Rasmusen Weblog

...Beta blockers - which are cardiac medications, not tranquilizers or sedatives - were first marketed in 1967 in the United States for disorders like angina and abnormal heart rhythms. One of the commonest is propranolol, made here by Wyeth Pharmaceuticals and sold under the brand name Inderal. By blocking the action of adrenaline and other substances, these drugs mute the sympathetic nervous system, which produces fear in response to any perceived danger, be it a sabre-toothed tiger or a Lincoln Center audience.

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Musicians quietly began to embrace beta blockers after their application to stage fright was first recognized in The Lancet, a British medical journal, in 1976. By 1987, a survey conducted by the International Conference of Symphony Orchestra Musicians, which represents the 51 largest orchestras in the United States, revealed that 27 percent of its musicians had used the drugs. Psychiatrists estimate that the number is now much higher.

"Before propranolol, I saw a lot of musicians using alcohol or Valium," said Mitchell Kahn, director of the Miller Health Care Institute for the Performing Arts, describing 25 years of work with the Metropolitan Opera orchestra and other groups. "I believe beta blockers are far more beneficial than deleterious and have no qualms about prescribing them."

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For the last two decades, such use of beta blockers has generally met with approval from the medical establishment. "Stage fright is a very specific and time-limited type of problem," said Michael Craig Miller, the editor of The Harvard Medical Letter. Dr. Miller, who is also an amateur pianist, noted that beta blockers are inexpensive and relatively safe, and that they affect only physical, not cognitive, anxiety.