Klarinet Archive - Posting 000507.txt from 2004/08

From: "Film & Music Promotion Management" <FilmPromotion@-----.net>
Subj: [kl] re: Inderal - Authority
Date: Tue, 17 Aug 2004 17:29:11 -0400

Here's the reply I got from Dr. Levine about Inderal for Musicians/
reactions, etc.

Posted with his gracious permission:

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Dear David--

Fine to take under medical supervision; not fine to take any
medication that has not been prescribed for you by a physician who is
supervising your care. Don't take somebody else's meds.

Other medications work for performance anxiety including
benzodiazepines [Valium-like substances--they can become addictive but
are good short term]; SSRI's [serotonin specific reuptake inhibitors
like zoloft, prozac]; antianxiety agents like Buspar [buspirone]. For
the latter medications, I would have a psychiatrist prescribe them.
Primary care physicians can prescribe them too and think they know
what they are doing. They do know how to prescribe them--they just
don't know when not to prescribe them. [SSRI's can induce mania in
predisposed individuals.] Relaxation techniques, yoga, physical
fitness [riding a bicycle regularly] all help too.

When in doubt, get a consultation with someone who sees you in
person and assumes responsibility for your care.

Note that I wrote the above before reading the clinical account
below. For Inderal to do this would be a paradoxical reaction but
possible; all sorts of medications have psychiatric side effects in
the predisposed. Tagamet, is used for ulcers, can cause depression and
confusion. Nexium, which is used for acid reflux, can cause
depression.

In summary, any non-psychiatric medication that affects
neurotransmission can have psychiatric side effects. Caffeine commonly
does.

Cheers,
Levine

John Braverman Levine, M.D., M.B.H.
Clinical Instructor in Psychiatry
Harvard Medical School
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