Better Playing Through Chemistry (meds for stage fright)

New York Times ^ | 10/17/2004 | BLAIR TINDALL

[Born Conservative]

RUTH ANN McCLAIN, a flutist from Memphis, used to suffer from debilitating onstage jitters.

"My hands were so cold and wet, I thought I'd drop my flute," Ms. McClain said recently, remembering a performance at the National Flute Convention in the late 1980's. Her heart thumped loudly in her chest, she added; her mind would not focus, and her head felt as if it were on fire. She tried to hide her nervousness, but her quivering lips kept her from performing with sensitivity and nuance.

However much she tried to relax before a concert, the nerves always stayed with her. But in 1995, her doctor provided a cure, a prescription medication called propranolol. "After the first time I tried it," she said, "I never looked back. It's fabulous to feel normal for a performance."

Ms. McClain, a grandmother who was then teaching flute at Rhodes College in Memphis, started recommending beta-blocking drugs like propranolol to adult students afflicted with performance anxiety. And last year she lost her job for doing so.

[Born Conservative]

Excerpted due to length of article.

[Born Conservative]

Ping

[Question Liberal Authority]

Imagine the performances Pauly Shore could come up with if only he were heavily medicated.

[okkev68]

I started on a mild dose of Toprol 2-1/2 years ago for borderline high blood pressure and PVC's due to stress. It is amazing how much better I feel. Toprol combined with losing 25lbs and becoming a runner has made a huge difference.

I really noticed a difference in flying. I can sleep the night before a flight and actually relax (to some degree)on a plane now.

I am not a big advocate of medicating away problems, but stress can be a killer and very hard to control.

[95Tarheel]

Beta-blockers have been used for years by nervous medicine residents who have to present grand rounds. They are also likely used by many PGA golfers, particularly on the last day of a tournament.

In simple terms, these drugs are an anti-adrenaline.


I think the crucial distinction about whether or not this teacher should lose her job is in this paragraph:

"College officials, who declined to comment for this article, said at the time that recommending drugs fell outside the student-instructor relationship and charged that Ms. McClain asked a doctor for medication for her students. Ms. McClain, who taught at Rhodes for 11 years, says she merely recommended that they consult a physician about obtaining a prescription."


As an aside, don't ever do cocaine and beta blockers at the same time, it can cause your heart to stop. Just so you know. I know there are a lot of closet freeper-cokers out there! J/K.

[STD]

Quote Belushi "Never mix heroin and cocaine, those speedballs are a real killer, Duh"

[jwpjr]

re: "I am not a big advocate of medicating away problems"

I would not put using propranalol to control an overactive nervous system as medicating away problems. Every human body is built differently and what's a problem for one person is a blessing for another. For the boxer or the runner the nervousness is great, but for the person who must perform anything delicate it's a real bummer. I have been through at least a dozen 'new' drugs over the last 30 years to control my essential hypertension. None has worked, and I always end up back on propranalol! Every new doc I see is just positive the newest drug will do a better job. I have left a better trained trail of new docs behind me as the years have gone by.

[Chemist_Geek]

I am not a big advocate of medicating away problems,

I am trying to figure out what you mean by that. Do you suggest that humanity not use pharmaceuticals?

[mtbopfuyn]

Just another excuse to pop a pill.

The flutist either needs to find another line of work or learn to manage her stage fright. Stage fright is, after all, brought on solely by the individual and as such can be controlled by them. When my kids were young and were going on stage for the first time, I explained to them that the audience was made up of parents who would only have eyes for their own kids. They've never had butterflies since.

[DanTheAdmin]

Jeez... I've though all along that his performances were because he was heavily medicated.

[Born Conservative]

Stage fright is, after all, brought on solely by the individual and as such can be controlled by them.

I disagree. Stage fright is a physiologic phenomenon based on the primitive "fight or flight" response. For some, it is very difficult to control.

Just another excuse to pop a pill.

If we were talking about Valium or other benzo's, I might be able to see your point. However, beta blockers don't even REMOTELY produce a buzz, so other than the desired therapeutic effect, there would be no compelling reason for someone to "pop" a beta blocker.

[Doctor Stochastic]

I suggest about 4 oz of Gatorade about 15 mins before performance. (The dosage may vary with individual sweatiness.) I found that stage fright often causes a drop in blood pressure and that sipping a little Gatorade (or eating a small melon slice) does wonders. (Don't drink so much that the bladder becomes a problem.)

Other tricks (psychological) are to imagine that the audience is dressed in their underwear or that they are just cantelopes or sheep. I like to think that the audience is there to hear me and thus I'll give them something worthwhile (a big ego helps.)

[okkev68]

Seems clear to me. I believe in using the most effective treatment, whatever that may be. As a society, we have a tendency to treat the symptoms with "pharmaceuticals" first, instead of getting to the root cause.

I have a son and a daughter that they wanted to test and classify as ADHD. Instead of going for the easy fix and medicating them we chose to work hard to teach them self control. We also changed their diet and researched vitamins and supplements until we found something that worked. It wasn't easy but it is worth every parent/teacher conference when they report how outstanding they are doing.

Having said that, I chose to get on Toprol only after watching my dad have quadruple bypass surgery. He led a life of high carbs, high stress, high weight, and low exercise. But I didn't just depend on the meds. I lost weight, got in better shape, and changed my diet.

[Born Conservative]

In extreme cases of stage fright, this wouldn't work (Gatorade). Also, there is an INCREASE in blood pressure with the Fight or Flight response (i.e. stage fright), not a decrease. The mental imagery trick would be beneficial in a person with a more mild case of stage fright.

[Chemist_Geek]

Don't disparage symptomatic treatment. Attacking the "root cause" will not immediately solve the patient's need for relief.

Furthermore, how do you propose attacking the "root cause"(s), if not by pharmaceuticals if they're the appropriate treatment?

[t_skoz]

I'm in a band. The surefire way to kill stagefright is lots of practice, 2 or 3 vodka and tonics about 15 minutes before you hit the stage, and a flask full of whiskey. I've also heard that smoking a big fat joint with your bandmates helps, but that's illegal and of course I would never engage in such activities.

:-O

Your mileage may vary!