A Drug for Fear and Anxiety? Yes—It’s Called Propranolol

Explore the human trials for this phobia-busting drug

By Peter M. Vishton, PhDWilliam & Mary
Edited by Kate Findley and proofread by Angela Shoemaker, Wondrium Daily

It might sound like science fiction, but some recent studies with humans have used a rather mundane drug called propranolol to rapidly reduce or even eliminate phobias. Professor Vishton examines the evidence.

Propranolol pill concept
Recent studies with humans have used a rather mundane drug called propranolol to rapidly reduce or even eliminate phobias. Photo By Sonis Photography / Shutterstock

What Is Propranolol?

The beta-blocker medication, propranolol, is often used to treat high blood pressure, irregular heartbeat, migraine headaches, and a variety of other ailments. 

Beta-blockers such as propranolol block the receptor sites for adrenaline and norepinephrine, which are associated with stress-based arousal. When your fight-or-flight system is activated, it does so on the basis of these neurotransmitters. 

If a beta-blocker is in your system, the neurotransmitters are still released, but the ability of the neurotransmitters to affect neurons on the receiving side of a synapse is reduced. Thus the effects of adrenaline and norepinephrine on your system are reduced. For this reason, propranolol is also used to treat many anxiety-related disorders.

“I’ve known a few people who periodically use a beta-blocker when they have to give a research presentation under high-stress circumstances,” Professor Vishton said. “They often describe themselves as still feeling terrified as they walked across the stage and begin their presentation.” 

Even as they feel frightened, though, their voice remains completely calm. As they hold a laser pointer and aim it at the projection screen, their hands don’t shake; they stay completely still. The adrenaline is still flowing, but many of its effects are blocked by the aptly-named beta-blocker.

Propranolol Studies

In a study recently published by Merel Kindt and her colleagues at the University of Amsterdam, participants were recruited who had particular phobias—for example, arachnophobia, or a fear of spiders. Others were recruited who suffered from anxiety associated with some past experience, such as being mugged or assaulted at gunpoint.

Dr. Kindt was directly inspired by rat studies involving memory reconsolidation and disruption of that reconsolidation using anisomycin. She wanted to try this technique with humans. 

Anisomycin, however, is bad for your health—especially in the doses needed to generate the memory disruption effects that she sought. Kindt settled for something much gentler. She didn’t aim to eliminate the memory, but rather to change its emotional associations.

In these studies, participants experienced the fear-inducing stimulus—just like the rats experienced the beep. The arachnophobia patients handled a large tarantula in a jar. The painful memory group answered questions about their memory and verbally described it in great detail. 

Once the fear state and the memories associated with it had been activated as fully as possible, some of the participants took a dose of propranolol. Somewhat amazingly, in the days—and, in a few cases, months—after this experience, many patients reported a dramatic drop in their fear.

It was as if the propranolol, by blocking the participants’ ability to fully experience the fear, also blocked the tendency to reconsolidate that fear into long-term memory.

Exercise Patience for Phobia Treatments

“Now, I am not urging you to go get your hands on some propranolol and experiment,” Professor Vishton said. “Propranolol is a prescription medication that should only be used under the supervision of a doctor. And this is very experimental medicine at this point.”

We are still at least several years from treatments like this being certified as safe and approved for general use. A large number of follow-up studies are being conducted, however. It might be that this, or something like this, will become a standard part of the toolbox of therapists who focus on treating phobias.

This article was edited by Kate Findley, Writer for Wondrium Daily, and proofread by Angela Shoemaker, Proofreader and Copy Editor for Wondrium Daily.
Image of Professor Peter Vishton

Peter M. Vishton is an Associate Professor of Psychology at William & Mary. He earned his PhD in Psychology and Cognitive Science from Cornell University. Before joining the faculty of William & Mary, he taught at Northwestern University and served as the program director for developmental and learning sciences at the National Science Foundation.