Propranolol - Often safe at low doses But not side-effect-free, especially if taken daily for months/years without review What propranolol does • Slows heart rate • Reduces adrenaline effects • Helps palpitations, tremors, anxiety-related symptoms Possible long-term side effects (even at 10–20 mg) as below Common • Fatigue, low energy • Cold hands/feet • Dizziness (especially on standing) • Sleep disturbances / vivid dreams Important but less common • Too slow heart rate (bradycardia) • Low blood pressure • Worsening asthma / wheezing • Low blood sugar masking (important if diabetic) • Reduced exercise tolerance • Sexual dysfunction Mental health • Can worsen low mood or cause emotional blunting in some people Etizolam 0.25 mg daily — the bigger concern. This needs extra caution. Risks with long-term daily use (even 0.25 mg) • Dependence (can happen in weeks) • Tolerance (needs higher dose for same effect) • Rebound anxiety & insomnia when stopped • Memory issues, brain fog • Daytime drowsiness • Reduced deep sleep quality (ironically worsens sleep over time)