Q. I hope you can help me because my career is on the line. I was recently promoted to a position which requires me to make periodic presentations to our senior staff and to other organizations.
The problem is that public speaking makes me very nervous. My doctor prescribed alprazolam to calm me down. It does relax me, but during my last presentation I forgot the name of a team member I was introducing. It was incredibly embarrassing and I fear my memory is getting worse. I have also experienced panic attacks for the first time in my life and wonder if they are linked to alprazolam.
A friend told me you wrote about a natural remedy for stage fright. Please tell me about it.
A. Alprazolam (Xanax) has been associated with forgetfulness. Although alprazolam is sometimes prescribed for panic attacks, stopping the drug suddenly can trigger anxiety or panic. Taking it intermittently as you do might lead to such a withdrawal phenomenon.
Beta Blockers for Stage Fright
Physicians sometimes prescribe beta blockers such as atenolol, metoprolol or propranolol to treat musicians, actors or public speakers who suffer from performance anxiety. Such medications are usually prescribed for heart patients or to control high blood pressure. There are not a lot of scientific studies that demonstrate beta blocker effectiveness against stage fright.
Use of such drugs for this purpose is strictly off label. They can help control a pounding heart, rapid pulse or other symptoms of excess adrenaline such as shakiness. However, there are possible side effects (dizziness, drowsiness, etc) and people with asthma should generally avoid beta blockers.
Herbal Mixture to Help
One reader told us about an herbal concoction that works for her. The day before an event, she takes valerian and scullcap tinctures. She puts them in cranberry juice to make them palatable. Then, half an hour before the performance, she takes a smaller booster dose and spends fifteen minutes meditating.
Valerian and scullcap were used together in traditional medicine to calm the nerves, though modern research suggests most of the efficacy may be attributed to valerian. You will have to experiment to see whether this approach might help you.
You could also join Toastmasters, an organization which provides public speaking experience in a supportive environment.