What Doctors Want You to Know About Beta Blockers for Anxiety

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Start-ups are making it easier to get the pills online, but experts warn they should be used with caution.

Anxious ahead of a big job interview? Worried about giving a speech? First date nerves?

The solution, some digital start-ups suggest, is a beta blocker, a type of medication that can slow heart rate and lower blood pressure — masking some of the physical symptoms of anxiety.

Typically a trip to the doctor’s office would be necessary to get a prescription, but a number of companies are now connecting patients with doctors for quick virtual visits and shipping the medication to people’s homes.

“No more ‘Shaky and Sweaty,’” one online ad promised. “Easy fast 15 minute intake.”

That worries Dr. Yvette I. Sheline, a professor of psychiatry at the University of Pennsylvania Perelman School of Medicine.

“The first question is: What is going on with this person?” Dr. Sheline said. Are they depressed in addition to anxious? Do they have chronic anxiety or is it just a temporary case of stage fright? “You don’t want to end up prescribing the wrong thing,” she added.

In addition, although beta blockers are generally considered safe, experts say they can carry unpleasant side effects and should be used with caution.

Beta blockers such as propranolol hydrochloride have been approved by the Food and Drug Administration for chest pain, migraine prevention, involuntary tremors, abnormal heart rhythms and other uses.