learn exactly how long it takes for propranolol to work for you. (Other factors can also affect how quickly the drug works—more on that later.) Make sure to ask your doctor exactly when they suggest you take the medication. Studies exploring the effectiveness of propranolol for anxiety have found that the drug is typically taken 1-1.5 hours before the triggering event, such as a performance or exam.

Once propranolol kicks in, you’ll notice your anxiety symptoms lessening: You will feel calming effects, like a slower heart rate, less shakiness and tremors, and reduced sweating. As your physical anxiety symptoms begin to subside, you may notice that your anxious thoughts start to lessen.

Propranolol does not directly impact psychological anxiety symptoms, but if your physical symptoms, like shortness of breath, trigger anxious thoughts, propranolol can indirectly calm down your mind, too. And when you’re not dealing with anxiety’s physical symptoms, you’ll also be better able to use coping skills you learned in therapy to help with its psychological aspects.  

When does propranolol reach its full effects?

After taking propranolol, the medication peaks (reaching the highest level of the drug in your blood) between 1-4 hours. This is when you will feel the full effects of the drug and experience relief from anxiety symptoms, and ultimately, it means that propranolol extended-release takes longer to kick in, but the effects last longer.  

How long does propranolol last?

Propranolol has a half-life of 3-6 hours. The half-life of a medication is the amount of time it takes for the body to metabolize and get rid of half the dose of the drug. That means that propranolol starts to wear off anywhere in this time frame. This means you may need to take propranolol a few times a day as needed. (But remember, if you have anxiety your goal should be to learn how to cope with your anxiety over time so you don’t have to rely on propranolol long-term.)

If you take the extended-release version of propranolol, you’ll reach peak levels of the medication in your blood around six hours after taking it. The half-life of propranolol extended-release is 10 hours.  

Your psychiatrist will help you decide if you are a better fit for the original propranolol or its extended-release form based on your symptoms and what you are using the medication for.  

What affects how quickly propranolol works?

Many factors can influence how quickly propranolol works for you compared to how quickly it works for someone else. That’s why your doctor will typically start you on the lowest dose and then adjust your propranolol dosage time accordingly. They can help you out with any questions related to the timing of dosage—always reach out to them with any concerns.

Here are three factors that influence the response time of propranolol for anxiety.

  • Type of propranolol: There’s a big difference in the onset of regular propranolol versus extended-release capsules. The effects of regular propranolol will kick in much sooner than extended-release  will.
  • Drug metabolism: Everyone metabolizes drugs differently. Some people metabolize certain drugs quickly, while other people may metabolize these drugs more slowly so they take longer to work. Often this is due to genetics.
  • Drug interactions: If you take other medications, it can affect the way propranolol works. For example, taking certain antipsychotic medications may increase the levels of propranolol in the blood. Drinking alcohol can also increase these levels, which could intensify the effects and put you at risk for dizziness, fatigue, and changes to blood pressure. Always let your doctor know about all medications you take so they can consider interactions and safety.  

What if it isn’t working?

If you don’t feel like propranolol is making a difference in your anxiety symptoms, it’s important to talk to your psychiatrist. You should never change or increase the dose of a medication on your own, as this can lead to unwanted or even dangerous side effects.. Keep taking your recommended dose until you are able to speak with your doctor.  

Since propranolol is off-label for anxiety, there is no standardized dose for anxiety from the FDA. Your doctor will help you determine what is the most effective dose for you..  

If propranolol isn’t the right fit for you, even at a higher dosage, your doctor might suggest a different class of medication altogether. There are many types of anxiety medications to choose from, ranging from other fast-acting short-term options like benzodiazepines (such as Xanax or Klonopin) or slower-acting long-term medications like SSRIs (such as Prozac or Zoloft). Sometimes it takes a bit of trial and error to figure out which medication or mix of meds—like a daily antidepressant plus an as-needed beta-blocker—is best for your symptoms.  

Many people experience the most anxiety relief by using a combination of talk therapy along with medication. Therapy can help you learn to identify the root causes of your anxiety, learn to cope with triggers, and create healthier thought patterns.  

If you’re looking for a psychiatrist to provide you with anxiety treatment, consider Talkiatry.  We’re a national psychiatry practice that treats mental health conditions, including different anxiety disorders. Our psychiatrists will work with you to understand your anxiety symptoms and help you find balance. We provide virtual, in-network services so you can get the care you need from home.  

To get started, complete our free online assessment to get matched with a psychiatrist.

FAQs

Here are more detail about how long propranolol takds to work for anxiety.

What is propranolol?

Propranolol is a medication classified as a beta-blocker, commonly prescribed to treat various heart problems and issues, including high blood pressure, arrhythmia, angina, and anxiety. Propranolol works by blocking the effects of adrenaline on the beta receptors, resulting in decreased heart rate and lower blood pressure.

How long does it take for propranolol to work?

The onset of action for propranolol can vary depending on the condition being treated. For conditions such as high blood pressure and heart rhythm disorders, the effects of propranolol may be noticeable within the first hour of taking the medication. However, for conditions like anxiety or migraines, it may take a few days or weeks of consistent use to experience the full benefits of propranolol.

What are the side effects of propranolol?

Common side effects of propranolol include fatigue, dizziness, nausea, cold hands or feet, low blood pressure, and slow heart rate. It's important to note that not everyone experiences side effects, and they may vary in  from person to person. Consulting with a healthcare professional can provide personalized information and guidance regarding potential side effects.

Are there alternatives to propranolol?

There are other anxiety medications available for conditions out there to take instead of propranolol. Alternatives may include benzodiazepines,  and antidepressants, like SSRIs and SNRIS. It is essential to discuss alternatives with a healthcare provider who can evaluate your needs and consider factors like medical history, co-existing medical conditions, and potential drug interactions.

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Frequently asked questions

Does Talkiatry take my insurance?

We're in network with major insurers, including:

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The best way to get a detailed estimate of your cost is to contact your insurance company directly, since your cost will depend on the details of your insurance.  

For some, it’s just a co-pay. If you have an unmet deductible it could be more.  

Call the number on your insurance card and ask about your plan’s coverage for outpatient psychiatric services.

How does Talkiatry compare to face-to-face treatment?

For most patients, Talkiatry treatment is just as effective as in-person psychiatry (American Psychiatric Association, 2021), and much more convenient. That said, we don’t currently provide treatment for schizophrenia, primary eating disorder treatment, or Medication Assisted Treatment for substance use disorders.

What kind of treatment does Talkiatry provide?

At Talkiatry, we specialize in psychiatry, meaning the diagnosis and treatment of mental health conditions. Your psychiatrist will meet with you virtually on a schedule you set together, devise a treatment plan tailored to your specific needs and preferences, and work with you to adjust your plan as you meet your goals.

If your treatment plan includes medication, your psychiatrist will prescribe and manage it. If needed, your psychiatrist can also refer you to a Talkiatry therapist.

What's the difference between a therapist and psychiatrist?

Psychiatrists are doctors who have specialized training in diagnosing and treating complex mental health conditions through medication management. If you are experiencing symptoms of a mental health condition such as depression, anxiety, bipolar disorder, PTSD, or similar, a psychiatrist may be a good place to start.  

Other signs that you should see a psychiatrist include:  

  • Your primary care doctor or another doctor thinks you may benefit from the services of a psychiatrist and provides a referral    
  • You are interested in taking medication to treat a mental health condition  
  • Your symptoms are severe enough to regularly interfere with your everyday life

The term “therapist” can apply to a range of professionals including social workers, mental health counselors, psychologists, professional counselors, marriage and family therapists, and psychoanalysts. Working with a therapist generally involves regular talk therapy sessions where you discuss your feelings, problem-solving strategies, and coping mechanisms to help with your condition.

Who can prescribe medication?

All our psychiatrists (and all psychiatrists in general) are medical doctors with additional training in mental health. They can prescribe any medication they think can help their patients. In order to find out which medications might be appropriate, they need to conduct a full evaluation. At Talkiatry, first visits are generally scheduled for 60 minutes or more to give your psychiatrist time to learn about you, work on a treatment plan, and discuss any medications that might be included.

About
Austin Lin, MD

Dr. Austin Lin is a double board-certified adult and addiction psychiatrist who has been in practice for over 9 years. At the center of Dr. Lin’s clinical approach is a strong emphasis on establishing trust and using a collaborative approach to help patients develop an individualized and cohesive plan so that they are able to achieve their goals.

Dr. Lin's practice focuses on medication management. Typically, he offers this in conjunction with supportive therapy, motivational interviewing, and/or cognitive behavioral therapy in 30-minute follow-up visits. Occasionally, Dr. Lin may recommend that additional therapy is needed and ask that you bring a therapist into your care team in order to provide the best outcome.

Dr. Lin received his medical degree from St. George’s University School of Medicine. He went on to complete his residency in psychiatry at Harvard South Shore, an affiliate of Harvard Medical School, where he served as Chief Resident and earned his 360° Professionalism award. He then had additional training in Addiction Psychiatry through his fellowship at the University of Texas Southwestern Medical Center. After completing training, Dr. Lin has worked as an Addiction Psychiatrist and Director of Adult Services in the Trauma and Resilience Center (TRC) at the University of Texas Health Science Center at Houston (UTHealth). He specialized in treating patients with a history of depression, anxiety, trauma, and substance use disorders.

Dr. Lin has held an academic appointment at UTHealth, and he has spent his professional career supervising and teaching medical students and psychiatry residents.



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