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 Re: One in Four Classical Musicians Use Beta Blockers
Author: DaveF 
Date:   2006-03-28 22:57

As a physician, and a clarinetist, I thought I would chime in to clarify a few points. Lots of great discussion here that's been very interesting and enlightening.

I believe the medical field considers performance anxiety syndrome as a very legitimate disorder, and one that can be easily managed. The remainder of the chronic anxiety disorders however can be very difficult to manage. Beta blockers however, as many have pointed out, are certainly not performance enhancing, but simply blunt parts of "flight or fight" response that includes rapid heart beat, or perceived rapid heart beats, PVC's (premature ventricular contractions, also called skipped or irregular beats), sweating, tremor, and overall sense of nervousness. I think physicians like myself readily recognize the potential benefit of beta blocker use to an individual who is sufferring with performance anxiety, although would hope that relaxation techniques would also be pursued as well.

Short acting beta blockers are typically used, of which propanolol (Inderal) is the prototype, and as a generic makes the most sense. Longer acting beta blockers such as atenolol, metoprolol, nadolol, and others are not appropriate here due to their sustained release. These are used for hypertension, coronary artery disease, migraine prevention, among other conditions.

Side effects have been mentioned by some.......however these are generally related to sustained release long term use. Depression, lethargy, constipation can be problems here, but would not be expected with intermittent use of a short acting drug. Beta blockers can worsen asthma, but usually only a problem in an individual with uncontrolled severe asthma. Since beta blockers will slow the heart rate, individuals with a baseline slow resting heart rate (say 50 or less) and relatively low blood pressure may well feel lightheaded and be at risk for syncope (passing out). Finally, a cardiac conduction problem, such as advanced heart block is a contraindication, that could lead to dangerous syncope.

Lastly, I would expect you'd find physicians happy to help here. It's one the conditions we feel we can make a big difference for our patients. Many other acute anxiety disorders (such as panic attacks) patients seek us out for benzodiazepines (Valium, Ativan, Xanax, etc), and since beta blockers are unrelated, not controlled substances, not abused, we feel happy to help.

Dave F. (Emergency physician)
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 One in Four Classical Musicians Use Beta Blockers  new
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 Re: One in Four Classical Musicians Use Beta Blockers  new
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 Re: One in Four Classical Musicians Use Beta Blockers  new
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 Re: One in Four Classical Musicians Use Beta Blockers  new
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 Re: One in Four Classical Musicians Use Beta Blockers  new
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 Re: One in Four Classical Musicians Use Beta Blockers  new
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 Re: One in Four Classical Musicians Use Beta Blockers  new
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 Re: One in Four Classical Musicians Use Beta Blockers  new
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 Re: One in Four Classical Musicians Use Beta Blockers  new
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 Re: One in Four Classical Musicians Use Beta Blockers  new
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 Re: One in Four Classical Musicians Use Beta Blockers  new
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 Re: One in Four Classical Musicians Use Beta Blockers  new
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 Re: One in Four Classical Musicians Use Beta Blockers  new
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 Re: One in Four Classical Musicians Use Beta Blockers  new
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 Re: One in Four Classical Musicians Use Beta Blockers  new
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 Re: One in Four Classical Musicians Use Beta Blockers  new
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 Re: One in Four Classical Musicians Use Beta Blockers  new
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 Re: One in Four Classical Musicians Use Beta Blockers  new
Brenda Siewert 2006-03-30 15:10 
 Re: One in Four Classical Musicians Use Beta Blockers  new
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 Re: One in Four Classical Musicians Use Beta Blockers  new
Mark Charette 2006-03-30 16:41 
 Re: One in Four Classical Musicians Use Beta Blockers  new
ghuba 2006-03-30 17:19 
 Re: One in Four Classical Musicians Use Beta Blockers  new
ginny 2006-03-30 16:06 
 Re: One in Four Classical Musicians Use Beta Blockers  new
Gregory Smith 2006-03-30 16:42 
 Re: One in Four Classical Musicians Use Beta Blockers  new
Gregory Smith 2006-03-30 19:15 
 Re: One in Four Classical Musicians Use Beta Blockers  new
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 Re: One in Four Classical Musicians Use Beta Blockers  new
ginny 2006-03-30 23:05 
 Re: One in Four Classical Musicians Use Beta Blockers  new
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 Re: One in Four Classical Musicians Use Beta Blockers  new
tictactux 2006-03-31 19:19 
 Re: One in Four Classical Musicians Use Beta Blockers  new
Carol Dutcher 2006-03-31 19:33 
 Re: One in Four Classical Musicians Use Beta Blockers  new
3dogmom 2006-03-31 20:34 
 Re: One in Four Classical Musicians Use Beta Blockers  new
DaveF 2006-04-01 08:57 
 Re: One in Four Classical Musicians Use Beta Blockers  new
tictactux 2006-04-01 11:24 
 Re: One in Four Classical Musicians Use Beta Blockers  new
EEBaum 2006-04-02 00:13 
 Re: One in Four Classical Musicians Use Beta Blockers  new
CK 2006-04-02 18:14 


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