Performance anxiety guide

Performance anxiety treatment online in Virginia and West Virginia

This guide is for adults with situational performance anxiety before a specific test, presentation, interview, audition, or public-speaking event who want an as-needed, non-controlled beta-blocker, not for panic disorder, daily anxiety, or asthma and certain heart conditions the safety screen checks for.

Start online

Start a $59 online review for Performance anxiety.

This visit is for situational performance anxiety tied to a specific, upcoming event, the racing heart, shaking hands, or trembling voice that shows up before a test, presentation, interview, audition, or public-speaking moment. When the safety screen comes back clear, the physician can prescribe an as-needed, non-controlled beta-blocker (propranolol) to take before the event to take the edge off the physical symptoms. It does not treat panic disorder, daily or generalized anxiety, or depression. Those fit our anxiety and depression visit or in-person care better. Propranolol is never safe for anyone with asthma, certain heart-rhythm conditions, or a few other factors, so the intake screens for those before anything is prescribed.

If treatment is appropriate, your physician can send a non-controlled prescription to your pharmacy and provide portal instructions for the next step.

Start this visit See response times

Quick facts

You must be physically located in Virginia or West Virginia at the time of request.
Starts at $59
No insurance needed
No app download
Physician review around the clock
Non-controlled prescriptions can be sent to your pharmacy when appropriate
A work or school note can be included when medically appropriate
Response times apply 24/7, every day

Common symptoms

A pounding or racing heart before a specific event
Shaky hands or a trembling voice under pressure
Sweating or a knot in your stomach tied to one upcoming event
Symptoms that show up only around that event, not day to day

May fit online care

Adults 18 and older
An adult with anxiety tied to one specific upcoming event, not everyday life
No asthma, COPD, or any wheezing or reactive-airway history
No slow heart rate, heart block, pacemaker, or low blood pressure
Not pregnant, and not treating diabetes with insulin or a sulfonylurea

Look for another care setting

Asthma, COPD, or any reactive-airway or wheezing condition (an absolute exclusion: propranolol can trigger dangerous bronchospasm)
A slow heart rate, heart block, a pacemaker, low blood pressure, or unstable heart failure
Panic attacks or daily, constant anxiety that affects your everyday life (see our anxiety and depression visit instead)
Pregnancy, insulin- or sulfonylurea-treated diabetes, or taking verapamil or diltiazem

What to have ready

What the upcoming event is and when it's happening
Whether you have asthma, wheezing, or any heart-rhythm condition
Current medications, especially diabetes or heart medicines
Whether this is truly occasional, or something you feel most days

What happens next

Standard

$59

Within 6 hours

Priority

$99

Within 3 hours

Rush

$149

Within 1 hour

Start the request on the website, answer a few questions to check that this visit fits you, and choose how fast you want an answer (the response window). If your concern still fits this service, a physician reviews it and sends you a secure update after you sign in. When appropriate, non-controlled prescriptions can be sent to your pharmacy, and a basic work or school note can be included at physician discretion.

Your physician

Every visit is personally reviewed by Ankur Fadia, MD. He is board-certified, has extra training in heart care (a cardiology fellowship), and is a member of Alpha Omega Alpha, a medical honor society. He is licensed in Virginia and West Virginia, and your care is never handed off to someone else.

Verify Virginia medical license Verify West Virginia medical license Verify board certification

Is propranolol a controlled substance?

No. Propranolol is a non-controlled beta-blocker. It's prescribed here specifically because it treats the physical symptoms of situational anxiety without the misuse risk of a controlled medication.

Why does asthma rule this out completely?

Propranolol can trigger dangerous airway tightening (bronchospasm) in people with asthma, COPD, or other reactive-airway conditions. Because of that risk, it is never prescribed here if the screen shows any of those, no exceptions.

I have daily anxiety, not just before events. Is this the right visit?

Probably not. This visit is built for anxiety tied to one specific, upcoming event. Panic attacks, or anxiety that shows up most days and affects your everyday life, fits our anxiety and depression visit better, which treats the underlying condition rather than a single event.

Read the anxiety and depression guide

How and when do I take it?

The physician's plan covers timing before your event once the safety screen is clear. Propranolol can lower heart rate and blood pressure, so it's worth trying it once before a lower-stakes moment first to see how you respond, and never combining it with alcohol.

What if I'm having thoughts of harming myself?

Please reach out right now: call or text 988 (the Suicide & Crisis Lifeline), available 24/7. This visit does not prescribe when those thoughts are present; the safest next step is crisis support and in-person care.

Other conditions we treat

Not quite what you have? Here are other conditions we treat.

Adult ADHD (non-stimulant)Anxiety & depression Grief and adjustment support Insomnia (trouble sleeping)Panic attacks Postpartum mood support