Metaprolol and propranolol are both beta blockers, but the metaprolol (and its ilk) are cardiac specific. I took it way back when I first had trouble with a benign PVC, which is an extra heartbeat--very common but for me it felt like my heart was racing. Some years later when I had akathisia from Abilify Cogentin worked but gave me side effects. I stopped the Abilify. This time when Latuda gave me terrible akathisia (but no tremors) I switched beta blockers to propranolol, which is a systemic beta blocker. Either kind of beta blockers can help with physical effects of anxiety, like heart pounding, but I don't think a heart specific one would help akathisia. Propranolol doesn't help much when my anxiety is more mental. I've been on propranolol at 80mg now for at least 5 years. If you already have low blood pressure it wouldn't be a good idea--it would probably make you dizzy. For me it has no side effects that I can tell and works beautifully.