Musicians' Health Collective

Musicians' Health Collective: Supporting the health of musicians

What does a Beta-Blocker Do?

So in the last few weeks, I've been busy (and stressed, too!), but I've been thinking about stage fright, sympathetic response of the nervous system, and why things happen to us when we're nervous.  Most musicians will at some point run into beta blockers as an antidote to stage fright- whether a colleague uses them or even a teacher, by adulthood, we have encountered someone who uses them for something not related to its initial prescriptive purpose.  (Musicians are certainly not the only folks who use these-actors, presenters, etc., have been known to use them as well).

Whether or not you take them, it's useful to know what the heck is going on if one does take them. 

First of all, a beta blocker is typically prescribed for folks with heart issues, arrythmia, and who need to lower their standing heart rate.  It tackles the beta-receptors of the smooth muscles of the heart, kidneys, and sympathetic nervous system to prevent norepinephrine and epinephrine (adrenaline) from attaching to beta receptors, which ultimately encourages blood flow (as opposed to restricting vessels) and reduces overall heart rate.  If that language didn't make things clear, let me simplify.  Beta Blockers reduce overall heart rate and prevent adrenaline from playing its role in sympathetic response, AKA fight or flight.  That means it reduces the physiological symptoms of sympathetic system, which affects breathing, fine muscle control, tremors, etc. 

While this may sound like a wonder-drug, there are a few things to consider. 

This is one of the most common BB's: propranolol.

This is one of the most common BB's: propranolol.

-There are side affects, like all mysterious chemical concoctions, and they're fairly standard: nausea, vomiting, headaches, as well as more complex effects if one already has heart problems.  (And of course, there's a warning about sexual dysfunction, so don't forget about that.)

-Beta blockers are banned in the Olympics, but not in auditions.  What would it be like if they were banned in auditions?  It's a question I've pondered, because I think performance under pressure differs so widely person to person.  It would even the playing field, whether that's a good thing or bad thing.

-Beta Blockers only target the symptoms of panic, but don't address any of the psychological/somatic issues.  If your anxiety is based in a constant fear of being good enough, or prepared, or talented, then BB's will only help so much. 

-Some people (audition committees/teachers/etc.) feel that BB's limit expressivity, spontaneity, and in the moment performing creativity, which is something to consider.  If you regularly take them for performances and auditions, it might be worth wondering if you always need them. 

-The sympathetic response does have some benefits when you are in a stressful situation.  Your response time is quickened, your brain is particularly focused, heart rate/blood sugars increase to fuel the body, and muscles tense up to provide speed and power.  The whole point of sympathetic response is to support the body under dangerous conditions, so the changes that occur are meant to support.  I realize that performance is not life or death, but it is an interesting physiological response to notice.

I leave the decisions with you, but notice if beta blockers become a crutch.  Do you need them for every performance opportunity?  Do you find yourself using them for rehearsals as opposed to concerts or auditions?  (And if you're not a BB user, that's great too.)

Read more:

Musicians use Beta Blockers as Performance Enabling Drugs

3 Reasons Why Beta Blockers Could Be Holding You Back

Addiction in the Orchestra

Better Playing Through Chemistry


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