Can Metoprolol be used for anxiety?

This blog answers the question “Can metoprolol be used for anxiety?”

The blog also briefly touches upon what Metoprolol is, it’s use, side effects, and precautions to be taken related to use.

Can Metoprolol be used for anxiety?

Yes, Beta blockers such as Metoprolol can be used to treat the physical symptoms of anxiety however, this class of drug has no recorded effect on the psychological symptoms of anxiety. 

This means that while the drug metoprolol can be used to reduce anxiety physical; symptoms like rapid heart rate, it does not relieve or alleviate psychological symptoms such as rumination, or avoidance behaviours related to anxiety. 

One of the first studies that explored the effectiveness of beta-blockers such as metoprolol for anxiety treatment was a study that consisted of 15 out-patients suffering from moderate levels of Anxiety who had been affected between 1-12 months were prescribed metoprolol for 2 to 6 weeks.

During the course of this study, only a few reported side effects related to the drug, and by the end of the study the researcher found that there was significant improvement of physical or somatic symptoms of anxiety in the participants. 

While the researcher of this study did not report any effects of the drug on psychological symptoms of anxiety, the researcher speculated that with the reduction of psychical symptoms, there is a possibility that there can be a reduction in thoughts and feelings related to anxiety. 

Another study also found that metoprolol and other beta-blockers is best for managing short term anxiety and not necessarily long term treatment for anxiety. 

In this study that consisted of 90+ participants who were to undergo surgery, some of the patients were given the drug 1-3 hours before the procedure and it was reported that patients who were given the drug were less anxious as compared to the ones who were not given the drug. 

This finding led to researchers to believe that Beta-blockers work best for managing short-term anxiety before specific events rather than a long term pharmacological treatments for 

A 2016 review of studies on propranolol which is another form of beta-blockers also stated that the use of beta blockers, short term use, had similar effects as other medications used to treat anxiety disorders, especially similar to Benzodiazepines. 

The study also suggested that it could be possible that beta-blockers could be a better form of treatment than Benzodiazepines because Benzodiazepines has a wide range of side effects, and puts some groups of individuals at a higher risk of addiction or dependency to the drug.

When it comes to specific anxiety disorders such as social anxiety disorder, the review s state that the results are not promising- meaning that either there is more research to be done in this area or that the research that has already been done so far doesn’t show much promise for the treatment of social anxiety with beta-blockers such as Metoprolol. 

This is also the same for another anxiety disorder- panic disorder. An initial review of beta-blockers on anxiety found that beta blockers do not seem to have reported much efficacy for the case of panic disorder. The review pushed what has already been reported by other researchers- that beta-blockers give somatic symptom relief. 

What is metoprolol?

Metoprolol is a beta-blocker that is commercially sold with the brand names Kap Spargo Sprinkle, Lopressor, Toprol-XL. 

This drug is a beta-blocker that affects the heart and circulation by dilating the heart vessels to lower blood pressure and it is also used to treat chest pain. 

Metoprolol or Beta-blockers work by preventing or blocking norepinephrine (adrenalin) from affecting the beta receptors in blood vessels and in the heart- thus known as a “beta-blocker”. 

By doing this, the blood vessels relax thus reducing the heart rate and decreasing the need for oxygen and in turn reduces blood pressure and chest pain. 

Metoprolol comes in two forms: extended release or immediate release tablets and capsules. It can also come in the form of an injectable but only for healthcare providers- hospitals and clinics.

What are the uses of Metoprolol?

Metoprolol is used, either alone or in combination with other medications, to treat high blood pressure. 

The drug is also used to prevent angina or chest pain as well as to improve recovery after a heart attack. 

While these are the approved uses of metoprolol by governing bodies, it is also possible that metoprolol has other “off-label” uses such as it being used for anxiety.

How to use Metoprolol?

When it comes to the dosage of Metoprolol, it is important that you follow the doctor’s instructions strictly regarding dosage, timing of dosage, and other relevant instructions related to safe use. 

It is important to take the drug with food or right after a meal since this food can cause digestion due to its reaction with the stomach so, by taking the drug with a meal, it is easier to digest.

Don’t crush the extended-release tablet however, you can cut the immediate release tablet. You can cut both forms of the tablet along the groove marks of the tablet in case the doctor recommends a smaller dose. 

What are the side effects of Metoprolol?

Like any other drug, Metoprolol has various side effects to its use. 

The more common side effects that can occur with metoprolol include:

  • tiredness
  • dizziness
  • diarrhoea
  • constipation
  • breathing problems such as shortness of breath, cough, and wheezing
  • bradycardia (heart rate that’s slower than normal)
  • reduced interest in sex
  • rash

Usually these side effects tend to be mild and they may go away within a few days or a couple of weeks. However, if they become more severe or don’t go away, talk to your doctor immediately.

Serious side effects and their symptoms that call for immediate medical aid or attention can include the following:

  • Low blood pressure (hypotension). Symptoms can include:
  • severe dizziness
  • lightheadedness
  • fainting
  • Cold hands and feet that may be painful
  • Very slow heart rate (severe bradycardia)
  • Extreme fatigue that gets progressively worse each day

It is also possible that this particular drug can lead to psychological side effects with symptoms that include:

  • feelings of sadness or anxiety
  • feelings of hopelessness or worthlessness
  • lack of interest in hobbies you once enjoyed
  • eating too much or too little
  • trouble concentrating
  • Disrupted sleep patterns.

What are the precautions you should take to use Metoprolol?

Here are a few things to keep in mind before you consider taking Metoprolol, make sure that you inform your doctor if:

  • You are allergic to metoprolol, acebutolol (Sectral), atenolol (Tenormin, in Tenoretic), betaxolol, bisoprolol (Zebeta, in Ziac), carvedilol (Coreg, Coreg CR), esmolol (Brevibloc), labetalol, nadolol (Corgard, in Corzide), pindolol, propranolol (Inderal, Inderal LA, Innopran XL, in Inderide), sotalol (Betapace, Betapace AF, Sorine), timolol, any other medications, or any of the ingredients in metoprolol tablets. 
  • You have heart related conditions such as slow heart rate problems with blood circulation, heart failure, high blood pressure etc. 
  • tell your doctor if you have or have ever had asthma or other lung diseases
  • If you have liver disease
  • If you have diabetes
  • If you have hyperthyroidism
  • If you are pregnant or planning to get pregnant or breastfeeding. 
  • if you are having surgery, any surgical procedure shortly/
  • Do not drive a car or operate machinery after you take the drug as it can cause sleepiness. 
  • Avoid alcohol and other drugs since alcohol can add to the drowsiness caused by this medication.

It is important to note that Seniors may need a smaller dosage of metoprolol at first then continue to increase dosage slowly and gradually under the instruction of a doctor. 

Also note that, The extended-release form of the drug is safe for children above 6 years but the immediate- release form has not been established as safe or effective in children. 

Conclusion

This blog answered the question “Can metoprolol be used for anxiety?”

The blog also briefly touched upon what Metoprolol is, it’s use, side effects, and precautions to be taken related to use.

FAQ related to Can Metoprolol be used for anxiety?

What beta blocker is best for anxiety?

Propranolol is the beta blocker that researchers believe to be most effective for some anxiety conditions while ineffective for other anxiety conditions such as panic disorder or social anxiety disorder. 

Can metoprolol cause anxiety and depression?

Metoprolol has been observed to reduce anxiety somatic symptoms such as fast heartbeats for short term use or for specific events however, it is believed that metoprolol’s side effects do include worsening of anxiety as well as development of depression. 

When should I take beta-blockers for anxiety?

When it comes to the use of Metoprolol, it is important that you follow the doctor’s instructions strictly regarding dosage, timing of dosage, and other relevant instructions related to safe use. 

It is important to take the drug in the evening with food or right after a meal since this food can cause digestion due to its reaction with the stomach so, by taking the drug with a meal, it is easier to digest.

Can beta blockers make anxiety worse?

Beta-blockers have been observed to help reduce anxiety symptoms for temporary use however, expertes do not suggest it for the use of treating anxiety long term as it can lead to anxiety symptoms worsening. 

What are the most common side effects of metoprolol?

The more common side effects that can occur with metoprolol include:

  • tiredness
  • dizziness
  • diarrhoea
  • constipation
  • breathing problems such as shortness of breath, cough, and wheezing
  • bradycardia (heart rate that’s slower than normal)
  • reduced interest in sex
  • rash

Can metoprolol be chewed?

The answer depends on which form of metoprolol you are taking. Don’t crush or chew the extended-release tablet however, you can cut the immediate release tablet. You can cut both forms of the tablet along the groove marks of the tablet in case the doctor recommends a smaller dose. 

References

Metoprolol. Drugs.com. Retrieved on 2nd February 2022. https://www.drugs.com/metoprolol.html#:~:text=Metoprolol%20is%20a%20 beta%2 Blocker,be%20hospitalized%20for%20heart%20failure.

Metoprolol. MedlinePlus. Retrieved on 2nd February 2022. https://medlineplus.gov/druginfo/meds/a682864.html

Bliss. S. Metoprolol, oral tablet. Medicalnewstoday. Retrieved on 2nd February 2022. https://www.medicalnewstoday.com/articles/metoprolol-oral-tablet

Brown. M. Can Beta-Blockers Help Your Anxiety? Healthline. Retrieved on 2nd February 2022. https://www.healthline.com/health/beta-blockers-for-anxiety

Chaturvedi SK. Metoprolol, a new selective beta-blocker in anxiety neurosis. Psychopharmacology (Berl). 1985;85(4):488. doi: 10.1007/BF00429671. PMID: 2862654.

Jakobsen CJ, Blom L, Brondbjerg M, Lenler-Petersen P. Effect of metoprolol and diazepam on pre-operative anxiety. Anaesthesia. 1990 Jan;45(1):40-3. doi: 10.1111/j.1365-2044.1990.tb14502.x. PMID: 2316838.

Steenen SA, van Wijk AJ, van der Heijden GJ, van Westrhenen R, de Lange J, de Jongh A. Propranolol for the treatment of anxiety disorders: Systematic review and meta-analysis. J Psychopharmacol. 2016 Feb;30(2):128-39. doi: 10.1177/0269881115612236. Epub 2015 Oct 20. PMID: 26487439; PMCID: PMC4724794.

Hayes PE, Schulz SC. Beta-blockers in anxiety disorders. J Affect Disord. 1987 Sep-Oct;13(2):119-30. doi: 10.1016/0165-0327(87)90017-6. PMID: 2890677.

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