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I am a 21 year old post-grad law student with social anxiety

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Hi there, I am a...
Hi there, I am a 21 year old post-grad law student with social anxiety which emerged earlier this year after a particularly stressful period of me trying to get a job (which I did, thankfully!). What this did however, was give me anxiety when I speak to a group of people - be it at work, or socially. My heart starts pounding and I start shaking uncontrollably on the face and legs. It is a nightmare and has significantly interfered with my life. The biggest shame is I am an incredibly outgoing personality (always been) so this change is literally the worst thing that has ever happened to me.
I went to my GP and she prescribed me with propranolol 40 mg as and when needed. As I am doing my qualification (i.e. one-year post-grad law diploma) at the moment and this involves loads of everyday mini presentations in front of my future colleagues (peers or a tiny bit older usually), I found that it helps me if I took 20 mg in the morning daily. I would break the 40 mg pill in half. If I had an extra social event in the evening, I would take another 20 before that too (but this would not happen more than 3 times a week). Also, on days when we have big events in the law firm and I have been staying home the whole day (hence, haven't taken my morning dose), I go ahead and take 40 mg altogether in one single dose an hour before the stressful big event. On days like Sundays when I do not usually leave the house, I do not take any (I give myself a day off).
I went back to my GP and although I told her it helps me to do this as it eases my anxiety and I don't have to live in fear any longer, she said the specific clinic is not a big fan of prescribing propranolol for daily usage and that it is only for situational anxiety. She went on to recommend me to take Zoloft which I have not started or planning to start as I am not suffering from depression of any kind and the side effects are just awful. In all honesty, if I am to be taking medication every day, I would rather this was a beta blocker as opposed to an unnecessary anti-depressant.
Propranolol also helps me immensely with my palpitations that have been an absolute nightmare during this year. I used to get maybe 3 palpitation 'events' a day. Now, after I started taking propranolol daily those have stopped - with the exception of maybe one very minimal event at night (on days when I have not taken a night dose as I am staying in) which ends after a while.
I have read in plenty of medical websites that propranolol is a very safe drug and I still use it daily without the 'sickness' side effects. I have been trying so many different things to overcome my social anxiety (like Cognitive Behavioural Therapy which did not work, or Magnesium supplements) without the success of Propranolol. I work out a lot (I never take an evening dose when I do work out) and I am pretty terrified as I do not hear my heart in the way I used to when I was working out in the past. Is there anything you would like to advise me on re: propranolol, any advice when I work out, or any side effects for long term use. My GP is aware I use it daily but I am unsure why she is against actually prescribing me to use it every day - instead she keeps prescribing to use it 'as needed'. Is there a reason for this? Propranolol has helped me so much (I have been taking it daily for 10 days now). My life has completely transformed. Advice please! I don't want to be doing anything dangerous! Please!
Thank you so much in advance.
Submitted: 2 years ago.Category: Medical
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Answered in 5 minutes by:
12/13/2015
Doctor: Dr Basu, Experienced Specialist replied 2 years ago
Dr Basu
Dr Basu, Experienced Specialist
Category: Medical
Satisfied Customers: 29,282
Experience: MD
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Hi there,

This is Dr Basu, experienced Internal Medicine Specialist.

I am here to address your concerns and provide great service.

Propranolol is an age old medicatio.

Very effective in social anxiety situation.

Its safety profile is well established.

Your dose is low.

The usual dose of propranolol can be 120 mg daily maximum upto 240 mg daily.

Now long term use does have some side effects.

Weight gain, fatigue, sexual dysfunction are common side effects with long term daily use.

These side effects are much less on as needed basis use.

High blood sugar, cholesterol disorder also possible in some cases.

However, this is considered safer medication compared to other groups used for this disorder.

Daily exercise during morning time is considered good as your anabolic hormones responsible forbody build up are in higher level during mornings.

Best wishes,

It was my pleasure to help you today.

If I have answered all your questions, Please rate my response Excellent (click on the 5th star).

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