Last reviewed:
Feb 20th 2023
M.A., LPCC
Acebutolol, also known as Sectral, is a beta-blocker, typically used for the treatment of various heart conditions, but can also be prescribed to treat symptoms of anxiety. It is important to take this medication exactly as prescribed and to consult with your doctor before taking any other medications (prescribed or over the counter) while on acebutolol, as drug-related adverse effects can occur.
Acebutolol is a selective beta-1 receptor blocker, also known as a beta-blocker, which is approved by the US Food & Drug Administration (FDA) for use in the treatment of high blood pressure, also known as hypertension, abnormal heart rhythms, known as cardiac arrhythmias, and angina pectoris [1].
Acebutolol is also sometimes prescribed off-label, which means that it is not an FDA-approved use but has been deemed necessary for treatment by a medical professional. It can be prescribed off-label to help in the treatment of anxiety disorders [2][3].
Although it has been found to be somewhat effective in reducing some symptoms of anxiety, such as shaking, sweating, and increased heart rate, acebutolol has not been approved by the FDA due to limited research into the effectiveness of this use. There is also some evidence to suggest that beta-blockers can cause depression and create harmful side effects [4][5].
As such, further research is required to determine the safety and effectiveness of acebutolol and other beta-blockers in the treatment of anxiety.
Acebutolol works by blocking certain receptors in the heart, thereby reducing blood pressure and heart rate [6]. As such, it is an effective treatment for various heart conditions, but also helps to reduce some of the symptoms of anxiety and panic disorders [3].
While acebutolol may help to reduce some of the unpleasant symptoms of anxiety, allowing for improvements in daily, social, or professional functioning, it does not cure the mental effects or causes of anxiety.
Acebutolol is available as a capsule in 200mg and 400mg dosage strengths, which should be swallowed whole without crushing or breaking.
For the treatment of various heart conditions, acebutolol is prescribed at between 200-1200mg per day, to be taken in one or two doses. A daily dose of over 1200mg is not recommended [7].
For the treatment of anxiety disorders or trauma-related mental health conditions, research suggests that a dose of between 200-800mg per day can be effective, to be taken in one or two doses [2].
Your daily dose may depend on your age, weight, the severity of your condition, and your response to the medication [7].
Your doctor will monitor your physical and mental responses to the medication, to evaluate the safety and effectiveness of your treatment. They may alter your initial dose depending on your response to the medication to ensure you are prescribed the lowest therapeutic dose. A lower dose reduces the risk of side effects.
It is important to take your medication exactly as prescribed by your doctor, never taking more or less than is prescribed, or intentionally skipping doses, as this could cause adverse effects.
If you miss a dose, take the medication as soon as possible, or if it is close to the next dosage time, skip the missed dose. Never take double your prescribed dose in one go, as this may increase the risk of side effects or overdose.
If your doctor advises that you come off this medication, they will likely reduce your prescription slowly, to prevent adverse effects.
Acebutolol can begin reducing the symptoms of anxiety within 1-2 hours of your first dose and the effects may continue for several hours [3].
When you stop taking acebutolol, it can take 1-2 days for the medication to entirely leave your system [6].
When you start taking a new medication, you may experience some common side effects. These side effects will likely reduce within the first week or two, but if they continue or become problematic, consult with your doctor, as you may need a reduced dose or change of medication.
Common side effects of acebutolol include [7][8]:
Serious side effects of acebutolol are less common but may still occur. Contact your doctor immediately if you experience any of the following:
It is important that your doctor is aware of any past or present mental health conditions you have experienced, to enable safe monitoring of your condition while on this medication, or to decide if it is safe for you.
Discuss with your doctor all your past and present physical health conditions, including any medical history of heart failure, as they may impact your ability to take this medication safely.
Because of the potential effects of the medication, it may not be safe for you to take acebutolol if you have experienced asthma or any other lung diseases, heart, liver, or kidney conditions, blood vessel or circulation issues, severe allergies, or an overactive thyroid [8].
While you are taking this medication, particularly at the beginning of your treatment, your doctor will closely monitor your physical health, including your blood pressure, pulse, and respiratory rate, to ensure your safety and mitigate any potential risks to your health.
Acebutolol reduces anxiety symptoms such as flushing, sweating, and dizziness, which may also be crucial indicators of hypoglycemia, so it may not be an appropriate medication for you if you have diabetes [7].
Inform your doctor if you are pregnant or planning to get pregnant, as acebutolol can potentially cause developmental harm or heart issues in your fetus. Your doctor will inform you of these risks so you can make an informed decision about your treatment. Pregnant women are advised to only use acebutolol if the benefits of the treatment outweigh the risks.
Inform your doctor if you are breastfeeding, as acebutolol may be excreted in breast milk and cause a risk to your baby. As such, it should be used with caution in patients who are breastfeeding, and it is advised to monitor your baby for any unusual changes in their physical or mental health. Using alternative medications may be advisable [7].
Acebutolol can make you feel drowsy, particularly when you begin your treatment. As such, it is advised not to drive until you know how acebutolol will affect you and it is safe to do so.
Tell your doctor about all medications you are currently taking, or plan to take (including vitamins and dietary supplements), as they may cause adverse reactions.
Some medications can interact with acebutolol, potentially reducing the effectiveness of your medication or increasing the risk of side effects and allergic reactions. This includes medications for migraines, allergies, diabetes, and asthma, anti-inflammatory drugs, medications for blood pressure and other heart conditions, sedatives, and some other mental health medications [7][8].
Always discuss your medications and potential drug interactions with your doctor prior to starting a new treatment.
Always keep all medications out of reach of children.
Store acebutolol in its original packaging, in airtight containers, and at room temperature (68-77°F).
If you need to dispose of medication that is out of date or no longer needed, contact a medical professional to ensure it is disposed of appropriately. Never flush medications down the toilet or put them in the trash, as this can create unnecessary risks.
If you overdose on acebutolol, call a medical profession, or Poison Control on 1-800-222-1222, or in case emergency treatment is required, call 911. Symptoms of an acebutolol overdose include slow or irregular heart rate, shortness of breath, seizures, and heart failure.
Acebutolol is one of many beta-blockers that can be prescribed to treat the symptoms of anxiety, including propranolol, atenolol, and metoprolol, although these are not FDA-approved for this use [3][5].
There are also several other types of medications that are commonly used to treat anxiety disorders. Antidepressant medications known as selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) are commonly the first choice of treatment and are typically effective in managing various anxiety disorders [9].
Benzodiazepines, such as diazepam and lorazepam, can also be prescribed to help manage the acute symptoms of anxiety, although are generally prescribed for short-term treatment, due to their potential for dependence and abuse [10].
Other medications used in the treatment of anxiety include buspirone, pregabalin, moclobemide, and tricyclic antidepressants (TCAs), all of which have been found to be somewhat effective in managing symptoms [9].
The effect of medications tends to vary from person to person, so what works well for one person may not work well for another. As such, you may need to try more than one medication before you find one that works for you. Therapeutic interventions can also help to alleviate symptoms of anxiety and it is recommended to utilize therapy alongside medication for the most effective treatment [9].
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