Beta Blockers vs. Xanax

  • Medical Editor: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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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

Beta blockers may cause:

Other important side effects include:

As an extension of their beneficial effect, they slow heart rate and reduce blood pressure, but they may cause adverse effects such as heart failure or heart block in patients with heart problems.

Beta blockers should not be withdrawn suddenly because sudden withdrawal may worsen angina (chest pain) and cause heart attacks, serious abnormal heart rhythms, or sudden death.

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.

Beta blockers may cause low or high blood glucose and mask the symptoms of low blood glucose (hypoglycemia) in people with diabetes.

Other serious side effects of beta-blockers include:

  • Toxic epidermal necrolysis
  • Raynaud's phenomenon
  • Lupus erythematosus
  • Bronchospasm
  • Serious allergic reactions
  • Erythema multiform
  • Steven Johnson Syndrome
  • Toxic epidermal necrolysis

Xanax

Xanax is used for the treatment of anxiety disorders and panic attacks. Anxiety disorders are characterized by:

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?

Beta blockers

  • 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.

Xanax

FDA Prescribing Information

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Reviewed on 10/6/2017
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