Experts are demanding a crackdown on the prescribing of a popular anxiety medication amid growing concerns that it could expose patients to life-threatening risks.

Propranolol, a type of drug called a beta blocker, was originally developed to treat high blood pressure.

However, it is now widely prescribed to control the physical symptoms of anxiety, including a racing heart, shaking and sweating.

It has become particularly popular among women, while social media is awash with claims that 'the panic pill' is a quick fix for everything from nerves before a big work presentation to wedding speeches and everyday worries.

It has also received celebrity endorsement, with Hollywood star Robert Downey Jr and former Great British Bake Off judge Dame Prue Leith both speaking publicly about taking beta blockers to calm their nerves before major appearances.

But experts warn that the drug, which slows the heart rate, can cause serious complications in some patients and is particularly dangerous if an overdose is taken.

Now leading medical and pharmacy organisations are demanding tougher national prescribing guidance. 

They warn that doctors may be underestimating the dangers of a medication increasingly seen as a harmless way to calm nerves.

In an open letter, they called on NHS watchdog the National Institute for Health and Care Excellence (Nice) to review its guidance on treating anxiety – and explicitly state that propranolol is not recommended for managing anxiety disorders.

There is currently no mention of the drug at all in the guidance.   

One of the main concerns raised by the joint signatories of the letter – the General Pharmaceutical Council, Royal College of Pharmacy, College of Mental Health Pharmacy and Patient Safety Commissioner for England – surrounds the dangers of overdose.

A study published last year in the British Journal of Clinical Pharmacology examined 363 intentional propranolol overdoses reported to the National Poisons Information Service between 2022 and 2023, including 35 deaths.

Almost seven in ten patients were women, while 52 cases involved children under 18.

And among patients whose original reason for taking propranolol was known, more than nine in ten had been prescribed it for anxiety.

According to clinical audits by the Health Services Safety Investigations Body, an estimated 10 to 15 per cent of all GP patients diagnosed with anxiety or depression are prescribed propranolol to help manage their symptoms. 

In UK general practice, the amount of propranolol dispensed is rising steadily, with 8.4 million prescriptions in the year to June 2026. This is up almost 5 per cent on the preceding 12 months.

And while the total number of patients taking the drug is unknown, figures obtained from the NHS Business Services Authority reveal its widespread use among younger people in England.

In one year alone, 97,362 people aged 20 to 24 were prescribed propranolol, along with 59,717 teenagers aged 15 to 19.

Separately, this week the Royal College of Pharmacy and Royal College of Physicians Medicines Safety Joint Working Group have asked the medicines regulator to review official prescribing information for the drug.

They have questioned whether propranolol should continue to be licensed for treating anxiety at all, arguing that there is insufficient evidence it is effective.

The Medicines and Healthcare products Regulatory Agency (MHRA) has confirmed it is now investigating.

The risk of overdose is by far not the only safety concern linked to beta blockers.

Propranolol blocks the effect of adrenaline on the heart, reducing heart rate and blood pressure.

Professor Penny Ward, an expert in pharmaceuticals at King's College London, says: 'It was originally licensed for the treatment of high blood pressure, but can also help with some of the symptoms of anxiety and panic.

'By slowing the heart rate, you shift people into a more tranquil state.'

However, this can cause dizziness, weakness and fainting in susceptible patients, particularly those with low blood pressure or heart rhythm problems.

It can also trigger potentially dangerous asthma attacks by narrowing the airways, while making common reliever inhalers less effective.

In people with diabetes, propranolol can mask the warning signs of dangerously low blood sugar, including shaking and a racing heart.

Other side effects include fatigue, cold hands and feet, disturbed sleep and nightmares.

The drug can also interact with certain heart medications and antidepressants, potentially increasing the risk of complications.

And suddenly stopping propranolol after regular use can cause a rebound increase in heart rate and blood pressure, which can be dangerous for people with underlying heart disease.

Prof Ward says: 'It has to be used appropriately, with people who don't have any contraindications to its use, which would include not having asthma, for example.

'Anybody who has had a heart attack in the past or evidence of a slowing heart rate, should not use it either.'

The concerns come amid wider questions over whether propranolol is an effective treatment for anxiety at all. 

Experts suggest that while it might help alleviate some of the physical symptoms, such as shaking and palpitations, it does little to ease the underlying psychological distress. 

Patients take the drug but continue to feel frightened, worried and overwhelmed. 

A systematic review of eight trials involving roughly 200 participants found insufficient evidence to support use of propranolol for anxiety disorders.

And a 2024 paper in the British Journal of General Practice, titled 'Propranolol in anxiety: poor evidence for efficacy and toxicity in overdose', raised similar concerns.

Its authors also examined why GPs continued prescribing the drug. 

Research suggested several reasons: clinicians considered it relatively low risk, viewed it as safer than sedative drugs such as benzodiazepines and believed patients appreciated its rapid effect.

Small studies have found that propranolol can reduce physical symptoms before anxiety-inducing events, including public speaking and musical performances.

Dr Philippa Kaye, a GP in north London and Daily Mail columnist, says that safety fears must be taken seriously and the view held by GPS – and the public – that propranolol is low risk may need to change. 

She adds that the drug shouldn't be seen as a quick fix or as a way simply not to feel nervous. 

'Anxiety and stress in the short term are part of the normal human experience, and can even sometimes be helpful,' she says. 'They can motivate us, sharpen our thinking and help us deal with difficult situations.

'Those feelings don't necessarily need to be treated with medication, whether that's a beta-blocker or anything else.

'But when anxiety becomes so severe that it develops into a mental health disorder, that's a different matter, and some patients may benefit from medication.

'When you experience anxiety, your body goes into fight-or-flight mode. 

'Your heart starts racing, you begin to sweat, your breathing becomes faster and your brain interprets all these physical sensations as a sign that something is wrong. 

'That can make you feel even more frightened, creating a vicious cycle.

'Beta-blockers can help interrupt that cycle. You might still have anxious thoughts, but your body doesn't react in the same way. 

'Without those physical symptoms reinforcing the fear, the anxiety can become easier to manage.

'That's why they can be helpful for some patients, particularly those who can't take antidepressants such as SSRIs, which are another treatment for anxiety, or who would prefer not to. 

'My concern is, with waits for talking therapies like CBT being so long, what else can we offer patients?'

Prof Ward adds: 'Personally, I would be cautious about stopping GPs prescribing this drug. It can be helpful for individuals who are unfortunate enough to suffer from chronic anxiety and a very rapid heart rate. 

'It doesn't hurt to have another look at guidance if there are safety concerns, but people often think anxiety and panic disorder are not important conditions, and that's not the case.

'They can be life-threatening in themselves because of the propensity of people who are overwhelmed by their symptoms to find life not worth living. 

'Withdrawing a treatment that some people rely on could have very serious consequences.'