A little blue pill is making waves in Hollywood, but it's not Viagra. Propranolol, a beta blocker originally designed for heart conditions, is now being used by celebrities to calm nerves before red carpet events, award ceremonies, and even first dates. Actors such as Kristen Bell, Rachel Sennott, and Natasha Rothwell have mentioned taking beta blockers this year, following in the footsteps of Khloé Kardashian and Robert Downey Jr., who quipped at the Golden Globes: 'I took a beta blocker, so this will be a breeze.'
Beta blockers like propranolol were developed in the 1960s to treat heart conditions such as high blood pressure, arrhythmias, and angina. Doctors soon discovered they also helped with migraines and an overactive thyroid. Their anxiety-reducing properties were first noted in 1965 during clinical trials for hyperthyroidism. While propranolol is licensed to treat anxiety in the UK, it is often prescribed off-label in the US, where it remains unapproved by the Food and Drug Administration.
These drugs work by blocking adrenaline's effects on beta receptors in the body, slowing the heart rate and reducing physical symptoms of anxiety such as trembling, sweating, and a racing heart. However, research on their effectiveness is mixed. Some studies show significant reductions in anxiety compared to placebos, while a recent review found limited evidence that propranolol outperforms other anxiety medications, with many trials being small and low-quality.
Unlike benzodiazepines such as Valium, propranolol is not addictive and carries a low risk of dependence. Common side effects include dizziness, fatigue, cold hands and feet, and vivid dreams, while rare but serious risks include heart failure, breathing difficulties, and allergic reactions. It is unsuitable for people with asthma, diabetes, or certain heart conditions. Cases of overdose have also been reported, which can cause dangerously slow heart rates, seizures, and breathing difficulties.
Doctors increasingly prescribe propranolol for anxiety, viewing it as a pragmatic, low-risk option for patients facing long waiting lists for therapy or reluctant to take antidepressants. However, it only targets the physical symptoms of anxiety, not the underlying psychological causes. It may help with public speaking or exam nerves, but it does not address persistent worry or panic attacks. As such, it is best used as a short-term aid rather than a long-term solution.
