UK health authorities are initiating a review into the safety of propranolol, a beta-blocker commonly prescribed for heart conditions but also used off-label to manage anxiety symptoms. The move comes after leading medical bodies raised alarms following a significant increase in intentional overdoses and related deaths.
Experts from the Royal College of Physicians and the Royal College of Pharmacy have called for an end to prescribing propranolol for anxiety, arguing that it lacks proven efficacy for generalized anxiety and that its risks outweigh its benefits. Data from 2022-2023 revealed over 300 intentional overdoses of the drug in the UK, resulting in 12 fatalities. The drug safety watchdog, the Medicines and Healthcare Products Regulatory Agency (MHRA), will now examine the available data on the harms and overdose risks associated with propranolol.
The review occurs as prescriptions for the medication have surged, particularly among younger demographics. In the last decade, prescriptions for propranolol increased by more than 92% for girls aged 12 to 17, reaching 1.1 million in 2025. Prescribing rates also saw an 81% rise among women aged 18 to 23 over the same period. The primary reason for these prescriptions was anxiety treatment.
While not officially recognized by the National Institute for Health and Care Excellence (NICE) as a treatment for mood disorders, doctors can prescribe beta blockers off-label. The experts suggest that general practitioners may have been led to believe that beta blockers are less risky than alternatives like benzodiazepines. However, they emphasized that exceeding recommended doses of propranolol can lead to life-threatening poisoning that is difficult to treat and has a significant mortality rate. Concerns were also raised about the continued prescription of propranolol to patients at increased risk of overdose, including those taking antidepressants.
Propranolol, which works by slowing the heart rate, is typically prescribed for high blood pressure and other cardiac issues. It can help mitigate the physical manifestations of anxiety, such as sweating and shaking. Celebrities, including Emma Watson, Khloe Kardashian, Dame Prue Leith, Robert Downey Jr., and Rachel Sennott, have publicly shared their experiences with taking beta blockers for performance anxiety or stage fright. Watson has stated she regrets using the medication for red carpet nerves and took a break from acting to protect her immune system.
Experts caution that beta blockers are not suitable for everyone. Common side effects include fatigue, dizziness, and fainting. Inappropriate or high doses can cause a dangerously slow heart rate. The risks are amplified when medications are obtained from unregulated sources. Furthermore, the long-term use of beta blockers for anxiety has been questioned, with recommendations for short-term use only. Abruptly stopping propranolol can lead to adverse effects, including irregular heart rate and increased sweating and shaking, and may exacerbate existing heart problems. Individuals with conditions like asthma or COPD may face higher risks and should consult their doctors before taking the medication.