Robert Downey Jr. Opens Up About Beta Blockers

The actor's mention of a medication used to treat abnormal heart rhythms and high blood pressure brought up new discussions about its role in managing anxiety.

During his acceptance speech after winning the Golden Globe for Best Supporting Male Actor in a Motion Picture Drama for his role in "Oppenheimer," Robert Downey Jr. ignited interest in prescription medications known as beta-blockers.

"Yeah, yeah, I took a beta-blocker so this will be a breeze," Downey said in the January 7 speech.

It appeared that the actor was referring to taking the medication as a way to quell performance anxiety, or 'stage fright.'

Downey isn't the only celebrity to mention taking beta-blockers. In 2022, Khloé Kardashian said that she took Kris Jenner's beta-blocker to manage stress and anxiety, according to a USA Today report.

Can beta-blockers reduce anxiety?

Beta-blockers are typically used to treat abnormal heart rhythms, including tachycardia and atrial fibrillation (A-Fib). Healthcare providers also prescribe these medications for angina and high blood pressure.

Yet, some people take them to manage anxiousness and the physical symptoms associated with anxiety.

These drugs work by preventing norepinephrine and adrenaline — neurotransmitters and hormones involved in the body's fight-flight-freeze response — from binding to beta-adrenoreceptors in the heart. This action prevents heart stimulation by the sympathetic nervous system, resulting in a reduced heart rate and other cardioprotective benefits.

However, a 2016 systematic review of research determined that the quality of evidence is insufficient to support the routine use of propranolol — a type of beta-blocker — for the treatment of any anxiety disorder.

In contrast, a 2022 study suggests that beta-blockers have shown promise as a treatment for situational anxiety like 'stage fright,' anxiety related to post-traumatic stress disorder (PTSD), and anxiousness associated with cognitive dysfunction.

These medications are also prescribed to autistic individuals to help improve emotional and behavioral dysregulation.

Because several symptoms of performance anxiety, such as shakiness and heart palpitations, are triggered by the release of adrenaline and norepinephrine, the researchers suggest that beta-blockers can help minimize these effects.

Though not approved for the treatment of anxiety disorders, the FDA acknowledges that beta-blockers are a common class of medications used to treat anxiety. Still, taking them to manage anxiousness is considered off-label use. Moreover, beta-blockers are primarily used to manage situational anxiety and are not considered a long-term treatment option for anxiety disorders.

Nonetheless, people prescribed beta-blockers for cardiovascular or other health conditions should be aware of the potential side effects associated with these drugs.

These include:

  • Slow heart rate
  • Low blood pressure
  • Fatigue
  • Dizziness
  • Constipation
  • Sexual dysfunction

Moreover, people with asthma, long QT syndrome, or Raynaud phenomenon should not take specific beta-blockers. Reports also indicate that individuals taking beta-blockers and aspirin during heat waves should be aware of potential heart risks.

Due to these potential risks, people who believe they have an anxiety disorder should not take beta-blockers prescribed to others. Instead, they should consider visiting a qualified healthcare provider for diagnosis. Their doctor can then help determine whether medications like beta-blockers would be a safe and effective treatment option.

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