[pshrinkery, med] Q re propranolol (Inderal) for anxiety
MDs, pharmacists, other Rx'ers, and medicine geeks: Is there some reason that propranolol is not more widely prescribed for anxiety? Like, in my reality, at all?
I have a patient who is elderly, had a bad reaction to benzodiazepines such that nobody sane will ever prescribe them to her, and raging agoraphobia. Her psychiatrist has only offered her SSRIs in replacement, and they're not helping; he's kind of thrown up his hands and given up. Is there some reason the psychiatrist hasn't suggested trying propranolol?
I have had lots of patients present to their psychiatrists with anxiety, many winding up in tension with their prescriber over benzodiazepines, many on meds where there was an interaction that made benzos counterindicated, and in not one case I've been involved with has a psychiatrist ever offered the patient a beta blocker.
Not even when I knew that the patient had hypertension.
What gives? I've heard such good things about propranolol for performance anxiety - the patient rating over on drugs.com is a whopping 9.6 out of 10 (N=190). I'm under the impression it isn't habit forming; it's not a controled substance; the adverse effects profile looks safer than the tricyclic antidepressants; random people on the internet suggest there's less issue with developing a tolerance to it than to benzos. Why isn't this being given out like candy? Or at least in favor of benzos?
I have a patient who is elderly, had a bad reaction to benzodiazepines such that nobody sane will ever prescribe them to her, and raging agoraphobia. Her psychiatrist has only offered her SSRIs in replacement, and they're not helping; he's kind of thrown up his hands and given up. Is there some reason the psychiatrist hasn't suggested trying propranolol?
I have had lots of patients present to their psychiatrists with anxiety, many winding up in tension with their prescriber over benzodiazepines, many on meds where there was an interaction that made benzos counterindicated, and in not one case I've been involved with has a psychiatrist ever offered the patient a beta blocker.
Not even when I knew that the patient had hypertension.
What gives? I've heard such good things about propranolol for performance anxiety - the patient rating over on drugs.com is a whopping 9.6 out of 10 (N=190). I'm under the impression it isn't habit forming; it's not a controled substance; the adverse effects profile looks safer than the tricyclic antidepressants; random people on the internet suggest there's less issue with developing a tolerance to it than to benzos. Why isn't this being given out like candy? Or at least in favor of benzos?