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Social Anxiety and beta-blockers

Posted by Susan on April 21, 1999 at 19:51:11
I have always suffered with social anxiety in particular situations. I am in college, and the situations which cause me to have excessive anxiety are many. Not only do I experience dread and apprehension at the thought of speaking/participating in class, but my heart also pounds uncontrollably when I am required to speak in public. I started taking Zoloft to control the anxiety (4 weeks ago), but my heart still races--up to 130bpm. My doctor gave me Atenolol(25mg) to take as needed, and I notice a wonderful decrease in the physical symptoms of my anxiety when I take it. Also, I've always been concerned with a generally high pulse rate;It is frequently at 100bpm at rest. My doctor says that it's possibly anxiety related.  I've been taking the Atenolol over the last few days when I don't have a perfomance issue because it brings my pulse down into the 80's. I like it because I don't have that sense of awareness about my heart--it's not pounding while I'm just sitting and relaxing. A friend recently told me that beta-blockers can be dangerous, and that I should rethink taking them. Now I'm worried. Have I made a mistake in taking them for non-preformance related heart racing? What are the dangers of Atenolol? Are there specific concerns for taking a beta-blocker on an as-needed basis? Thank you for any information.

Posted by HFHS.MD.D.E. on April 27, 1999 at 09:55:19
Dear susan;
The two most widely used medications for specific social phobia associated with performance situations are Atenolol and Propranolol.  These medications are also indicated for hypertension,cardiac disease and certain types of arrythmias and can help with the physical symptoms (heart racing) in patients with social phobia. The potential side effects include fatigue, nightmares,and bradycardia. If you have undergone a thorough medical evaluation and were given clearance by your primary care physician, then there should be no reason for concern. You might discuss with your physician the reasons for your rapid heart rate, which can be secondary to a number of underlying diseases such as thyroid disease. Atenolol is an appropiate medication for performance anxiety and it seems that it has been of help to you. For patients with generalized social phobia, antidepressants such as Zoloft are the treatment of choice. You have only been on Zoloft for 4 weeks and it might take longer than that for you to start feeling the benefits of this medication. I hope this information was helpful to you. It is however intended for general information only and is not a substitute for a medical consultation.
Key words: Socail phobia/performance anxiety/atenolol/propranolol

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