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Searching for a Solution for Stage Fright

Some people find that a beta blocker like metoprolol or propranolol offers a good solution for stage fright. Others can't tolerate the drug.

Musicians, actors, teachers and politicians may sometimes have one thing in common. They may feel anxious about appearing in public (well, maybe not the politicians). As a result, they’d like a solution for stage fright. We have welcomed a number of nondrug suggestions, including participation in Toastmasters for those who freeze up when they have to give a speech. Some readers rely on herbal approaches. If you consult a doctor about how to handle your stage fright, you might end up with a prescription for a beta blocker to slow your heart rate and keep your hands from shaking.

Is Metoprolol a Solution for Stage Fright?

Q. My doctor prescribed the drug metoprolol for my stage fright. The benefits last several hours.

I am an author and had terrible nerves and an embarrassing shaky voice when doing a reading. I wanted to share my experience with others who may also suffer from stage fright.

A. The FDA approved the beta blocker metoprolol (Lopressor, Toprol XL) for treating high blood pressure, angina pectoris and heart failure.

Doctors do sometimes prescribe beta blockers off-label for performance anxiety. These medications slow down the heart rate, which can help calm an overactive cardiovascular reaction (Psychopharmacology, 1991).

Not everyone can tolerate beta blockers, though. People with asthma or complicated heart problems may experience dangerous complications.

Trouble with Propranolol:

Metoprolol is not the only beta blocker. Some physicians have prescribed propranolol as a solution for stage fright. It can be helpful, but again, not everyone benefits.

Q. I love acting, but I suffer from stage fright. My doctor prescribed propranolol to ease my anxiety 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.

Instead, I took Benadryl an hour before going on stage and it took the edge off my anxiety.

A. Many people who love acting as you do also suffer from nerves or even debilitating stage fright. Others are gripped with fear when faced with a public speaking obligation.

Benadryl (diphenhydramine) is not an ideal solution for stage fright. This antihistamine can be very sedating and might interfere with your best performance.

Propranolol (Inderal) and other beta blocker heart medicines like atenolol (Tenormin) and metoprolol have been used for years by professional golfers and musicians to steady their nerves and hands. The PGA banned beta blockers in 2008 as part of its antidoping policy. While some people may find that a beta blocker is helpful for stage fright, it makes sense to test it before show time. You have plenty of company finding that this is not the ideal way to handle performance anxiety.

Another option is cognitive behavioral therapy. Although this may require several sessions with a trained therapist, the results are long-lasting.
Readers of this column also report the herb valerian can be quite helpful.

Here is one testimonial:

“I am a professional singer and my daughter does public speaking for her job. We both swear by valerian. It does the trick for nerves if you take it 15 minutes prior to performing or taking the podium.”

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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