Beta block­ers can help ease stage fright

The Dallas Morning News - - Healthy Living -

Pre­scrib­ing for anx­i­ety is a le­gal but off-la­bel use of beta block­ers — that is, not Fed­eral Drug Ad­min­is­tra­tionap­proved for that pur­pose. Beta block­ers were ap­proved for and are still pri­mar­ily used to treat heart dis­ease and high blood pres­sure. A 2006 study at the Uni­ver­sity of Illi­nois-Chicago Col­lege of Phar­macy found that off-la­bel ad­min­is­tra­tion of beta block­ers was higher than pre­vi­ously re­ported, but didn’t pin­point the preva­lence of par­tic­u­lar uses.

Un­like anti-anx­i­ety drugs such as di­azepam (best known as Val­ium) or al­pra­zo­lam (Xanax) or even al­co­hol, which work on neu­ro­trans­mit­ters in the brain to cause se­da­tion and mus­cle re­lax­ation, beta block­ers pre­vent the body’s nat­u­ral adren­a­line and no­ra­drenaline from stim­u­lat­ing their tar­get re­cep­tors. This slows the heart rate.

Beta block­ers have few side ef­fects, es­pe­cially for peo­ple who only take them oc­ca­sion­ally. Still, Wal­ton cau­tioned against shar­ing drugs without a pre­scrip­tion. Peo­ple with asthma, de­pres­sion, low blood pres­sure, car­diac is­sues and other prob­lems or who are on cer­tain med­i­ca­tions should not take beta block­ers. And beta block­ers will not help any­one with se­vere anx­i­ety.

Pro­fes­sional help

The drugs seem de­signed for stage fright. They in­hibit the har­row­ing ef­fects of the adren­a­line-laced fight or flight re­sponse that make a ner­vous per­former even more ner­vous: pound­ing heart, quaver­ing voice, trem­bling and sweaty hands.

It’s no won­der then that per­form­ers turned to them shortly af­ter their in­ven­tion nearly four decades ago.

Of the sev­eral beta block­ers de­vel­oped since, the most ef­fec­tive for per­for­mance anx­i­ety re­mains the first: pro­pra­nolol (brand name In­deral). Its use among ac­tors and mu­si­cians is com­mon­place, if some­what un­der­ground.

“There was a time I couldn’t go on stage without beta block­ers,” said James Hamp­ton, a for­mer tenor who is now artis­tic ser­vices man­ager at the Dal­las Opera. “There is a de­gree of ‘good nerves’ that you want, but that can go too far.”

Hamp­ton used pro­pra­nolol for one stress­ful year, when he was over­whelmed by a shift from singing to stage di­rec­tion and com­plet­ing a doc­tor­ate. Be­fore end­ing his singing ca­reer, he sang for four years without them, en­cour­aged af­ter he had a suc­cess­ful per­for­mance de­spite for­get­ting his pills at home.

Mu­si­cians and ac­tors have quit the stage be­cause of per­for­mance fright. Yet some doc­tors and mu­si­cians re­sist beta block­ers as treat­ment.

Many per­form­ers value that very rush of adren­a­line that sparks anx­i­ety. “It makes us aware of our­selves at a time when we need to be aware,” said Sally Nystuen Vahle of the Dal­las The­ater Cen­ter and act­ing and voice in­struc­tor at the Uni­ver­sity of North Texas.

Beta block­ers can in­tro­duce a dull­ness that in­ter­feres with that, ac­cord­ing to Dr. Bernard Ru­bin, a pro­fes­sor at the UNT Health Sci­ence Cen­ter at Fort Worth and a physi­cian who treats many mu­si­cians. For any­one fac­ing even heart-pound­ing nerves, Ru­bin ad­vo­cates “a lit­tle bit of time, a lit­tle bit of fore­thought and much less phar­ma­col­ogy.”

Re­gard­less of their stance on beta block­ers for stage fright, ev­ery physi­cian and per­former in­ter­viewed said al­ter­na­tive re­lax­ation tech­niques are also es­sen­tial. And the No. 1 an­ti­dote to anx­i­ety ad­vo­cated by every­one is prepa­ra­tion.

“Prac­tice, prac­tice, prac­tice,” said Kris Ch­esky, di­rec­tor of UNT’s Texas Cen­ter for Mu­sic and Medicine. “And put ev­ery­thing in per­spec­tive. If you fal­ter, your life is not go­ing to end.”

Daphne How­land is a free­lance writer in Port­land, Maine.

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.