Q. I have had anxiety attacks several times in the past 15 years. Always before I have been given Xanax and in several days I would be okay. Then I would take the pills as needed occasionally.

Last week when I went to the doctor and told him I was having anxiety attacks again, he prescribed the blood pressure pill atenolol. Have you ever known atenolol to be given for anxiety? When I tried it I developed an upset stomach and lost my appetite.

A. Atenolol has not been approved for anxiety. Such beta blockers are primarily prescribed for blood pressure and heart problems. Doctors sometimes prescribe propranolol or atenolol for the physical symptoms associated with stage fright, but these drugs are not appropriate for general anxiety (Journal of Clinical Psychiatry, Aug. 2006 Suppl.). Alprazolam (Xanax) is approved for anxiety and short-term use is often quite effective.

Join Over 90,000 Subscribers at The People's Pharmacy

Each week we send two free email newsletters with breaking health news, prescription drug information, home remedies and a preview of our award-winning radio show. Join our mailing list and get the information you need to make confident choices about your health.

  1. Mark

    I was put on atenolol 25 mg in 2007 for pre-hypertension and a murmur. I immediately felt calm and clear headed, but because of atenolol being very effecting in governing heart rate, cardio exercise was limited. So I tried Bystolic 2.5 mg, 5 mg, and 10 mg which at doses below 10 mg does not have the same effect on exercise induced tachycardia.

    2.5 mg gave a calming effect much like 25 mg of atenolol, but BP was not as controlled as effectively; 5 mg gave great BP control, but I began feeling a little anxious on it and HR wasn’t as controlled; 10 mg controlled HR and BP, but I felt a bit disconnected and would get tachycardic when I would have to present in front of people. 25 mg of atenolol kept me as calm as could be, as did 2.5 g Bystolic as I recall. Not sure why higher doses of Bystolic did not share the ability to keep me calm when speaking publicly.

    Anyway in 2011, it was discovered that I had a bycuspid aortic valve. My cardiologist put me on candesartan 4 mg as well as 25 mg of atenolol (I refused to go off atenolol due to calming effect). My BP at the time of that office visit was 108/72. So one would be safe to assume that the need for additional BP reduction was questionable at best. But it has something to do with limited data on after-load reduction with candesartan and central aortic pressure increases with atenolol.

    Fast forward to 2013…cardiologist wanted me to start taking 8 mg of candesartan, which mad me nauseous. We agreed to try 5 mg of Bystolic again, which I soon moved to 10 mg to control HR. After months of mid-afternoon (peak-dose) lightheadedness, orthostatic hypotension, and disconnect, I switch to losartan 50 mg in place of the candesartan. Better tolerated in combination with Bystolic, at least for me.

    Today, I am on 50 mg losartan BID (2X’s per day) and working my way back down to 2.5 mg Bystolic. If all goes well, I am going to then move back to 25 mg atenolol, and dial down the losartan if possible.

    Ideally 25 mg losartan BID and 25 mg once daily atenolol is my goal.

    Switching from 10 mg Bystolic back to 25 mg atenolol is not as easy as I thought. Body gets use to nitrous oxide effect and 10 mg of Bystolic is like taking 100 mg or atenolol. So a slow downward dosing regimen is probably best.

    In my opinion atenolol gets a bad wrap. But then again I am an “N” of 1 in the clinical trial known as ME. It is also interesting to note that most combinations of BP meds have never really been studied for efficacy and/or side-effects. Personalized medicine is a MUST with BP meds. Find a doctor who will take the time to treat you in steps. In my case, older meds may be better, but that will not apply to a vast majority of patients, IMO.

  2. Linda

    Reading all these posts is so helpful…like many others when you are experiencing these awful symptoms you need to read you are not alone in this. Comforting that others are going through it as well…no fun that we have to go through it. I am mad at the doctors that fail to tell you how hard it is to get off the meds. Yes, it initially makes you feel better but then….a costly mistake financially and then later physically. I found another site with good stories and comments that are helping me as well…it is such a relief to be able to reach out to others. Especially when your body feels like it is going crazy. If anyone else wants to read posts from others like this site http://benzoaddictionsupport.com/ go there as well, both places are great. Hang in there…I say this to myself and to all others experiencing withdrawals.

  3. marcia v.
    United States

    I am 61 years old with high blood pressure my doctor prescribed this medication for blood pressure and anxiety. I was tired not motivated sat around all day gained 10 pounds and became depressed. Not sure if this is from the medicine or weight gain but I have stopped taking it.

  4. s H

    I have a fear of flying, And I have been taking Atenolol before I fly for years. It works great for anxiety.

  5. khan

    I am 52 and suffered from anxity at the age of 30. Started with indirol and lexzellium. But once I saw the doctor at 40, he suggested atenolol 25( 1/2 morning and 1/2 evening) and half lexotonil at night. After a month I started only 1/2 of 25 mg atenolol and 1/2 of lexotonil at night. I am fine. My bp in rest position is 100/60 and in day time 110/70 or maximum 120/80 and heart rate as approaching 70. But I am afraid of taking these medicines for a long time due to their possible side-effects. Can you suggest me some thing, because I do not want to go doctor where my heart start racing with 120 bpm and bp 150/100. Waiting for reply

  6. Wanda M.

    Thanks for that Ps. Comment. Yes anxiety is an awful feeling many times I prayed I wouldn’t die. I hope yours in finally under control.

  7. lauraK

    hello all, I too was on atenolol for 2 years. Soon after reaching my 40’s I started having heart palpitations and anxiety however I didn’t know the two had anything in common. I started seeing a heart dr. who put me on atenolol to control the palps, but I already had low blood pressure. It worked great for the first year but the atenolol felt as if it was being accumulated in my system as if I kept taking a high dose even though it was the same. My blood pressure dropped and my pulse was in the 50’s and I was tired all the time. My dr. cut my does in half, which worked for a while then my pulse dropped into the 40’s and we cut the dose to a quarter. each time I felt better, then after a month or two it would fall again and I got to the point I was so tired I was afraid to drive and would fall asleep in less than a minute from the time my head hit the pillow, and now I started having dizzy spells.
    In all, the atenolol worked but the drop in my blood pressure was becoming a problem. I had to ask myself, what is causing this problem? and why am I using a drug to cover it up? Needless to say, I stopped taking the drug because I wanted to see if I could fix it with diet. I felt like I ate a healthy diet already, but wanted to take it to the next level. I had a clue because it was always worse after I had a glass of red wine so I knew it had an affect on me. I did some research on the internet and decided to stay away from preservatives even food that had high amounts in it naturally. I tried eating organic when ever possible too.
    Sooo, after no more buying food in boxes, cans or select frozen foods, I have not only stopped my palpitations but it stopped my anxiety, rashes, and night sweats. I still have to watch what I eat because it is always there waiting to pop up after too many bad food choices or too much alcohol (especially alcohol and sugar together).
    My advice to everyone is to fix your problem, don’t damage your body more by adding medications to it. most every health problem is cause by diet. Americans eat and sell the worst food, even our fruits and veggies are chemically altered to grow faster and produce more cheaper, don’t forget about poisons and pesticides.

  8. S. H.

    I am 54 now, started at 35 to regularly take Atenolol with clonazapam. Back when I was 35 to age 46 or so, the combination seemed to work great. I felt ‘cured’ of panic disorder. I went off atenolol and cut way back on clonazapam and such, I got worse. And worse. My dr put me back on a smaller dose of atenolol with a smaller dose of clonazapam. Hoping it will work like the first time. (no side effects from atenolol)

  9. Debbie F.

    Josh, I just read about your medication problems and anxiety. I too have suffered with anxiety most of my life and I am 59. In 1998 I was introduced to Inderal which saved my life because of the anxiety- high b.p. and night time awakenings of pure terror I developed and arrhythmia. It is indescribable the anxiety one feels at night when the heart starts pounding out of a sound sleep. I have never found out what caused it, but it was the first time I used Paxil and the last. Paxil brought out a heart problem I believe, even though my Dr. thinks it didn’t.
    Any way I cannot take SSRI of any kind or I have a panic out of a sound sleep and 15 mins of my heart going into A fib. Any way, what I would like to ask you is, have you had any weight gain problems from the Atenolol? Inderal has been a miracle drug to me but the weight gain is making me very depressed, I was once very small until I started taking Inderal, I am now over a 100lbs. over weight and Inderal has gradually caused this. Any information would be helpful Thanks, Debbie F.

  10. MJ

    I was prescribed Atenolol 25 mg once a day. BP was elevated due to anxiety. I started taking Atenolol and feel tired and BP is dropping. I researched at the library books on lowering blood pressure without prescription drugs. There is a book titled, The Blood Pressure Cure, 8 weeks to lower blood pressure without prescription drugs, by Robert E. Kowalski. I am going to read it and empower myself to find other options.

  11. Caetas

    I started taking Atenolol three months ago after being diagnosed with high blood pressure due to anxiety (all bio reports were fine after a general check-up at 42). I also was having huge migraines and digestive problems for two years, which took me to the gastroenterologist who prescribed me the drug.
    Along with increasing my general condition and well-being, bringing my blood pressure level to 12/7 and a resting heart rate to 55-60, I also noticed that my behavior changed a lot. I got more introspective and less interactive with people, and felt somehow “empty” in many moments from then on.
    As I am in an executive position which demands decisions, presence and leadership, I feel this condition is quite difficult because not only I feel detached from everything, but it´s also hard to focus on any subject and I´m totally driveless.
    I started to wonder if this might be a side effect of Atenolol, which I´m taking as a single dairy 50 mg dose (doc said that I should take it forever). If yes, which would be my alternatives considering that it also brought me many positive effects such as the end of migraines and heartburn and also a good weight loss?
    Thanks in advance for any help/insight provided!

  12. Christi

    Hi Sherry,
    I have SVT as well. My doctor prescribed 25 mg of atenolol a day for me. It took care of my tachycardia for sure, but I was exhausted all the time and didn’t have the energy to do anything I liked. It slowed my heart rate down and lowered my blood pressure so much that I ended up in the hospital. I’m now on 250 mg of digoxin a day and I feel much better. The only bad thing about digoxin is that is has so many drug interactions with other drugs including acetaminophen, ibuprofen, antihistamines and so on. Getting a cold on digoxin sucks as a result, but I like it a lot more than atenolol.

  13. K.M.

    Dear Jennifer: You may not realize it, but those doctor’s are soooo right. I have been on a roller coaster with benzo’s since 2006. Two references I found for w/d’s are exactly what it feels like and it is hell. One reference “put your finger in an open, on, light socket for three weeks”. That is exactly what the withdrawal’s feel like.
    Another reference I read is “It’s like somebody putting gasoline in your veins, and then lighting them on fire”. God Bless whoever that doctor is. I am currently about 1 1/2 weeks without a benzo and I am in Hell. Am just laying here waiting, counting the hours, till I can refill my prescription.
    My physician gave me atenelol last week because I went in, without benzo’s in my system and my b/p was through the roof. She had me transported to the hospital via ambulance. They gave me an ativan, and poof, 20 minutes later, I was normal. A horrible, horrible way to live. Good luck.

  14. RR

    I haven’t been diagnosed with anxiety/panic attacks yet, but I’ve been on Atenlol for years for hypertension (I’m 25). Recently, I started seeing a naturopath and I was taken off the atenlol and put on supplements, and next thing I know, I’m having panic attacks and anxiety. My pressure got up to 175/121. Once I took my Atenlol, it lowered very quickly. I took a loranzapam to sleep and now I’m doing just fine. I was told I’ve probably been medicating anxiety this whole time, but if it’s working, then it’s a lot better than the other addicting drugs. Works for me

  15. K.D.

    I have had chronic anxiety panic disorder, I started to lose my memory so my Dr. put, me on atenolol, 25 mg I don’t know if it works.

  16. kris

    Hope all is well today. It’s good to know that your there to listen about anxiety attacks. We are of the same age and I was diagnose with Generalized Anxiety Attack recently. Three days after my dad died of Myocardial Infarction, I was brought to ER twice because I feel like I’m having a heart attack, Palpitation, chest pain, difficulty breathing, numbness of extremities and pale nailbeds. I was referred to a shrink and said I have GAD and prescribed with Valium 1/2 tab once daily or if necessary. I like it first but the second time I took it I had palpitations, so I stopped it. I’m having attacks even if I’m not stressed out or is just sitting watching TV. I could hear my hear beating so fast (palps) and is very hyper vigilant with any symptoms.
    The fear is paralyzing. I still went to see a cardiologist just to make sure my heart is fine, after she took my ECG, it showed up fine and I have yet to undergo Echocardiograph. She prescribed me with atenolol and is hesitant to take it as maintenance. I’m wondering if there are times you managed your attacked without medications? Would this ever go away and not come back? I’m scared this would ruin my life.

  17. zyra

    Hi Joshua,
    My name is Zyra. I’m 27 years old. I was diagnosed with Generalized Anxiety Disorder. I just want to know if your symptoms are like having a heart attack, starting from having palpitations, chest pain, difficulty breathing and increased in blood pressure..etc. Because that’s what I usually feel when having an anxiety attack and most of the time it happened even while working or even on a fine day. This all started when my dad died last month from Myocardial Infarction and stress and grief probably triggered this because I use to function normally. I was brought to ER twice and was told I’m having an anxiety attack and should see a shrink. And so I went to one and was diagnosed with GAD.
    I went to a cardiologist just to make sure my heart is fine and I have yet to take echocardiography but my ECG was fine. She prescribed me with Atenolol too and is hesitant to take it. I’m scared every time I had attacks. I feel like I’m going to die. It’s good to know now you have it for 11 years and is still coping well. I want to talk to people having same problem as mine. Maybe just to have a support system or to feel better knowing others can overcome this. Thanks!

    • Caleb

      I have these same symptoms… Pvc episodes for no reason, chest pain… Google only seems to make my Pvc worse… I used to take metoprolol (atovan) but my Pvc was still there… Now I take 50mg of atenolol at bedtime… My chest pain is usually late at night or shortly after midnight I’ve noticed… I keep feeling like the end is near for me… Like it’s a dream and I can’t wake up… Now I also take pills for high triglycerides… Not sure what those are but I guess it has something to do with my cholesterol… Anyways, I was wondering if I can take my hydroxyzine AND atenolol???

  18. cj

    I was on Xanax too. Generics are NOT the same. I found the alprazolam by greenstone labs to be equal to the brand. Try that. Never Mylan. That generic caused withdrawal for me. Good luck.

  19. marcie

    I take 1mg of Lorazepam once a day for my panic disorder. I’ve had this for yrs. Its the
    best drug out there for anxiety. Also have highblood pressure.
    I was prescribed Atenolol for it. It will also help my palps too. I’m scared to start the drug. Any advice would help. Thanks:-)
    I’m 38 yr.old female
    People’s Pharmacy response: Ask your doctor why atenolol would be better for you than any of the other possible drugs. In the UK, it is not considered first line treatment for hypertension.

What Do You Think?

We invite you to share your thoughts with others, but remember that our comment section is a public forum. Please do not use your full first and last name if you want to keep details of your medical history anonymous. A first name and last initial or a pseudonym is acceptable. Advice from other commenters on this website is not a substitute for medical attention. Do not stop any medicine without checking with the prescriber. Stopping medication suddenly could result in serious harm. We expect comments to be civil in tone and language. By commenting, you agree to abide by our commenting policy and website terms & conditions. Comments that do not follow these policies will not be posted.