What is propranolol used to treat?

Propranolol has a wide range of medical uses, from hypertension to performance anxiety.


What is propranolol?

Propranolol is a 1st generation beta-blocker that originally was marketed as Inderal but is now available in generic form.  Propranolol has been around since the 1960s and today has a wide range of uses.  The British scientist, J. W. Black, who first developed propranolol, received the 1988 Nobel Prize in medicine for his work.

Different uses require different doses and treatment durations.  Therefore, propranolol is available as tablets, capsules, and liquid solutions, in doses ranging from 10 mg to 160 mg (with extended-release formulations).  It’s even available as an intravenous solution for direct injection into the bloodstream. Propranolol is one of the 50 most prescribed drugs in the United States.  

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Propranolol as hypertension treatment

Helping treat patients with high blood pressure (hypertension) was the original purpose of propranolol.  Propranolol works by blocking adrenaline’s constricting effect on blood vessels, which allows them to widen and allow more blood to pass through. This widening of blood vessels reduces a person’s blood pressure. Until the mid-2000s, propranolol was often a physician’s first treatment choice for hypertension.  Nowadays, propranolol has fallen out of favor, as there are more effective hypertension treatments available. This is particularly true for elderly patients, based on the concern that long-term use of beta-blockers may raise a patient’s risk of developing type-2 diabetes.


Propranolol as a treatment for other cardiovascular issues

Beta-blockers are used in the treatment of an irregular heartbeat (cardiac arrhythmias) and angina pectoris (chest pain because of insufficient blood flow to the heart muscle). They are also prescribed as a preventative treatment after a person has suffered a heart attack. 


Propranolol as a treatment for performance anxiety

A common use of propranolol today is to treat performance anxiety (stage fright, test anxiety, etc.). It’s not entirely clear why it works, other than by blocking adrenaline and lowering blood pressure, but propranolol has a good track record as a one-off treatment for performance anxiety.  It helps that the drug is fast-acting:  the effect starts 30 to 60 minutes after taking a pill.  The consensus in the medical community now holds that propranolol is a better choice than benzodiazepines (such as Valium and Xanax) because — when used infrequently — it has fewer side effects and is not plead tto addiction.


Propranolol as a treatment for tremors

When treating essential tremors, propranolol is common therapy choice for doctors, as it reduces the amplitude of tremors in up to 70% of cases. Propranolol is most effective for treating tremors in the upper and lower limbs and less successful in treating the rarer head and voice tremors.


Propranolol as a migraine treatment

Regular use of propranolol can lower the occurrence and intensity of migraines and cluster headaches.  It doesn’t help against ongoing migraines and headaches like painkillers would, but it can lower your chances of getting a headache in the first place. This effect is due to propranolol’s blood pressure-lowering property. Of course, this only applies to migraines and headaches that are blood pressure-related.  This also means that people who get fewer migraines because of using propranolol, in most cases, would get fewer migraines if they were using other medications that lower blood pressure.    


Propranolol as a treatment for hyperthyroidism symptoms

The symptoms of hyperthyroidism (excessive production of thyroid hormone) can be treated with propranolol and other common beta-blockers.  While beta-blockers won’t treat the underlying hormonal condition, they can effectively alleviate the symptoms, which usually include tremmors, palpitations and anxiety.  In the case of propranolol, there is only a modest effect on thyroid-related symptoms, so that it is not normally prescribed for this purpose.  


Propranolol as a treatment for post-traumatic stress disorder and phobias

Recent research has shown that propranolol may be effective in treating post-traumatic stress disorder (PTSD) and phobias, as the drug blocks norepinephrine, a neurotransmitter responsible for memory consolidation. Propranolol also appears to reduce the emotional impact of already formed (consolidated) memories, like a fear of spiders or flying. However, more research will be needed to establish whether propranolol can actually cure such phobias.



  1. Srinivasan, AV. “Propranolol: A 50-Year Historical Perspective.” Annals of Indian Academy of Neurology, vol. 22, no. 1, 29 July 2020, p. 21, 10.4103/aian.aian_201_18.
  2. Zhang, Manyu, et al. “Oral Propranolol for Treatment of the Subgroups of Essential Tremor: A Systematic Review and Meta-Analysis Protocol.” BMJ Open, vol. 10, no. 1, Jan. 2020, p. e032096, 10.1136/bmjopen-2019-032096. Accessed 29 July 2020.
  3. Steenen, Serge A, et al. “Propranolol for the Treatment of Anxiety Disorders: Systematic Review and Meta-Analysis.” Journal of Psychopharmacology, vol. 30, no. 2, 20 Oct. 2015, pp. 128–139,, 10.1177/0269881115612236. Accessed 29 July 2020.
  4. Linde, Klaus, and Karin Rossnagel. “Propranolol for Migraine Prophylaxis.” The Cochrane Database of Systematic Reviews, vol. 2017, no. 2, 17 Feb. 2017,, 10.1002/14651858.CD003225.pub3. Accessed 29 July 2020.

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