Sunday, November 16, 2008

Effect of Beta Blockade and Beta Stimulation on Stage Fright.

Reviewer: Liesel Deppe

Reference: Brantigan, C .O., Brantigan, T. A., Joseph, N. Effect of Beta Blockade and Beta Stimulation on Stage Fright.

Summary: The researchers have investigated the effects of propanolol, a beta blocker, and terbutaline a beta stimulator, on stressful situations (i.e. performances) for musicians. Physiologically, stage fright is a “fight or flight” response mediated by the sympathetic nervous system, and the researchers wanted to determine what effects beta blockers and stimulators had on performance. These studies were carried out in two different locations: At the Juilliard School in New York and at the University of Nebraska in Omaha in 1980. Participants included both professionals and students in both locations. Two mini-recitals were given on two consecutive days, each with a different drug. 7 participants also agreed to test the effects of a beta stimulator, which then meant that they presented three recitals on three consecutive days. Of course, participants did not know whether they were receiving an active pill or a placebo. Participants underwent a brief medical examination beforehand. Blood pressure was measured before and after performance, while continuous telemetric monitoring of an ECG took place during the performance. They also completed questionnaires after the performance.

In both New York and Nebraska there was a significant improvement in the physical/ somatic manifestations of stage fright when taking beta propanolol. Interestingly though, the musical evaluators in New York favoured the performances of the musicians when they were taking beta blockers. However, in Nebraska, because of the high incidence of random errors, the musical evaluators could not express a preference for one performance over another.

The researchers speculate on whether the whole music training system has caused stage fright. They surmise that the system coerces music neophytes into performance situations that they are not really prepared for, while constant negative feedback in the name of improving performance cultivates stage fright.

The researchers also mention that they suspected that one participant in each location did not take any of the pills before a performance – possibly an experiment conducted on the experimenters. The one in Nebraska, when confronted, admitted to this. The one in New York denied any wrongdoing.

Review: This was an interesting study conducted in the early 1980’s on the effect and effectiveness of beta blockers on performance. Its statistics demonstrate that beta blockers have a positive effect on the wellbeing of the performing musician, if no necessarily on his/ her performance. At least it does not seem detrimental to performance. On the other hand, it also demonstrates that taking a beta stimulator has a detrimental effect on the performer, with one participant describing the pill as “awful”.

Response: In the past there has been a lack of understanding in medical community of what a musician goes through when performing in public. While the public enjoys the performance and possibly finds that listening to music is relaxing activity, it certainly is not relaxing to the musician performing it. Stage fright is more of a somatic anxiety than a neurotic one, thus stage fright can be seen more as a physical disability than a psychological one – which course does not mean that it cannot turn into a psychological problem. When seen as a physical “disability” then perhaps taking certain beta blockers might be appropriate. Psychosis and depressions due to long-term use of propanolol, however, are not desirable for musicians. The investigators also point out that there may be serious withdrawal effects after long-term use. The propose that beta blockers be used as a temporary measure, while learning to use psychological techniques, such as self-hypnosis. I wholeheartedly agree with this. I support the temporary use of beta blockers, but I wonder whether, instead of popping a pill, why do we not try to improve our mental states, and by extension ourselves, through psychological training?

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