Anxiety can prompt people, in their wish for freedom from it, to try many unorthodox cures, some of them dangerous, others questionable.

Anxiety can be advantageous to us at appropriate levels because it can act as a motivator, but that's not always the case. Many people experience anxiety that's highly disturbing and counterproductive. When it reaches these levels, too many will search for cures they believe or have been told are natural, harmless, and readily available. Sometimes, the belief extends to people in the healthcare profession who may prescribe beta-blockers as the solution for anxiety. How do beta-blockers work?

One of the best ways to consider beta-blockers and, in fact, many medications, is the lock-and-key explanation. Certain substances, such as adrenaline, can work on the nervous system to ramp up its activity to help us in a fight-or-flight scenario. That's where adrenaline is playing a beneficial role. Some highly respected entertainment professionals have indicated they use beta-blockers for performance anxiety. Not that it's recommended without medical supervision.

But sometimes adrenaline needs to be controlled, and that's where beta- blockers come into play. They latch on to the receptor in the nervous system that would have been the site for adrenaline to connect. If adrenaline cannot reach these receptors because the beta-blockers have gotten in the way, our nervous system can remain calmer. We need to understand why physicians prescribed a medication meant for heart problems to people with anxiety and if it was safe. The primary reason was their calming effect and good side effect profile.

Consumers should be aware that beta-blockers were approved for a number of medical disorders, not anxiety. Patients with tachycardia, high blood pressure, myocardial infarction, congestive heart failure, cardiac arrhythmias, coronary artery disease, hyperthyroidism, essential tremor, aortic dissection, portal hypertension, glaucoma, migraine prevention, and other diseases were prescribed the drugs.

One thing to know about drug regulation is that once a drug is approved by the FDA, it, theoretically, can be used in any off-label use the prescriber intends. I once had a researcher, in a rather dark, jovial mood, tell me that he could prescribe paper clips if he wanted to. Of course, the FDA never approved paper clips for anything, but he wanted to make a point. Yes, he made the point.

Now, there is growing concern about the off-label use of beta-blockers for anxiety relief. One aspect of an anxiety disorder is intrusive, nearly constant thoughts that are highly disturbing. An experiment with cancer patients indicated that beta-blockers did not affect such intrusive thinking. If these drugs can't affect this disorder of thinking, are they useful or should something else be considered?

We know that one anxiety disorder, OCD, is not only disruptive to our daily lives, it is highly intrusive into our thinking. I once had a physician contact me in a state of desperation. He had an incredible problem with OCD and had exhausted every medication that could be prescribed or that he believed might be useful.

Despite trying various treatments, like beta-blockers, nothing worked for him. He mentioned the possibility of brain surgery to stop the obsessive thinking. It had totally disrupted his professional career. Unfortunately, after our brief discussion, I never heard back from him again. He lived thousands of miles away from me in an area where I was not familiar with the treatment facilities, and I could not make a referral.

Researchers have found several undesirable side effects with beta-blocker administration for disorders other than cardiac. One large overview of psychiatric studies (over 23,000 patients) found that many of the originals studies that supported beta blockers for anxiety had methodological problems.

This latest investigation into a wide range of studies with side effects found that it is pretty normal for PAEs (psychiatric adverse events) like depression to show up in people who need to take beta-blockers. A sleep disturbance was also noted.

Tiredness, cold hands or feet, and dreams are other possible side effects. Bizarre and unusual dreams are also brought on by other medications prescribed for anxiety, including benzodiazepines. Beta-blockers can also make you sick to your stomach with diarrhea, and sometimes they can make it hard to breathe.

The concern regarding beta blockers' prescription is not that they pose a significant problem, but that people may not have an adequate medical evaluation before they are prescribed these drugs. There could be underlying conditions that need to be addressed, and anxiety is the major presenting one, but not the disorder that needs to be treated.

While the Internet has information on natural remedies, be aware that some of it can negatively impact your health. Some of these substances have been associated with serious liver problems or high sensitivity to sunlight. As I've always told anyone who has come to me for an evaluation, please be sure that you first have a medical evaluation. There are many medical conditions that can mimic mental health disorders, and we need to rule those out first.