Piano World Home Page Forums Our Most Popular Forums Pianist Corner High blood pressure, beta-blockers and performing

We have all heard about performers who use beta-blockers to deal with performance nerves. I too tend to suffer from nerves when performing - accelerated heart rate, shaking hands, sweaty palms, etc. Normally, I would not consider dealing with these issues by taking medication; I would prefer to take a few deep breaths and hope for the best. However, it appears I will have to start using medication to control my blood pressure and thought that perhaps I could have a useful side-effect if I chose to take a beta-blocker over other classes of hypertension medication.

Has anyone who has had to take beta-blockers for hypertension noticed if it does in fact reduce your physical nervous systems when you are performing, or does that fact that you have to take it daily lessen the effect?

Great question!!
And it's a bit surprising that we haven't heard something about this. Like anything.

I'd guess that it does work in the way you're hoping. But if it were me, I'd hope it didn't. Call me purist.

When I started taking a beta blocker daily I did not notice any effect on nervousness and when I switched to an ACE inhibitor I again did not notice any effect. This is not to say that I would not have noticed any effect had I been looking for one, but it certainly did not produce a large effect.

Just to be clear about it: Beta blockers don't help with general "nervousness," but just with the specific kind of thing that Jehalliday described very well.

Is that what you're talking about too, or general nervousness? (Seems like maybe the latter -- which wouldn't tell us about the other thing.)

To be perfectly honest, I did not notice any effect of any kind. It did keep my blood pressure under control, so it must have been doing something, but no big changes in how I felt.

I have taken beta blockers long ago but noticed it only made me tired and caused me to get very icy cold hands and feet. It didn't really do anything for anxiety for me.

I have used baldrian which is a natural muscle relaxer, and generally mild. It works for me, but I wouldn't know how it interacts with other medications such as beta blockers.

We can still be more specific than that. Probably two things would need to be the case in order for this to be relevant for what the OP is asking:

-- Before going on beta blockers, were you prone to the specific kind of anxiety reaction described in the OP? If not, then you're lucky not to be a case study for this at all.

-- If yes.....Since going on the medication, have you been in situations of the kind that caused that reaction in the past?

Unless both are "yes," a person's experience doesn't really address the OP question.

If both are yes, then the question is, has the medication seemed to make a difference for that particular reaction in those kinds of situations.

Well, I am certainly not lucky enough to not get nervous or anxious at all when I perform or speak in front of an audience. When I was young, say early teens, I had a couple of spectacular meltdowns in competitions. My teacher just taught me strategies to cope with memory slips and the like and I was OK after that. In my work I have had to give talks and present papers at conferences. I usually get a bit nervous, but nothing debilitating. I have done these things before, during, and after the time that I was taking atenolol, and as I said before, I have noticed no effect.

Thanks for the elaboration.
Your experience doesn't address the specific thing that the OP asked, because to whatever extent you may have ever had that specific kind of problem, it wasn't any kind of established pattern and in any event it had ended before you went on the beta blocker.

In discussions like this, I think it's important to have it be clear that beta blockers aren't a general anti-nervousness thing. Looking for effects on some other kind of anxiety or nervousness than what the OP described is a whole different question -- and I think it would always come up empty, except maybe sometimes mild placebo effects when people think it's for that too. But in any event, it's important also to realize that what the OP is describing is really a different phenomenon and a different subject than anxiety in general.

beta blockers work on the sympathetic nervous system by subdueing the "flight or fight" response.
IF used to combat anxiety, they will be acting like a crutch.
Also, they are not combating the underlying problem, they will be being used as a sort of sticking plaster.
One day the sticking plaster will have to be removed, or the crutch taken away.
Dont go there unless you absolutely have to.
There are many differing types of beta blockers, some will make you tired and induce the symptoms listed above; cold hands and drowsiness, the things you want to avoid whilst performing.

I'd experiment with bananas, chamomile tea (quite a lot) and see if you could get used to not being nervous with diet and meditation. Recording yourself could mimic the pressure of performing flawlessly and perhaps contribute to your fears' easing.

It took me years to get over my terror of performing in public when i was quite little. I would puke in the hours before a recital.. like 4 times. I started playing at church at about age 11, and rather quickly overcame my terror tho. the first few months were absolutely awful. I was kind of a spectacle being so young and short and people stared CONSTANTLY.

I offer recitals for my few students and have them envision their attitude, stance, walking out, sitting down with reserved drama and poise, bowing afterwards.. it really really helps them.. They look sooooooo very pro.

1. jehalliday- check your pm, please.

2. Mark, I'm concerned. You didn't use any 's in your reply. Are you feeling OK?

That is the most ideal solution, plus a little dark chocolate too...

Hopefully some people will have answers for your actual question.....

Obviously the answer isn't easy to come by. But we can be pretty sure that some people somewhere do know....

I belong to a piano club. I noticed some of our members always play cleanly.
After our recital, I asked one of the guys how could he play so clean. With big smile he said "The Magic of beta blocker". Another guy who sat next to him (a physician) was laughing, and said " I take beta blocker too".
The next recital, I took beta blocker, it was the first time in my life. Wohoo.....I have never played cleaner than what I did that day. I do not get nervous or have anxiety, but for unknown reasons, I just cannot play cleanly in front of people.

The question that I have, is it OK to take beta blocker, say, once every three month for the purpose of improving our piano playing during recital. Is it dangerous to our body?

Oh, gosh, I can't keep quiet anymore after that question, lest someone answer incorrectly. I'll preface this by saying I am a pharmacist with 25 years of experience and I once worked in an outpatient clinic setting that treated hypertension. Also, I am not going to address whether or not someone SHOULD use these for this indication, as that is a separate issue altogether. Of course, I have an opinion on that as I do on most everything.

The answer is (surprise): it depends. On what? Your medical history. There are some contraindications to using beta blockers and some precautions, as with all meds. Your physician is the best person to determine whether or not it would be OK for you to occ. take a beta blocker. While they won't take away anxiety, per say, at the *right dose* (this is different for everyone) they can virtually eliminate the outward signs of anxiety, ie. shaking hands, high heart rate. Eliminating these symptoms sometimes serves to allay one's anxiety just a wee bit; in other words, having steady hands and not feeling your heart racing in your chest pre-performance is a bit calming in and of itself. Dosing is very important, as too low a dose will not eliminate or even reduce physical symptoms of anxiety, however, too high a dose can lower both heart rate and blood pressure low enough that it's possible someone can faint or feel very weak and tired.

Hope this helps, feel free to PM me with any further questions.

Good answer, of course.
About the important side effects to watch for, there's also various kinds of severe breathing difficulties -- but very unlikely at the doses usually used for what we're talking about, as are the side effects you mentioned.