I have taken propranolol 40 mg (20 mg morn/20 mg evening) for at least 12 or 13 years now. It doesn't give me any side effects whatsoever, that I know of. I was originally prescribed another beta blocker, called metoprolol, by a cardiologist about 14 years ago for tachycardia (very fast heart beat rate), but I sort of think the tachycardia was related to anxiety and mood elevations rather than heart issues. In any case, during a psychiatric hospitalization, a psychiatrist switched me from the metoprolol to the propranolol, perhaps because the psych hospital pharmacy didn't have metoprolol? Or maybe the psychiatrist thought the propranolol would just work better for me? In any case, propranolol has been equally if not more effective for keeping my heart beat rate normal.

I would not say that propranolol eliminates all of my anxiety, but I am sure it does help to a decent degree. I still have prn Ativan for major anxiety/panic issues. Ativan works great for that. I also take a small dose of Klonopin. I'm not sure how much that does. I mostly take daily Klonopin more to prevent benzo withdrawal than anything else. I've taken Klonopin for at least 9-10 years.

The very first time I took Lithium, at 1,200 mg per day, I had very bad Lithium tremors. I was not on propranolol, or any other beta blocker, at that time. However, about four years later, I was put back on Lithium at 900 mg per day after being off it for a few years. I was then on propranolol, too, and had mild or even no tremors at all that time.

Some people are prescribed propranolol for akathisia. I assume it can help some people for that. My propranolol (at least at 40 mg) did not help with my past bouts of akathisia. Medications like Cogentin and Ativan did, on top of my propranolol.

Honestly, given how effective propranolol is at keeping my heart rate down, and it's zero side effects for me, I have no desire to ever stop taking propranolol. The generic is super cheap, the pills are very small, the benefits are significant for what it's meant to do for me. My blood pressure is almost always perfect at 120/80.