Musicians Use Beta Blockers as Performance-Enabling Drugs

Friday, August 16, 2013

Anyone who has had to give a speech at a wedding or deliver a Powerpoint presentation at the office knows the symptoms: sweaty palms, racing heartbeat, even nausea.

That age-old curse, stage fright, is nothing new. But for classical musicians it's come with a considerable stigma. Despite the fact that famous artists like Vladimir Horowitz, Renee Fleming and Glenn Gould have all experienced crippling performance anxiety, a hush-hush attitude has long prevailed.

"The reason people don't talk about it is because it would affect your opportunities,” Diane Nichols, a psychotherapist who calms a stage-fright class in Juilliard's evening division, told host Naomi Lewin (listen to the full discussion above). “How seriously is someone going to look at you if they're auditioning you, if they know you have a history of choking or of panicking?”

But in an age when people broadcast details of their daily lives through social media, there are also signs that the taboo may be lifting. Holly Mulcahy, a violinist who won the job of concertmaster of the Chattanooga Symphony and Opera in May, says there’s a greater openness than even a decade ago, and new methods of coping.

"Some of my teachers in conservatory days would gladly carry around a flask of Scotch and take it before they went on stage," she said. “But I don’t see that in any of the orchestras that I've played in recently.”

Instead, Mulcahy and other orchestra musicians increasingly turn to beta blockers. According to Mulcahy and other musicians who spoke with WQXR, in some backstage areas, they're passed around like chewing gum or mints. Mulcahy recalls panicked colleagues calling "Oh my God, does anybody have any Inderal?"

Beta blockers have been common in classical music since the 1970s. Originally prescribed to treat high blood pressure, they became performance enablers when it became clear that Inderal (the brand name) controlled stage fright. As long ago as 1987, a study of the 51 largest orchestras in the U.S. found one in four musicians using them to improve their live performances, with 70 percent of those getting their pills illicitly.

But there are new stresses since a generation ago. Fewer jobs and heightened competition mean less room for error. For opera singers, looks are becoming as important as voice. A 2012 study from the University of Paderborn in Germany found that 30 percent of orchestra musicians suffer from stage fright; 13 percent said it was severe.

Mulcahy finds that not taking beta blockers puts an aspiring orchestra player at a competitive disadvantage. “When I’d get to the finals of orchestra auditions and I wouldn’t be winning, the people that would be winning were the ones that had the beta blockers,” she noted. Even so, she cautions that Inderal does not "enhance" a performance, nor is it a cure-all: "It doesn’t help your concentration. It doesn’t help your confidence. All it does is it keeps the shakes down and keeps the panic to a minimal level."

Some musicians still find other means of managing nerves. Lev "Ljova" Zhurbin, a violist and composer, was once steered towards everything from psychotherapy to eating bananas. He eventually overcame stage fright by taking a non-traditional career path that didn’t involve constant auditions. "I’ve become heavily invested in the music that I play,” said Zhurbin, whose ensemble, Ljova and the Kontraband, combines gypsy, folk and chamber music.

Nichols believes that stage fright will never go away entirely, and maybe it shouldn't. “I do think that it can be managed and careers are not devastated because of stage fright right now, because of Inderal.”

Photos: 1) Bo Huang 2) Anna Rozenblat


Brian Wise


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Comments [15]

Lex from NY

I never knew stage freight until my 40's competing with a Pipe band. I always envied the guys who would not miss a note under pressure. I later found out that most of them were on Beta-blockers. That's the dirty little secret weapon for the worlds top pipe bands. Playing bagpipe tunes at those speeds and all you need is for your hands to start shaking to blow it for your band. I never took them because my BP is naturally on the low side 110/70 and fear I could pass out in the competition circle. I may just try it.

Aug. 11 2015 03:47 PM
Vespasian from Suffolk

Beta blockers have also been used for suicide, particularly propranolol. Among those who left this valley of tears using this medication was the sister of David Coultard, the formula 1 race driver.

Feb. 25 2015 02:16 PM
Daniel Polowetzky from NYC

Beta-blockers are not generally considered anxiolytics. They may blunt some of the unpleasant signs and symptoms of stress but are essentially used to slow the heart rate, decrease blood pressure, and treat dysrhythmias. They are anything but benign.

Although not addictive, as are benzodiazepines, e.g., Valium, Ativan, and Xanax, they have a narrow therapeutic range, making overdose very dangerous.

Aug. 26 2013 08:03 PM
Janis from southern CA

*sigh* Some of us have no choice but to take beta blockers, you know. My dad died of an aortic aneurysm, my oldest brother had his entire aorta removed and replaced with a dacron graft, and my mom and older brother have blood pressure that can stun a horse. I myself have a bad mitral valve.

Whoops, I'm also a pianist!

So if a bunch of musicians use my family's life-saving drug as a crutch to avoid dealing with stage fear, and a bunch of other musicians react by saying "Beta blockers turn you into an unmusical jelly-brain!" then what options are there for the millions of people who need these drugs to live?

In between the "beta blockers cure stage fright" and "beta blockers turn you into an unmusical zombie" positions, might we also take the time to remember that BETA BLOCKERS SAVE LIVES and that some of those lives saved might be devoted to music? That it's not the drug that's the problem but its use as a psychological crutch?

I really wish you people who kindly choose someone else's life-saving drug as a psychological crutch and leave mine the hell alone.

Aug. 24 2013 03:18 PM
Silversalty from Brooklyn

I read somewhere years ago that Glenn Hall used to throw up before performing and during intermissions.

Of course he was an NHL goalie in the era before masks were worn. :P

Aug. 21 2013 09:27 PM
June Severino Feldman from NYC

I never had performance anxiety until my 40's - which turned out to be undiagnosed high blood pressure. I take an ARB (angiotensin receptor blocker) which is not exactly the same thing as a beta blocker but it works!
I'm able to sing or play either solo or in small ensembles without panic or the shakes. And I'm no longer terrified of making a mistake. I won't say I enjoy messing up, but if something goes awry in a performance, I can still live with myself afterwards.

Aug. 20 2013 01:07 PM
Brunnhilde from NYC

Very interesting article - and comments! As a performer, I look forward to the "frights." It's a part of performing. I feel the adrenaline it rouses, thanks to nature, gives the performance the impetus to do the best one can and carries you through those difficult parts which impart fear! Without that rise, it would be like just practicing at home.

And, as an added note, I was prescribed, last year, metoprolol for blood pressure and I am doing my darndest to get OFF of it. (I've been successful in being able to cut the dosage in half.) I would not have thought in a million years that fellow musicians (at least singers) would use blood pressure medicine as a "performing enhancing drug"! Maybe that is the reason why we have so many unexciting performances. A performer needs that excitement and blood flow, whether they like it or not .....!

Aug. 20 2013 11:12 AM
D.D.Sims from NYC

What happened to old fashioned prayer? It's hard to think that so few classical musicians believe. I'm a singer, and praying and praising God always does the trick for me.

Aug. 20 2013 01:58 AM
Barry Owen Furrer

Unless of course the first baseman for the NY Yankees is Lou Gehrig!

Aug. 19 2013 10:50 PM
Lorraine from New York

Somehow the use of beta-blockers (or yoga, meditation, green tea etc.) to ease stage fright in order to deliver a performance that reflects the artist's best talents is not up there with an athlete who is engaged in a competitive sport and being richly compensated for delivering a winning performance. When we expect our children to admire the first chair of the Philharmonic as much as we do a first baseman for the Yankees, I think we can begin a discussion in earnest of the use of beta-blockers to relieve stage fright.

Aug. 19 2013 01:22 PM
Neva D. Strom from NYC UWS

The nervous system is the most used and least fed system in the body. We expect it to operate at 100% capacity 100% of the time and most of us do nothing for it. As a nutritional educator and counselor, I teach clients nutritional and herbal sources of legal, effective and safe nervous system nutrients. As a musician, stage fright has not been a problem for me personally, except for my senior recital in college, where hiccups had me use my then-cure, Angostora Bitters. It wasn't until weeks later when I had a recurrence that I realized I had taken the whole bottle within the 2 hours prior to the recital, and that it was an alcohol base. LOL I would welcome inquiries on consulting. Contact me at

Aug. 19 2013 12:49 PM
AC Haley from Brooklyn

I really appreciated this podcast. Just remembering that other artists go through this was in and of itself helpful.
For me the main way I cope is to stay connected to the 'truth' of what I am performing. If I am really conveying a message, my message, there's lots less chance I'll choke than if I go 'off message' and get into bits and pieces and say, "Oh boy, here comes the tricky part". For desperate situations though there is the old, 9parts Poland Spring water and 1 part Jack Daniels consumed in one fell swoop. Thanks WQXR.

Aug. 17 2013 10:28 AM
Barry Owen Furrer

@ Concetta Nardone:
The use of beta blockers by golfers was par for the course especially when going through a rough patch.

Aug. 16 2013 11:04 PM
Margaret from Park Slope

I was prescribed Toprolol for high blood pressure in 2002. At some point thereafter I noticed that my fear of speaking, asking questions in class, and the like, had gone away. I was pleased that I had finally mastered those fears. Then I came across an article in the Times a few years ago that explained it-- it was the Toprolol. Here's the good news: my doctor took me off the beta blocker a couple of years ago, and the panic at speaking has not come back. Could it be that the experience of performing without the panic reaction has a lasting effect, even after discontinuing the medication? That would be worth exploring.

Aug. 16 2013 04:18 PM
concetta nardone from Nassau

Golfers have been known to use beta blockers. It used to be banned but do not know if that is true. A golfer who has high blood pressure might really need this medication. Beta blockers can also cause some users to run to the bathroom a lot. Even though it is not considered a diuretic, it can have that effect. A doctor once told me that all blood pressure medications have a diuretic effect to some degree. I am not a doctor and do not play one on television.

Aug. 16 2013 03:05 PM

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