# Xanax and Propranolol



## peterj1986

Hi all,

Apologies if this rambles on a bit as it is my first post.

I suffer from discrete SA, varying from mild symptoms when having to speak up at a work meeting to extreme physical symptoms (shaking, racing heart etc.) when giving a work presentation where I am the centre of attention. I take 40 – 60 mg of propranolol 1.5hours before the dreaded events and have done for several years and have afforded me immense relief from the physical symptoms.

I wonder if anyone agrees, it is easy to forget how effective a drug can be when taken for such events. When taken over time, it is easy to expect more from it and even easier to forget how effective it is when you are taken by surprise and have the extreme physical symptoms. It has allowed me to pursue the career I have at the moment, god bless the chap that invented it!

So, for the majority of situations barring presentations, it does the trick, I certainly don’t feel comfortable, far from it, but I make it through. However, for presentations, the mental persecution / self evaluation / anxiety is becoming more difficult to cope with. They are all I think about for weeks and during it is mental torture.

I began to research other options when I came across benzo’s. In the UK, they have a bad reputation, so when I went to my doc I was expecting a running battle. After much debate, he eventually gave me a script for 0.25 mg Xanax which I now have in my possession. I plan to take the Xanax and propranolol in combination before a future presentation, propranolol for the physical symptoms, and Xanax to ease the mental.

So ... does anyone have any experience of taking these two meds in combo? How many mg Xanax and how long before the presentation (propranolol ~ 1.5 hrs) should I take the Xanax?

What I will say is that due to the nature of the presentations, and knowing Xanax can cause some mental blunting, it’s really not going to be a good idea to come across as un-coordinated / thick-headed during these presentations, pretty disastrous really. My stage fright is a guilty secret, although others may perceive me to looking uncomfortable onstage (or is that my SA kicking in?!hehe) I certainly couldn’t admit to taking meds for this, as I am sure is the case for lots of people. Sign of weakness I guess.

I will of course try the combo at home beforehand, but I am sure that when not in an anxiety situation, the sedating effects are probably more pronounced than when sh*ting it onstage. Any advice on dosage would be really appreciated. I have no previous with taking Benzo’s and the hastle I went through to get Xanax, there is no way my doc will prescribe another benzo.

Thanks for reading,
Matt


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## euphoria

Dosage can vary a lot depending on tolerance, body weight, other medication, and many other factors. Most of the posts on here regarding Xanax seem to indicate at least 1mg is often required for effective anxiety relief in high-stress situations, but you do have the added bonus of propanolol so will likely need less than sole Xanaxers.

Personally I'd say if you're a fairly well-built fellow you'll find it hard to notice much from 0.25mg, and 0.5mg would probably be a better starting point. Then again, my experience with 2mg and upwards was coming across as a drugged-up lunatic, so you don't wanna over-cook it. Unfortunately I happened to need 2-4mg for things like presentations.


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## arth67

take the first dose at home about 1 hour before and give a practise presentation at home

carry xanax tablets with you in case more are needed, fastest way for help is to disolve them under the tongue

also remember to breathe deep and slow


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## peterj1986

Thanks for the replies,

I guess the best mode of action would be to start with 0.25 mg of Xanax an hour before my presentation along with my usual dose of propranolol. I'm of decent stature (27yrs 90kg) so I doubt i'm going to feel it (maybe start at 0.5 mg?). I will then increase the xanax in 0.25 mg increments for successive presentations untill i get effective relief. 

Isn't 1.5 mg xanax prn a high dose? would you looked drugged up on that? 

As my anxiety is highly predictive, is a beta blocker + benzo the best treatment choice or could an SSRI be useful?

thanks again,
matt


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## miha21

Hi, Matthew,

I have the exact same problem as you, so I can tell you a little about my experience. I normally have no problem interacting with small groups of people, in fact, I enjoy meeting new people and having long conversations with them without feeling uncomfortable at all. On the other side, I get very anxious especially I have to give an oral presentation (with physical symptoms such as shaky hands and legs, slurred speech, inability to maintain eye contact, blushing) or mildly anxious when I'm being in the center of attention within a large group of people. 

The first time I tried xanax was for a two minute oral report in college. I took 0.25 mg, which took away probably 50% of my anxiety, but it didn't help much with the physical symptoms. No blushing, but still my hands and legs were shaking. The following times I increased the dose to 0.50 and 0.75 mg. The result pretty good, but like I said, xanax doesn't help with the physical symptoms. I would suggest that you take at least 0.50 mg, but no more than 0.75 for your first presentation, combined with Inderal (Propranolol). More than that could probably affect your concentration and coordination, and you could feel a little out of it. Also, for me it works best If I take it about 1.5 hours before the presentation, or maybe even a little bit more than that. If i take it 1 hour before or so, the sudden change makes me feel like I'm drugged.

Good luck and let us know how your presentations went!


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## La_Resistance

> So ... does anyone have any experience of taking these two meds in combo? How many mg Xanax and how long before the presentation (propranolol ~ 1.5 hrs) should I take the Xanax?


I have experience with these meds taken in combo.

1mg of Xanax does the trick. Sometimes I go to 1.5mg if high stress situation. My propanolol dose however, is much lower than yours, 20mg does it for me. I rarely combine them, maybe once a week, or even less. But when I do mix them, I feel bulletproof. It's awesome how it kills the anxiety. Just to give you an idea. I can't speak up during meetings or in classes without being a sweaty mess, with my heart pounding at 200mph...But with this combo, I managed to go in court, in front of a crowded room, presented my case to the judge without feeling any anxiety at all and being confident. Simply amazing what you can do with it.


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## lucey

I'm so glad you asked this question! I have the exact same problem with speaking in groups and planned on trying out this combo as well... Thank you all who replied and for the positive comments.. I'm hoping it works as well as it does for many of you!


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## La_Resistance

Guys, if I can allow myself to add one more thing to this combo to make it the ultimate anti-anxiety cocktail. Yesterday I was on 1mg Xanax, 10mg Inderal (propranolol) and had one energy monster drink. Felt absolutely amazing in school, no anxiety at all.


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## SweatnBulltets

Hello

This seems like an interesting combination. However, i have zero experience with propranolol. I have however taken Xanax, klonopin and Ativan. And yes, they can be life savers for public speaking and job interviews and first dates. But! they can also be physically and mentally addictive.

As far as dosage and timing I would recommend this. Remember, I am not a doctor, I am just speaking from personal experience and from what psychiatrists have told me. 

Ok Xanax... fast acting and strong! My MD told me about 20 min to kick in, however to me it feels more like 30-40 for the full effects. I have taken .25 mg and I have also gone up to 6 mg (that was a sh*t show). If i was taking it for work or any type of public event, I would take it about 30-40 minutes before arriving. The thing to remember about Xanax though is that it is not very long acting. I really only feel the effect for 2-3 hours. So depending on how long the event is I will somtimes take another 1mg half way through (by the way, that is my average dose). Remember though, I have never mixed it with Propranolol.

Now, onto Propranolol. Can anyone tell me how this stuff is? does it feel like a Benzo? I really would like to stop taking benzo's all together because I dont want to get horribly addicted (as I already am a litte) So any information would be helpful. Thanks

And Matthew, Goodluck!


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## sandradee

****HELP!!! PLEASE READ AND REPLY!


I have an oral presentation in about a week and a half and i get super nerveous, to the point where i start shaking, cant think at all...my mind usually draws a blank and i cant speak. I decided to try xanax but its going to be my first time...im 17 and i weigh around 120 lbs...if that helps or matters. Can someone PLEEEASE tell me what my dosage should be since its my first time, && what to expect and how ill be feeling....etc., and i really wanna know if ill be able to think straight, gather my thoughts and be able to speak without looking like im on crack.

any advice or info would be greatly appreciated!!!


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## jestech

I'm new to propranolol (Inderal), and wil be giving it my first try tomorrow as I have a one hour meeting with hospital executives.
The irony of my panic disorder is that my biggest strength used to be my extreme coolness under fire and ability to give high level presentations in front of huge audiences. Then I had my first panic attack as the result of an accident and it screwed me up.
I would say the best plan is to combine the beta blocker with a fast acting benzo such as Xanax or Ativan. I will likely go with 20mg of Inderal and .5mg of Xanax 1.5 hours before the presentation. I will report back here the results.
I just want my friggin life back....worrying about having a panic attack in situations that my job depends on is awful.

The key with any Benzos is PRN, which works great for me since my panic disorder is very situation specific.


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## Cletis

matthewt said:


> Thanks for the replies,
> 
> As my anxiety is highly predictive, is a beta blocker + benzo the best treatment choice or could an SSRI be useful?
> 
> thanks again,
> matt


SSRI's are great for longterm treatment of anxiety disorders. If you're only anxious when giving presentations then I wouldn't recommend an SSRI, just keep taking the benzos and propanolol. If you're anxious all the time, but get even more anxious for presentations, then an SSRI would help you a lot.


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## toeach

*beta blockers and benzodiazepines*

mathewt:
I've tried many combinations of SSRIs, benzos, and beta-blockers; all of these medications can really help--they need to be tailored to the individual, of course; and don't do that on your own (you know that). For 13yrs., it was paroxetine, clonazepam, lexapro, effexor, alprazolam, gabapentin, remeron, propranolol, and on ...

My panic/anxiety was bad enough for awhile that I would never be sedated by taking the proper dosages of my medications (means they are doing what they need to). I've used too many benzodiazepines and experienced withdrawal anxiety as a result.

Now, I cannot tell if I really need the medication (after 13 years) or if I need it because of withdrawal. The independence that I am gaining stopping medication is actually increasing my confidence (lessening my anxiety). It is difficult to distinguish non-withdrawal and withdrawal symptoms when they occur simultaneously and are often the same experiences. It's nice to know 'what is what'.

I probably had, or have, a 'condition'; but the medication helped me realize what I am capable of doing; so now it's just about perspective. Things do/can settle down for people; as life is a learning process for behavior. I am 'all for' medication. I am also for the self-reliance you can find without it.
Good Luck Sir


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## Li Hou

*It is a good combo: xanax plus propranolol*

Hello guys,

I like to share some of my experience on this topic.

I'm an engineer, 53yr-old guy. I've been suffered social anxiety since my college days. Most challenge part has been presentation in front of a group more than 10 people. If for some topics I wasn't so confident then I would had got shaking voice. I was so worried about showing this weakness to my boss and colleagues. This worry had made me depressed. 

My brother who was a family doctor at that time suggested me to get Xanax and Propranolol prescribed. I saw my family doctor and got the prescriptions. I started with 1mg Xanax and 40mg Propranolol one hour before presentation. Since then it had worked for me for about 10 years. On those jobs presentation is occasionally.

After long term use the dose had to be increased to get it effective. I saw three psy doctors at Kaiser (HMO) they all didn't want to give me Xanax. Instead, they asked me to try some antidepressant meds. Since then I've been on 20mg Prozac and 30mg Mirtazapine. I feel that those meds help lifting my mood but do nothing on my social anxiety part.

Last year I changed job. In the new job each engineer has to do a weekly 15min presentation to 25+ people including a few directors and a VP. It has been hard to find a stable job in these days and as a single-incomer I knew I have to overcome this hurdle. First I switched my insurance plan to PPO (from HMO) and found a doctor who is willing to prescribe Xanax to me.

So far I have successfully done 25 presentations without problem. I'm so happy about it. I would say Xanax and Propranolol combo is a miracle med.

I slowly increased the dose until it is effective. Also I tried different timing to make the peak effective window to cover presentation period. Currently I take 3mg Xanax and 160mg Propranolol 1.5 hour before the talk.

The things I've learned so far:

1. Xanax is the most effective and robust med to take care anxiety mentally. If I take too less I'll still feel nervous. If I take too much I'll feel like drunk and lose some memory during that window. You need on the right dose which is carefully achieved by try-and-error. So far I don't have addiction problem. Maybe I'm lucky, or maybe I'm a good self-control person. For regular days I try to use Xanax sparely in absolutely need-basis to keep it effective, like 0.25~0.5mg once.

2. Propranolol makes me slowdown physically. Even I felt nervous (if didn't take Xanax with it) but my voice had less tendency to shaky. Be careful on this med since it will slow your heart beat rate a lot. Start from low dose like 20mg. I take a high dose of 160mg that is because I've also used it as a daily drug for my high blood pressure for over ten years (80mg/day). I've had built up tolerance on it. My HB rate will be from 65~70 down to 45~50 after taking 160mg. When you start to try it, watch your HB rate closely. You need talk to your doctor before starting take this since this med will affect your heart.

3. In HMO system doctors are very conservative since they got money from insurance by default. Then they try to give you minimal care to save their cost. So that they don't want you to be drug addictive especially if you admit that you are drinking often. They don't care if you lose your face during the presentation but they do care if you become a drug addictive then they have to put a lot of effort to take care of you. So at beginning they just block this drug to you. On PPO system the doctors are willing to help you more since they want you are back to their offices so that they can charge your insurance by visit and treatment.

4. On one hand we are relaying on our doctors, on the other hand we are the only one really responsible to our own body and metal. So that, starting from low dose carefully slowly increasing the dose until you feel calm and effective. Do a dry run at home or office. Adjust the dose as needed. Be very careful, at the same time, be a bit more aggressive. It won't work if the dose is not enough. For Xanax it seems to me I have to increase more in the future. I don't know when will be the limit. But I have to do it since I can't afford to lose face during presentation. 

It is bit long, thank you for reading!


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## Pippo

*XANAX vs Alopam*

Hi everybody,

Anybody knows the difference between Xanax and Alopam. I got alopam 15mg from my doc. This friday i'm going to take 7,5 mg along with 40 mg propanol....

I can see that everybody is talking about Xanax and nobody mentions Alopam or any other benzo...

Thanks people


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## spartan7

DOnt mess with Heart medications, use benzo's. propanol is used for diabites not for panic attacks


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## Pippo

Public speaking....the idea is the prop for the physical (betablok) and benzo (alopam) for the mental. Thanks


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## LLP

*My experience*

Hi guys, I just want to share with you my experience with these two meds. (xanax and propanol).

I am a mid 30 guy with a senior level in an accountant firm in Mexico. I suffer from social anxiety since I was 15. I remember that it started with small cases, such as shaky hands when I have to sign official papers and gradually increased with the years on several other cases such as public speaking, first date, having lunch with a new client, introducing myself in front of a group, etc. The symptoms are shaky hands, shaky voice, nightmares and even nausea.

Nine years ago when I was to get married I was prescribed by my doctor Xanax (Tafil in Mexico) .25mg twice a day, it took the nightmares away and I managed to give my speech very well. Since then I took Xanax on as needed basis having acceptable results.

Last year I was promoted in my job and as a result I have to give more regular presentations to clients and colleagues. Even though I took Xanax before my presentation that took the nightmares away, I just realized that physical symptoms, were still with me (shaky hands, fast heart beat) and this worried me as my audience could note it. 

I started to search in the web and found this forum and was glad to find a lot of people who* fully understand my situation* and are glad to share their experience and recommendations such as the effects of propanol.

I discussed the use of propanol with my doctor and he prescribed a low dose. From that day I can tell you that I just found the perfect complement to my treatment. I took from .25mg to .5mg of Xanax and 20mg of propanol an hour before my presentations and I can tell you that I have just nailed it every time. The nightmares and the physical symptoms are far more manageable I could say that they almost disappear.

Thanks to SAS for thinking about millions of people who suffer this disorder and let us know that we are not alone. Thank to all of you who take time to share your valuable experiences with us and I hope that this experience helps somebody else just as yours have helped me so much.
:clap:clap:clap


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## APOCALYPSEE

Alprazolam+propranolol are a miracle


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## istayhome

sandradee said:


> ****HELP!!! PLEASE READ AND REPLY!
> 
> I have an oral presentation in about a week and a half and i get super nerveous, to the point where i start shaking, cant think at all...my mind usually draws a blank and i cant speak. I decided to try xanax but its going to be my first time...im 17 and i weigh around 120 lbs...if that helps or matters. Can someone PLEEEASE tell me what my dosage should be since its my first time, && what to expect and how ill be feeling....etc., and i really wanna know if ill be able to think straight, gather my thoughts and be able to speak without looking like im on crack.
> 
> any advice or info would be greatly appreciated!!!


There is no way to say what someone's first time dosage *should* be everyone varies so much with this drug. A first time dose, if it is the same for two people with the same weight, height, situation etc. can vary so much. What may make one person appear to be a drunken slobbering clown may do almost nothing to the other person. It totally depend on your inherent anxiety levels, How well your NT's function, just things in your brain that there is no way of knowing. For my first xanax dose I needed 2 mg to get ANY anxiety relief, others get it from 0.25 mg of xanax. So it is impossible to say, you need to try it several timed before hand. If you wait until the big day, you might seem like a belligerent drunk or someone who is very anxious and cannot speak. Maybe you'll get randomly lucky and land at the right dose. no one knows.

Basically to find the ideal dose, start low and work your way up, until you just get anxiety relief but don't actively feel loopey, drugged, sleepy, dopey, tired, etc. good luck.


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## JGeiger

I would always choose Xanax as the best drug


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## peterj1986

Well it's been three or so years since i initially posted and it's good to see some interest in this combination.

Over the past three years i ahve continued to stuggle with stage fright and rely on these drugs to help me through.

For me, propranolol has saved my career in-numeral times, the guy that invented this has my admiration. However, you will still feel very nervous on propronolol, and this is made worse by poor preparation (lazyness on my part).

I have had some mixed results with adding xanax in. 0.25 mg is not therapuetic and twice this is usually required. If I take xanax+propranolol and prepare until it is painful to go through it again, i.e. you know it word for word, then i'll be ok. As i get older though i tend to not be as nutty about the preparation. The net result...i generally feel nervous presenting, but i guess i am more comfortable with appearing nervous in front of others, rather than spending the previous week going throught it hundreds of times.

I feel all your pain, good luck to all in your treatment of this.

Matt


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## fishhead

*valium + inderal*

A touch off topic, as my experience is with Valium, but I find the combo of a benzo and prop as a life saver in speeches. I got the idea here from SAS.

a recent, very stressful experience, was made 100% successful and totally stress free by taking 2.5mg Valium + 40mg inderal 1.5hr prior. then another 5mg Valium one hour prior.

this combo has proven successful twice now. no stress, clear head, could think clearly and improvise during speech.

BUT, you need to experiment a little first, and i did so under less stressful situations where i wasn't THE focus of attention.


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