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Beta blockers vs. Xanax
- Beta blockers and Xanax (alprazolam) are drugs prescribed for anxiety.
- A difference is beta-blockers are typically prescribed to treat high blood pressure and heart problems, and they are prescribed off-label for anxiety. Xanax is a different kind of drug, a benzodiazepine that is a type of tranquilizer, widely prescribed for anxiety.
- Beta-blockers work best for short-term event-related anxiety, such as social phobias and stage fright by blocking physical symptoms of anxiety including rapid heart rate, tightness in the chest, or sweating. They don’t affect the emotional and psychological aspects of anxiety such as worry.
- The beta-blockers most commonly prescribed for anxiety include propranolol (Inderal) and atenolol (Tenormin).
- Xanax works differently than beta blockers. It is a sedative and can cause drowsiness but it can be taken during an acute episode of anxiety or a panic attack, and they can relax people and help reduce stress and worry.
- Common side effects of both beta-blockers and Xanax include:
- Side effects of beta blockers that are different than Xanax include:
- Side effects of Xanax that are different than beta blockers include:
- Unlike beta blockers, Xanax can be addictive.
What are beta blockers and Xanax?
Beta blockers are drugs that block the effects of stress hormones norepinephrine and epinephrine (adrenaline). These hormones are what cause the physical symptoms of anxiety and blocking them reduces these effects, helping control some of the physical symptoms of anxiety.
Xanax (alprazolam) is an anti-anxiety medication in the benzodiazepine family, similar to diazepam (Valium), clonazepam (Klonopin), lorazepam (Ativan), and others. Xanax acts to enhance the effects of a neurotransmitter called gamma-aminobutyric acid (GABA) in the brain, reducing the stress response and helping the body relax.
What are the side effects of beta blockers and Xanax?
Beta blockers may cause:
Other important side effects include:
- Central nervous system effects of beta blockers include:
Beta blockers that block β2 receptors may cause shortness of breath in asthmatics.
As with other drugs used for treating high blood pressure, sexual dysfunction may occur.
Other serious side effects of beta-blockers include:
- Toxic epidermal necrolysis
- Raynaud's phenomenon
- Lupus erythematosus
- Serious allergic reactions
- Erythema multiform
- Steven Johnson Syndrome
- Toxic epidermal necrolysis
Xanax is used for the treatment of anxiety disorders and panic attacks. Anxiety disorders are characterized by:
- Unrealistic worry and apprehension
- Symptoms of restlessness
- Shortness of breath
- Smothering sensation
- Cold clammy hands
- Exaggerated startle responses
- Problems concentrating
Panic attacks occur either unexpectedly or in certain situations (for example, driving), and can require higher dosages of Xanax.
What are the drugs that interact with beta blockers and Xanax?
- Combining propranolol (Inderal) or pindolol (Visken) with thioridazine (Mellaril) or chlorpromazine (Thorazine) may result in low blood pressure (hypotension) and abnormal heart rhythms because the drugs interfere with each other's elimination and result in increased levels of the drugs.
- Dangerous elevations in blood pressure may occur when clonidine (Catapres) is combined with a beta blocker, or when clonidine or beta blocker is discontinued after their concurrent use. Blood pressure should be closely monitored after initiation or discontinuation of clonidine or a beta blocker when they have been used together.
- Phenobarbital and similar agents may increase the breakdown and reduce blood levels of propanolol (Inderal) or metoprolol (Lopressor, Toprol XL). This may reduce effectiveness of the beta blocker.
- Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) (for example, ibuprofen) may counteract the blood pressure reducing effects of beta blockers by reducing the effects of prostaglandins, which play a role in control of blood pressure.
- Beta blockers may prolong hypoglycemia (low blood sugar) and mask symptoms of hypoglycemia in diabetics who are taking insulin or other diabetic medications.
- Ketoconazole (Nizoral), itraconazole (Sporanox), nefazodone (Serzone), cimetidine (Tagamet), and fluvoxamine (Luvox) increase concentrations in the blood of alprazolam and therefore may increase the side effects of alprazolam.
- Alprazolam interacts with alcohol and medications (for example, barbiturates, and narcotics) that suppress activity in the brain by suppressing activity more and causing sedation.
- Carbamazepine and rifampin reduce the effect of alprazolam by increasing metabolism and elimination of alprazolam in the liver.
FDA Prescribing Information
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alprazolamAlprazolam is a member of the benzodiazepine family, which are sedatives that cause dose-related depression of the central nervous system. Alprazolam is used for the treatment of anxiety disorders and panic attacks, which cause:
- unrealistic worry and apprehension,
- shortness of breath,
- smothering sensation,
- cold clammy hands,
- exaggerated startle responses,
- problems concentrating, and
AnxietyAnxiety is a feeling of apprehension and fear characterized by symptoms such as trouble concentrating, headaches, sleep problems, and irritability. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults. Treatment for anxiety may incorporate medications and psychotherapy.
atenololAtenolol (Tenormin)is a beta-adrenergic blocking agent, blocking the action of the sympathetic nervous system, a portion of the involuntary nervous system. Atenolol is prescribed for patients with high blood pressure (hypertension), used to treat chest pain (angina pectoris) related to coronary artery disease, and is also useful in slowing and regulating certain types of abnormally rapid heart rates (tachycardias). Other uses for atenolol include the prevention of migraine headaches and the treatment of certain types of tremors (familial or hereditary essential tremors). It is important to be aware of the drug interactions related to atenolol, effects on pregnancy, as well as common side effects on the user.
atenolol and chlorthalidoneAtenolol and chlorthalidone (Tenoretic) is a combination drug prescribed to treat high blood pressure and abnormally rapid heart rhythms. Side effects, drug interactions, storage, dosing, and pregnancy asfety information should be reviewed prior to taking this medication.
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propranololPropranolol (Inderal, Inderal LA, Innopran XL) is a medication prescribed for the treatment of high blood pressure, angina, certain heart rhythm disorders, migraine headache prevention, and certain types of tremors. Side effects, drug interactions, warnings and precautions, and pregnancy safety information should be reviewed prior to taking any medication.