Beta Blockers And Performance Anxiety In Music-Musicians

“Having passed 40, I am becoming more and more health concious and I really want to know exactly what I put in my body, so this article is going to dig into how and IF using betablockers is dangerous for us.”

betablockers I use when performing trumpet music
Holding my propranolol which I’m drastically trying to cut back the use of

Beta Blockers And Performance Anxiety In Musicians

Many people suffer from stage fright and using beta blockers to treat performance anxiety is pretty common. Personally I have been using them, on and off, for 20 years on my trumpet gigs…

…in fact since I also have a bit of issues with panic attacks and social anxiety, beta blockers are very familiar to me…to say the least.

Short summary of the post
  • Is using drugs to be able to perform a common thing?
  • Beta blockers long term use for performance anxiety…is it dangerous?
  • Have people died from using beta blockers ?
  • Is it safer if I take them just once in a while?
  • Are there other, natural, alternatives to beta blockers?

90 minutes before a trumpet performance I use to pop a proranolol, or propral, as the name for them are in my country. This has happened on and off for more than 20 years but somewhere around 35 years of age, I really started thinking a lot more about my health and now, at 42, even more so.

The last couple of years I have also started noticining some side effects from the beta blockers, that I did not have in my early years of using them. In addition to that, more and more people are coming out saying that beta blockers actually can be harmful for us.

What are beta blockers really?

Beta blockers are a prescription medication that are used to treat high blood pressure and abnormal heart rhythms. Beta blockers block the receptor sites for adrenaline and noradrenaline on adrenergic beta receptors, of the sympathetic nervous system, which mediates the fight-or-flight response.

This is why they can be used for performance anxiety since, while we still might experience the anxiety mentally, the physical response of the anxiety is less pronounced. In other words…

…beta blockers tend to significantly lessen the nasty, physical, side effects that we get when we are really nervous.

Most musicians using beta blockers experience:

  • A lowering of heart rate
  • Less sweating
  • Less shakiness / tremors

And because of this it is easy to understand why people suffering from performance anxiety find them useful since they indeed help with having better control over our hands, arms and the rest of our body. However…

…it can come with a price to pay later on, as you will find out further down in he article.

How common is the use of beta blockers in music?

There are no data on how common the use of beta blockers are in people that play music for recreational purposes only but there are a few studies made on professional musicians.

One study showed that 72% of professional musicians have tried beta blockers for performance anxiety

Note that this is not the same as saying 72% use beta blockers. But 72% of them have at some point tried it. 89-90 % said they would perhaps consider using them for auditions, while 70-73% would consider them for solo or featured performances.  Another 35-37% said they maybe would consider using them for orchestral performances.

We have to keep in mind that this means that people how actually are using them are lower in % than the % of people who said they could “consider” using them.

“An estimated 18-23% of professional musicians regularly use beta blockers for their performance anxiety”

Also when taking a step back to think about the numbers, we must remember that not everyone that are performing suffers from stage fright or performance anxiety to begin with…

…those lucky bustards!

Look:

I say lucky bustards because, indeed not everyone is so lucky and there are a lot of people who never completely get rid of their performance anxiety no matter how much experience they have and many of the tools and tricks they try don’t really seem to be helping that much.

I myself belong in this category however, speaking of tools and tricks, there are actually a few biological and mental tricks I have found that can indeed help a bit with anxiety. If you are interested you can read the post dealing with nervousness on stage when performing music in which a share a few of those tools.

Are beta blockers safe to use for anxiety issues such as performance anxiety?

Well, this is the question that led me to more and more consider alternatives to beta blockers and nowadays I try to avoid using them as much as I can. I admit that I still take them on some occasions but I’d say I have managed to cut down my use by at least 95% and I’m happy for that because…

…apparently there are some pretty serious health risks involved with using beta blockers. I hope you are ready for this…

Let’s first start with the side effects of using beta blockers

Some common side effects of using beta blockers are

  • Fatigue
  • Cold hands or feet
  • Dry eyes
  • Weight gain
  • Depression
  • Sexual problems
  • Decreased testosterone levels

I personally experienced the lowering of testosterone as well as the depression, dry eyes and sexual problems.

In addition to this our body becomes worse at handling stress in situations where we do not use beta blockers. This is because, by often using beta blockers the gets used to having a “brake” on the adrenaline and heart, and the bodies whole “relax mechanism” does not get enough practice. In other words we become less able to deal with stress BOTH mentally and physically.

 

 

Here’s the deal:

If the bodies relax mechanism is functioning poorly we might even run into issues like very high levels of anxiety, triggered by seemingly small things in our lives and for some people…

…even full blown panic attacks! This is also something I have experienced first hand but, sadly, the negative effects and risks do not end here.

There are some warnings coming out on the safety of beta blockers

Besides the very common side effects I already listed, and the ones I have noticed myself, there are more uncommon side effects of beta blockers that are more serious

  • Hallucinations
  • Confusion
  • Toxic epidermal necrolysis
  • Bronchospasm
  • Rashes
  • Insomnia
  • Muscle loss and weakness
  • Hair loss

Also many experts warn that asthma symptoms may become much worse if using beta blockers, which is another reason for me switching to other alternatives since I suffer from asthma.

Doctor Mercola Claims that beta blockers killed 800.000 people in 5 years

Now, I’m NOT a doctor or an expert in any way and I have not read everything that is out there but Doctor Mercolas article here goes pretty hard on beta blockers and their safety.

What he is saying is that beta blockers can indeed be beneficial for people that are at high risk of having a heart attack but on the other hand they can even be harmful for others. Quote form the article…

“Beta blockers may have helped those with the most serious conditions, while harming those with little or no prior heart risks”

…now, as I understand it the article is about “surgery patients” and while most musicians belong in the later category “people with little or no heart risk” we would not be classified as “surgery patients”…

…that said I personally do not want to use a drug that can cause such a big difference between life and death in “non cardiac patients” whether the circumstances are surgery, anxiety, or anything else in life.

I have been listening a lot to what Dr. Mercola has to say during my years but I’m note 100% sure what to make of his article about the beta blockers but so far I have found his work and material to be very professional and I have trusted him over the years so…

…I have to admit that this article scares me a bit.

Beta blockers are still commonly used but we do have to remember that even if a drug or treatment is “frequently prescribed” this does no way guarantee that it is safe.

Again, I’m a trumpet player not a doctor or a health expert

I’m sure there are other opinions out there, even among experts and God knows who we should listen to, but it appears that for people who do not fit in the category “high cardiac risk” the risks of using beta blockers HIGHLY outweigh the benefits.

In this study, they concluded that the risks of using beta blockers for high blood pressure, in older adults, did NOT outweigh the benefits. I wanted to find out what they mean by “risks” so deeper down in the study I found this…

“These additional references provide preliminary evidence that certain risks like fatal and non-fatal stroke, major vascular events, cardiovascular morbidity, death from all causes, and death from cardiovascular causes may be increased with the use of beta blockers compared to other antihypertensive treatments. The uncertainties regarding these risks imply that independently from the age group beta blockers should be prescribed with caution for the treatment of hypertension.”

But what about musicians?

Ok, fair enough, I understand that the study is done on people with hypertension but if beta blocker means “increased risk of fatal and non fatal stroke and vascular events” in elderly adult people with hyper tension, what exactly do they do for people in my age group, 40+,  that are using them in their music performances?

I have a hard time finding any studies made on their safety in non cardiac patients. Some doctors say that they are “generally pretty safe” but as far as I can tell, there are no real research on what effects occasional use of beta blockers can have….

…this is just not good enough for me and another strong reason why I don’t want to take them any more, and given that they can be that harmful for people with hyper tension, as I quoted from the study, then that means they obviously have some pretty powerful effects on the human body.

What my personal doctor warned me about

As I already touched upon is the fact that when using beta blockers our bodies gets used to having a “brake” on the heart. This means that the heart, and nervous system, may become extra sensitive when we DON´T have beta blockers in our system…

…according to my doctor this can potentially be a health risk if we like to exercise and for example do pretty intense training.

What do I mean?

Let’s say you take a beta blocker on Wednesday evening. Well, since the body is trying maintain “homeostasis” it tries to counteract for the “brake” the pills are putting on our heart….

…so the next day on Thursday, when you no longer have the beta blocker in your system, your heart and nervous system may be more sensitive to stress than it normally would be, if you if you hadn’t been taking the beta blocker in the first place so…

…Listen up here!

So if you now, on that Thursday go for a very intense interval training for example, it might be that your heart, being extra sensitive that day, might not be able to cope as well with sudden intense exertion… and if you are unlucky, it might even get damaged in some way from the hard exercise…

…or even worse.

But again, this is what my doctor tells me and I am NOT an expert on this myself.  However my doctors words does indeed sound very logical and one thing is for sure, as I love to do intense exercise, I WILL NEVER AGAIN do it the day after I have been taking beta blockers.

For the last time, I am no expert and this is NOT medical advice or any form of recommendation

I probably could have done more and better research about this but what I have come across so far is enough for me personally to want to limit my use of beta blockers as much as possible.

That said I am NOT recommending you do the same!

In fact I am not recommending anything at all with this article. The purpose is just to share my personal experience and the findings I have made. I’m not recommending that you quit using beta blockers nor am I recommending that you use them. When in doubt, always talk to your doctor.

And as for sharing my personal experiences I am now mostly using natural anxiety supplements instead of beta blockers.

Alternatives to beta blockers for performance anxiety

A few years ago I found an anxiety supplement that has made it possible for me to drastically reduce my use of beta blockers. This is a natural supplement that everyone can order as there is no need for a prescription to use it.

I have tried many anxiety supplements and, honestly, most of them does not do much at all for my anxiety. However ProVanax is something that indeed works pretty well and ever since I first tried it, a couple of years ago, I now order a few bottles of it a year.

I like it because, not only does it drastically reduce my bodies physical response to anxiety, but unlike beta blockers, it also makes my brain calm. And all this is without dulling my senses like for example alcohol would do….

…this makes it perfect for performance anxiety and if I have an important trumpet gig I really feel I can do my very best and, most of the time, nail the performance with the help of this supplement.

The pros and the cons of using ProVanax instead of beta blockers
The cons
  • Works best if used in cycles

It works best if not taking it daily but 3 times per week at max in order for the receptors in our brain not to get too used to it. Personally i cycle it and use it every other day (if having a period of high stress) or just when needed.

The pros
  • No need for a prescription 
  • Works better than beta blockers for me
  • Makes you relaxed but you are still alert
  • Is probably a safer alternative than beta blockers

Now, the last point there is something I have put a lot or research into and I honestly have to say that I’m not 100% sure whether it is actually safer than beta blockers for everyone. However everything I have come across regarding the ingredients, so far,  points to it being a much safer alternative than using beta blockers, being a natural supplement and all.

That said we are all unique and react differently to everything so don’t take my words as a written in stone fact. It works for me and I think that, if using it instead of beta blockers at least 75% of the times, it is a win for my body in the long run.

If you are interested in learning more about the product I have made a more detailed review on it on my other website about anxiety. You can read that review by clicking here. If you would like to hear other opinions about ProVanax then you can click here to go read other real user reviews on their website.

A word of warning!

If you do decide to try it for your own performance anxiety you have to know a couple of things first. It takes longer to kick in than beta blockers so do not take it 60 minutes before your gig. Also, the effects are much better if you take it on an empty stomach.

Say I have a trumpet performance Sunday at 6pm here is what I personally do:

  1. I take 2-3 capsules of ProVanax at  1 pm (this should be on an empty stomach, as in you should not have been eating anything 2 hours prior to taking it)
  2. After that I wait for at least 30 minutes before I eat something (if I want to eat of course)
  3. I take another 2-3 capsules at 3 pm (this one does not have to be on an empty stomach however it will work even better if it is)

If I follow that routine I will be calm, cool and very focused when my trumpet gig roles around at 6pm and this will significantly help me nail the performance, which I think is pretty impressive for a natural supplement. Being that it works so well, I also sometimes use it in other situations where I tend to get anxiety as well, being a person with anxiety issues an all.

Final words on using beta blockers for stage fright

As I said earlier, some people never get rid of their stage fright and the performance anxiety always seem to be at levels that are just too high for the musician to be able to perform as well as he or she would want to. In that case it is very understandable to reach out and use a little extra help….

…and this is nothing to be ashamed of. It is certainly not cheating because the beta blocker, or ProVanax in my case, only makes us perform more like we are able to play in the practice room at home. They wont give us some magic musical powers to make us suddenly play better than what our current skill levels alow us to do.

So no, using beta blockers or other anxiety supplements is not cheating at all, in fact they even make our performances MORE honest because, when using them, what we are presenting for the audience is a result that is much closer to how we actually play when not completely destroyed by anxiety!

Whether you continue to use beta blockers or try to go completely “clean”, and not use anything at all,  or whether you try to find alternatives like I do…

… the choice is completely up to you!

…personally I am so tired of having massive anxiety and I have more and more adapted the mindset “life is too short for panic attacks” so, yeah, I’m going to continue to use the anxiety supplement whenever I feel I need it without any feelings of guilt or shame whatsoever.

Thank you for reading the article “Using beta blockers for performance anxiety in music”

-Robert Slotte-