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    Old 03-10-2004, 09:38 PM   #1
    marcen
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    Red face Beta blockers for anxiety relief/public speaking

    Hi there,
    anyone know of the side effects of using small dosages of beta blockers for anxiety relief? I have an intense fear of public speaking that I cannot seem to lose. Meditation, natural supplements, etc. have not worked. I do not have any anxiety except for this, so I only need it occasionally. It is starting to affect my career choices etc because I am always avoiding it and cant anymore. I think I worry more about my voice shaking etc than the actual presentation.
    Thanks for any advice!

     
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    Old 03-10-2004, 10:37 PM   #2
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    Re: Beta blockers for anxiety relief/public speaking

    Quote:
    Originally Posted by julia_girl
    Hi there,
    anyone know of the side effects of using small dosages of beta blockers for anxiety relief? I have an intense fear of public speaking that I cannot seem to lose. Meditation, natural supplements, etc. have not worked. I do not have any anxiety except for this, so I only need it occasionally. It is starting to affect my career choices etc because I am always avoiding it and cant anymore. I think I worry more about my voice shaking etc than the actual presentation.
    Thanks for any advice!
    Beta Blockers (IE: Metoprolol, Atenolol, Propranolol) are not FDA approved to be given for the relief of anxiety.

    The list of complications and side effects for Beta Blockers is long. The following are the list of side effects that have been reported with all of the various Beta Blocker Medications; that is not to say that all are present for each medication, just that these are the side effects for the entire catagory. Some Beta Blockers might have more or less of the below than others:

    Side Effects and Adverse Reactions
    agranulocytosis
    alopecia
    angina
    arthralgias
    asthenia
    AV block
    bronchospasm
    cardiac arrest
    depression
    diaphoresis
    diarrhea
    dizziness
    dyspepsia
    dyspnea
    edema
    ejaculation dysfunction
    elevated hepatic enzymes
    exfoliative dermatitis
    fatigue
    hallucinations
    headache
    heart failure
    hepatic necrosis
    hyperglycemia
    hypoglycemia
    hypotension
    impotence
    insomnia
    jaundice
    lacrimation
    libido decrease
    myalgia
    nausea/vomiting
    nightmares
    ocular irritation
    orthostatic hypotension
    paresthesias
    peripheral vasoconstriction
    peripheral edema
    pharyngitis
    priapism
    pruritus
    QT prolongation
    sinus bradycardia
    skin hyperpigmentation
    syncope
    torsade de pointes
    urinary retention
    ventricular fibrillation
    ventricular tachycardia
    wheezing
    xerosis

    If you have anxiety over public speaking (social anxiety disorder), speak to your doctor about Paxil. It's FDA approved for exactly that.

    Last edited by Katyana; 03-10-2004 at 10:38 PM.

     
    Old 03-11-2004, 05:32 AM   #3
    marcen
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    Re: Beta blockers for anxiety relief/public speaking

    hmmm I posted but it didnt seem to work.

    Thanks for the advice. I actually read on a few sites that beta blockers were used for this in small doses. I dont want to take Paxil, as I dont have typical social anxiety. In fact, I love working with and being around lots of people. I just hate and dread public speaking. This stems from an incident in my childhood when a teacher critized my soft voice I think. Anyway, I really only need something 3-4 times so I can get through these damn seminars. My heart just races and I fear my voice shaking more than anything. I know that without something I will just continue to avoid it.

     
    Old 03-11-2004, 12:35 PM   #4
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    Re: Beta blockers for anxiety relief/public speaking

    Talk to your Dr about benzodiazepines, they work quickly and can be taken when needed. I take Ativan for Panic attacks...or did, I am weaning off right now(I took them regularily, but they can be taken occassionally). They prescribed a valum type med when I had me teeth pulled several years ago(to relax me). Hope this helps

     
    Old 03-11-2004, 03:09 PM   #5
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    Re: Beta blockers for anxiety relief/public speaking

    Julia,

    Beta-blockers are occasionally used to quell the physical manifestations of anxiety/panic attacks. They don't help your fear at all, but they will decrease the racing heart, sweaty palms, etc. Side effects to look for are headache and dizziness, especially when changing position rapidly - ie going from laying down to sitting or sitting to standing. With rare usage like you are talking about, you probably won't have too many of the other effects.

    Benzodiazepines are also effective for short-term, prompt treatment of anxiety. With them, you would have more potential for drowsiness than with the beta-blockers.

    As seldom as you need treatment, I doubt that you would want to take Paxil on an everyday basis (and then have to deal with side effects upon its discontinuation).

    Good luck!

     
    Old 03-11-2004, 05:28 PM   #6
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    Re: Beta blockers for anxiety relief/public speaking

    Having been on both benzos (Xanax) and beta blockers, specifically propranolol, I would say that the longer term side effects for the beta blocker is less. I have weaned off the Xanax (but still suffer its occasional withdrawal side effects which can be quite unpleasant) and in the process of (trying very hard!) weaning off the propranolol!

    Beta blockers are prescribed in small doses (typically 10mg of propranolol) for "stage fright". At these small and infrequent doses, it is unlikely that you will have many (if any) of the side effects listed, which affect differrent people in different ways. Propranolol works fast (typically within 20-90 minutes) and is "washed out" of our system quickly as well (in medical terms, it has a short "half life"). You will feel less jittery and your heart will beat slower (thereby indirectly making you feel "calmer").

    This of course is not a recommendation for you to take propranolol or benzos to manage your "stage fright". You'll need to discuss with your doctor what's the best option for you as taking medication is never desirable (unless to control an existing permanent medical condition) and getting hooked on them is the last thing you want to happen.

    Good luck in furthering your career!

     
    Old 03-11-2004, 10:16 PM   #7
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    Re: Beta blockers for anxiety relief/public speaking

    I am surprised that a Dr would prescribe such a drug as a beta-blocker for 'anxiety, stage fright, whatever. These are heart rate AND blood pressure lowering drugs, and can be dangerous to take. I have never heard of such a thing. I guess you learn something new everyday.
    Anyway, the best alternative would be to practice something like mediation or another relaxation technique so you could mentally calm yourself before speaking. Good luck,

    Last edited by abbygirl2; 03-11-2004 at 10:17 PM.

     
    Old 03-12-2004, 12:14 AM   #8
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    Lightbulb Re: Beta blockers for anxiety relief/public speaking

    Julia, I've performed onstage for many years. Stage fright, fear of public speaking are very real phenomena. If I may, one thing that helped me was this. But you have to be very prudent and cautious because you can get into some serious dependency issues if you aren't. Try to take a very minimal amount of Diazepam (Valium) about twenty or thirty minutes prior to your event. This should only be done a couple of times. What will happen is that your anxiety will be relieved enough to get you over the hump, so to speak, and allow you to experience what can be a very exhilerating time and to give the performance you want to give. The most important thing is that it will let you tap into the reality that it is perfectly normal to be a little nervous in that situation and that nervousness wears off quite rapidly as you "get into" what you are there for in the first place, that is relating your information to the audience in a positive and convincing manner. Having suggested this, I would again stress that you abandon the use of anxiety suppressants completely afterward. They are extremely addictive and very difficult to withdraw from. Good luck.




    Quote:
    Originally Posted by julia_girl
    Hi there,
    anyone know of the side effects of using small dosages of beta blockers for anxiety relief? I have an intense fear of public speaking that I cannot seem to lose. Meditation, natural supplements, etc. have not worked. I do not have any anxiety except for this, so I only need it occasionally. It is starting to affect my career choices etc because I am always avoiding it and cant anymore. I think I worry more about my voice shaking etc than the actual presentation.
    Thanks for any advice!

     
    Old 03-12-2004, 05:07 PM   #9
    vali
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    Re: Beta blockers for anxiety relief/public speaking

    Beta blockers are perscribed for public speaking anxiety. A fraction of the normal dose is needed eg 5mg Propranalol, and since you only take them occasionally, risk of side effects are low. Paxil has to be taken daily and is not without side effects so might be overkill for what you need. Beta blockers don't take away the fear but they do take away the voice shakiness. Hopefully after a few successful experiences, you can taper off.
    Good luck

     
    Old 03-12-2004, 07:58 PM   #10
    marcen
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    Re: Beta blockers for anxiety relief/public speaking

    Thanks everyone! I feel a little better just knowing there is something to help me through this!

     
    Old 03-13-2004, 11:30 AM   #11
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    Re: Beta blockers for anxiety relief/public speaking

    I just wanted to point out that physicians can (and do) prescribe things all the time without an FDA indication. A lack of an indication (propranolol for public speaking, for example) just prevents the drug manufacturer from marketing the drug as such. Most drugs have dozens of additional actions (AKA "side effects") that are not indicated but are potentially useful.

     
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