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From: Nathan Lavid, M.D.
Date: 05 Oct 2005
Time: 10:43:34 -0500
Remote Name: 71.107.205.117
Hello Jim, Beta-Blockers, such as atenolol, are occasionally used to treat the physical manifestations of anxiety, such as increased heart rate. Propranolol is more commonly used in psychiatry, but I have used atenolol in my practice. Atenolol decreases the action of norepinephrine and epinephrine by specifically blocking its receptors in the cardiovascular system. The benefit of atenolol is that when one suffers from an episode of anxiety, for example, a panic attack, the patient does not suffer from a racing heart rate or other adrenalin-triggered cardiovascular symptoms. The absence of cardiovascular manifestations of anxiety can be helpful when treating the psychological manifestations of anxiety. While working in an indirect manner to alleviate components of anxiety, the appeal of using Beta-blockers is that they do not tend to have the central nervous system side effects associated with anxiolytic medications that target the brain directly, such as SSRIs and benzodiazepines. In my practice, I tend to first use more direct CNS targeting medications and use second-line agents, i.e., Beta-blockers, if the first medication is not tolerated or ineffective when treating anxiety. I have not used Beta-blockers in stuttering, as I usually offer a medication that targets fluency directly. Also, I prefer to use cognitive-behavioral therapy to address the anxiety. Though, the Beta-blockers are a reasonable choice, and I am pleased to read that you have done well with the atenolol.