Can I stop taking metoprolol for anxiety? Understanding withdrawal and safe tapering

October 10, 2025 •

3 min read

The U.S. Food and Drug Administration (FDA) has issued a black box warning for metoprolol, emphasizing that abrupt cessation can cause dangerous health issues, including heart attack or chest pain. It is critical to consult a healthcare provider before you can I stop taking metoprolol for anxiety? to ensure a safe transition.

Quick Summary

Abruptly discontinuing metoprolol, even for anxiety symptoms, can cause severe withdrawal effects. A healthcare provider must supervise a gradual tapering process to prevent serious rebound phenomena and cardiac issues.

Key Points

Never Stop Abruptly: Abruptly discontinuing metoprolol, even if used for anxiety, is extremely dangerous and can cause severe health complications, including a heart attack.
Taper Under Supervision: A doctor must guide a gradual tapering process over several weeks to prevent harmful rebound effects and allow your body to readjust safely.
Expect Withdrawal Symptoms: Common withdrawal symptoms can include increased anxiety, palpitations, headaches, and tremors as your body’s stress response overreacts to the medication's absence.
It Only Treats Physical Symptoms: Metoprolol helps manage the physical manifestations of anxiety (e.g., rapid heartbeat), not the underlying psychological causes.
Consider Alternatives: For long-term anxiety management, alternatives like SSRIs, SNRIs, or psychotherapy are often more appropriate and can be transitioned to during tapering.
Monitor During Tapering: During the tapering phase, it is crucial to monitor your heart rate and blood pressure and report any concerning symptoms to your healthcare provider.

The Dangers of Abruptly Stopping Metoprolol

Metoprolol is a beta-blocker prescribed for conditions like high blood pressure and heart problems. It is also used off-label for the physical symptoms of anxiety. Although not habit-forming, the body becomes accustomed to its effects. Stopping metoprolol suddenly can lead to a rebound effect where the body's beta-adrenergic receptors become oversensitive, causing a dangerous increase in heart rate and blood pressure. Potential risks of sudden withdrawal include severe chest pain (angina), heart attack (myocardial infarction), and worsening of existing heart conditions. Metoprolol blocks stress hormones like adrenaline from affecting beta-receptors in the heart and body. Over time, the body increases these receptors to compensate. When metoprolol is stopped, this leads to an overreaction from the unopposed adrenaline, causing the rebound effect. The body needs time to adjust to managing its natural adrenaline response again.

How Metoprolol Works for Anxiety

Metoprolol manages the physical symptoms of anxiety, not the psychological ones, by blocking adrenaline's effect on the heart. This can help with rapid heart rate, trembling, sweating, and elevated blood pressure that occur during stressful situations. It is often used for situational anxiety but is not a primary treatment for generalized anxiety disorder. Long-term anxiety often requires different medications and therapy. Stopping metoprolol without medical guidance can lead to withdrawal symptoms, which may be mistaken for a return of anxiety. Common withdrawal symptoms include increased anxiety or panic, fast heart rate and palpitations, headaches and dizziness, tremors, difficulty sleeping, feeling unwell, and higher blood pressure. Rebound anxiety is a temporary increase in anxiety as the nervous system readjusts. These symptoms are part of the body's adaptation.

The Safe and Medically Supervised Tapering Process

A healthcare provider will create a gradual tapering schedule to allow the body to adjust safely over several weeks. Key aspects include an individualized plan based on dosage, treatment duration, and health history, a gradual reduction process, monitoring of heart rate and blood pressure, and symptom management if withdrawal occurs.

Alternatives and Complementary Treatments for Anxiety

To address the root causes of anxiety, other treatments can be integrated. These include therapy like CBT, other medications such as SSRIs and SNRIs, and lifestyle changes like exercise and stress management.

Comparison: Metoprolol vs. Long-Term Anxiety Treatments


Feature	Metoprolol (Beta-Blocker)	Psychological Treatments (e.g., CBT, SSRIs)
Target Symptoms	Primarily physical symptoms of anxiety (e.g., heart rate, trembling)	Both physical and psychological symptoms (e.g., worry, fear, rumination)
Mechanism of Action	Blocks adrenaline's effect on beta-receptors, slowing heart rate	Address neurochemical imbalances and thought patterns
FDA Approved for Anxiety	Used off-label for situational anxiety	Primarily approved for generalized and panic anxiety disorders
Long-Term Treatment	Generally not recommended for long-term management of generalized anxiety	Often used for long-term anxiety management
Withdrawal Risk	Significant risk of rebound effects, requires tapering	Risk of discontinuation syndrome, requires tapering

Conclusion: The Importance of Professional Guidance

It is unsafe to stop taking metoprolol for anxiety without a doctor's guidance. The body's adaptation makes abrupt discontinuation dangerous due to severe rebound effects. A doctor-supervised tapering schedule is essential for a safe transition and allows discussion of other long-term anxiety treatments. Always seek medical advice before changing your medication regimen.

Frequently Asked Questions

If you stop taking metoprolol suddenly, you risk experiencing severe rebound effects, including a rapid increase in heart rate, a spike in blood pressure, intensified anxiety, and palpitations. In individuals with pre-existing heart conditions, this could potentially lead to a heart attack.

The duration of a metoprolol taper depends on factors like your dosage, length of treatment, and overall health. A typical plan involves gradual dose reduction over one to two weeks, but for higher-risk patients, it can be longer, sometimes extending to several weeks.

Metoprolol withdrawal symptoms occur because the medication blocks adrenaline from affecting the body's beta-receptors. Over time, the body creates more of these receptors. When the drug is stopped, the now-hypersensitive receptors are flooded with adrenaline, causing an overreaction and rebound symptoms.

Yes, but this must be done under a doctor's supervision. Your healthcare provider can guide you through a safe transition, which may involve cross-tapering or a 'washout' period, depending on the medications involved, especially when switching to or from an SSRI or SNRI.

Rebound anxiety from metoprolol withdrawal is not permanent. The symptoms are temporary and will subside as your body adjusts to the absence of the medication. This process is managed and mitigated by a slow, gradual taper under a doctor's care.

Effective non-medication alternatives for anxiety include cognitive behavioral therapy (CBT), regular exercise, mindfulness and meditation, and stress management techniques. These approaches address the psychological root of anxiety, complementing or replacing medication.

While it can be difficult to distinguish, withdrawal-related anxiety often feels more intense and is accompanied by physical symptoms like palpitations, tremors, and headaches, which are the body's physiological response to the abrupt change. A doctor can help clarify the source of your symptoms.