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.
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. There are possible side effects (dizziness, drowsiness, etc) and people with asthma should generally avoid beta blockers.
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.

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  1. alxzba
    Reply

    one of the problems with offering advice/experience is that seldom does one get any feedback that is recognizable from the individual posing the initial question. I endorse the comments recommending ToastMasters before trying drugs. Do their introductory course — it does not take long and you’ll get mostly honest feedback in a supportive environment — you’ll know it if doesn’t fit your needs. You have nothing to loose and much to gain. Unless a professional speaker/politician, I doubt if anyone gets completely over some degree of nervousness when on stage — it keeps you sharp — and awake!

  2. OSJ
    Reply

    Peppermint in any form Candy, tea, etc 1/2 to 1 hour prior to the event works wonders. (from Dr. Oz)

  3. Andy
    Reply

    Hi LS.
    Did you find a solution to your problem? I shake, embarrassingly so, when I have to carry out certain often simple tasks – even though I feel confident in the task and am able to do it.
    I hope yr well, I feel your anxiety about this.
    Regards,
    Andy

  4. LS
    Reply

    I have never had performance anxiety when I sang until I got into an abusive marriage …several years later, I now shake involuntarily when I sing on stage or just for a crowd of unknown people… especially when I know I’m expected to… please help. My song (I have no problem recording in a studio), is taking off and I’m going to be expected yo perform it soon!!! :-o. Thank u in advance! :)

  5. Tom
    Reply

    No herb or Toastmasters course will help a person with real anxiety problems. I have decades of experience talking in public and I feel the same anxiety most of the time. Wasting time and no treatment can cause big problems

  6. Dale
    Reply

    I am a professional singer and my daughter speaks publicly for her job. We both swear by Valerian! It does the trick for nerves if you take it 15 minutes prior to performing/speaking.

  7. alxzba
    Reply

    Rather than attempting to get a quick fix with drugs and herbs, here’s another vote for the basic Toastmasters course. Try it first. Be open with yourself and others in the group and the feedback you’ll get will be great.
    It’s not group therapy, however you’ll learn much– importantly about yourself and how to be comfortable when speaking before others– and it can be fun!

  8. MMtexas
    Reply

    Toastmasters is a way better solution than drugs. With practice, coaching, and support, you will become a skilled and confident speaker. There are clubs all over the world. Go to http://www.Toastmasters.org to find one near you. Guests are welcome at no charge.

  9. Simon R.
    Reply

    Declaration of interest: I’m a professional trainer in presentation skills, so take everything I say with a pinch of “well he would say that, wouldn’t he!” :)
    Side effects of different people for different drugs vary, so there’s no point in sweeping generalisations. The only way to find out if a drug is going to work for you (let alone have side effects) is to try it. You may want to consider the implications of that, ‘cos you can’t test it ahead of time….
    People’s sensitivity to drugs varies over time, too, so what worked in the past may not right no – and visa versa obviously.
    Toastmasters is a mixed blessing. You’ll certainly get stage time, which will help over the years, but sometimes the advice you get from other amateurs isn’t the same as you’d get from professionals….. :)
    I’d suggest some training in the techniques of handling nerves and high-pressure anxiety, backed up by experiments with prescription meds and lots of practice.
    Or notes… notes are good…. for key facts such as who you’re introducing, notes are perfectly acceptable! Just learn some of the standard techniques for writing and using them professionally…..
    S

  10. Harriet B.
    Reply

    As a voice teacher for over 25 years, I have helped many people who struggle with “finding their voice while under pressure”. Relying on a vocal technique that teaches you how to breath in a healthy and productive way can be a life saver for those who rely on their voices in a professional capacity. Finding a reputable voice teacher can make a difference. National Association of Teachers of Singing (NATS) or Music Teachers Association of (any state) will guide you to a reputable teacher.

  11. fmk
    Reply

    Toastmasters is the best “medication” for stage fright. You will learn to speak easily in public and use the adrenaline rush. It will take work and time, but the benefits will extend far beyond your job.

  12. HHL
    Reply

    I’ve been using propranolol for public speaking for over 10 years with no side effects. The drug does not effect the memory.

  13. GMC
    Reply

    My doctor prescribed Propanolol for stage fright during a play. Fortunately, I experimented during the final days of rehearsal. The first night, I couldn’t remember where I put my clothes during a scene change. The second night, I couldn’t recall my lines. It was a very strange and frightening experience. I switched to taking ONLY Benedryl about an hour and a half before going on stage, and it helped take the edge off my anxiety.

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