Rhiannon Lucy Cosslett: Propranolol prescriptions to English teenage girls up 90% in a decade
Beta blockers blunt panic symptoms while the causes go untreated, therapy waiting lists make the cheaper pill the default answer
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Illustration: Matt Kenyon/The Guardian
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Rhiannon Lucy Cosslett
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Rhiannon Lucy Cosslett has taken the pill she writes about. Her first panic attack convinced her she was dying — pounding heart, shortness of breath, chest pain — and when the attacks began arriving several times a week, driven by post-traumatic stress disorder, a doctor prescribed her propranolol, a beta blocker designed for cardiac patients. She was in her early 20s. The drug, she says, let her hold down a job and live her day more comfortably. It did nothing for the underlying disorder.
Prescriptions of propranolol to teenage girls in England have surged by 90% in a decade. The medication has acquired a reputation as a 'magic pill' and a viral 'panic pill' — the actor Rachel Sennott's quip 'take that beta blocker, girl' has become a meme, and the hashtag #betablockers passed 55 million TikTok views by late September. A Cosmopolitan investigation found beta blockers easily available through online pharmacies. The evidence supporting propranolol's efficacy against anxiety is, by Cosslett's account, limited; pharmacy bodies have raised safety concerns centred on overdose risk, and the MHRA, Britain's medicines regulator, is reviewing the drug's benefits and risks for anxiety use.
The economics are not mysterious. Beta blockers blunt the physical symptoms — sweating, shaking, a racing heart — within minutes of a consultation. Therapy takes months, requires trained staff, and carries waiting lists the NHS cannot clear. A prescription is cheaper for the health service today than the treatment that would actually address the cause tomorrow. Cosslett's own doctor eventually referred her for therapy and prescribed an SSRI antidepressant, which brought its own trade-offs: emotional numbing and weight gain. Long-term therapy, she notes, remains hard to get.
She raises the question the surge itself poses: if the physical symptoms of anxiety are being damped at this rate in young women, the symptom is being managed while the cause goes untreated — and nobody is obliged to explain why female anxiety is rising in the first place. The regulator's review may settle whether the pill is safe. It is not designed to settle why so many teenage girls need one.