Pharmacy regulator and royal college call on NICE to state propranolol is not recommended for anxiety
Four health organizations have petitioned NICE to explicitly state that propranolol is not recommended for treating anxiety disorders. They cite concerns over patient safety, noting the drug's high toxicity in overdose cases.
Why it matters
This highlights a potential conflict in clinical guidelines and the ongoing debate regarding the safety and efficacy of off-label prescriptions for mental health.
Four health organisations have written an open letter to National Institute for health and Care Excellence (NICE) calling for it to make clear that propranolol is not recommended for the management of anxiety disorders.
The letter , sent to NICE chief medical officer Adrian Hayter on 25 September 2026, requests NICE to review its clinical guideline on generalised anxiety disorder and panic disorder in adults. It was coordinated by the General Pharmaceutical Council and co-signed by the patient safety commissioner for England, Henrietta Hughes; Emily Kennedy, head of professional standards at the Royal College of Pharmacy; and Nicola Greenhalgh, president of the College of Mental Health Pharmacy.
Guideline CG113 does not mention propranolol, and the organisations ask NICE to update it to clearly state that propranolol “is not recommended by NICE for the management of anxiety disorders and highlight the risk in overdose”.
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