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Inderal Use

Health: I'm writing a newspaper story about musicians' use of beta blockers. I would like to hear from musicians who have used Inderal for concerts or auditions.

From Blair Tindall
Posted August 16, 2004 at 05:34 AM

I'm writing a newspaper story about musicians' use of beta blockers. I would like to hear from musicians who have used Inderal for concerts or auditions.

I'm a professional oboist who has played with major orchestras, taken auditions, played a New York debut recital. I have used Inderal and am familiar with its effects, good and bad.

I'm especially interested in issues of psychological dependence (or not), and why musicians who are fairly open backstage are mum about using it to outsiders. (or occasionally to their colleagues,) as well as ethical issues surrounding some musicians having an "advantage" at auditions that others do not.

Also, has anyone had bad experiences from taking too much, mixing it with a contraindicated drug, using without a doctor's supervision (consequences are serious for asthmatics and diabetics), or from buying abroad/online?

You may email me directly at crimsons@hotmail.com. In case this application blanks out email addresses, that's crimsons-at-hotmail-dot-com.

Thanks very much, and I look forward to your discussions both online and in my email.

Yours,
Blair Tindall

I used it on several occasions for high-pressure performances and auditions over a period of about 1 1/2 years. I found, personally, that it didn't have nearly as much of an effect as I thought it would. A mild relief from the physical symptoms of stage fright (sweating, shallow breath, pulse increase), but certainly not a cure-all or anything close to what I would term an 'unfair advantage'. Eventually, I stopped using it. Now my main talisman backstage is a little Vitamin C and some deep breathing.

I do credit using the Inderal with helping restore enough self-confidence for me to go out on stage and not have the symptoms appear. That seems to have been its best overall effect.

The way that my doctor explained it to me is that they're not performance enhancers, they're performance providers -- meaning they allow you to perform when otherwise you couldn't. But that doesn't mean that they make your performance any "better".

As far as experimenting with it, it's extremely dangerous to do so... I am a 240-pound man. When I was taking Inderal, I would do so in 10 mg (sometimes 5 mg) increments. The possibility of overdose on Inderal is very real, and an overdose can be fatal if it drops your blood pressure too much. So the word of warning is that it's not to be used unless absolutely necessary, and only with the advice and supervision of a physician.

I too have a memory problem, but only when I get really nervous. My problem isn't the kind that should be solved with chemicals. I know from experience that the more I work on relaxation techniques and mental focus exercises the less I go completely blank.

Everyone is different, but I personally lean towards non-chemical cures if possible, though I realize it is not possible for everyone.

Blake was clearly a prune lover,
Cheers,
Buri

Wrong. Dead wrong. This is a judgement I used to make too when I thought that inderol was cheating and that I could find something else (read mental/natural remedy/rehearsed technique) to control my enormous shots of adrenaline. I had such bad problems not with nerves but with adrenaline rushes from the excitement of being on stage. My right arm would not just shutter, but actually physically freeze and stop moving. I would calmly massage it out during rests in order to continue playing. As you can imagine, this was not at all condusive to continuing a career in performance.

I tried everything from changing my diet, to eating bannanas before I would play, to meditation/prayer, to breathing exercises, to waving my elbow while playing and almost started taking Java root before it was pulled from the shelves in Canada because of the links it has to liver damage. You name it, I tried it.

My body metabolism is set in such a way that in any situation, whether it be fear, being startled, excited, angered (especially angered) that I get HUGE adrenaline rushes and I physically begin to shake, my lip twitches (anger), my bow arm locks (violin), and my I vision goes tunnel (being startled or in fear). I don't know why, but that's the way I am and NOTHING helped except Inderol.

I would never encourage someone to use it as an excuse for not having a proper set up, or proper preparation, or mental state etc. but it does have it's uses for those that really need it.

The side effects are minimal. If taken in the proper doses, one does not feel sleepy, or dozey, or disconnected and ones' playing certainly does not become any less exciting or riviting. For those who need it, it actually brings out their actual abilities that nature has, in confusion, tried to suppress.

I am certain that had the drug been available to Elman (who had TERRIBLE nerve problems) or Glen Gould, or Rabin, that they would have had no problem using it if they correctly understood it's function and uses: just as a shoulder rest is a great tool for those that need it as long as they properly understand it's function. Personally I don't find it controls my nerves (I still get nervous, which is a good thing in performance if you control it) but it keeps me from having to worry about my adrenaline rush and locked bow arm.

I think it's a rather nieve outlook to rule out elements like inderol or a shoulder rest (as that argument is often made as well) if they help someone be able to perform at their truest ability.

So please be sure to have all the facts before making a blanket statement like you did about "not knowing too much about playing."

Preston

My teacher told me a story about Henryk Szerying and how Szerying had to be drunk before setting foot on stage in order to play well. This one time however when my teacher went to his concert in Mexico Szerying was fighting off a viral infection which required him to take medication. As you well know I hope by now that one cannot mix alcohol and anti-biotics or other such drugs. So this was the very issue with Szerying that night since he was on the medication. According to Friedman, Szerying's bow that night could not stop shaking. Which brings me to the point that I made of how we can naturally become reliant and develop habits that are very hard to break.

For instance look at Nomar Garciaparra the Boston Redsox SS when he's at bat. The guy has to adjust his batting gloves and cleats after each pitch cause that is his ritual. Who knows, if he didn't do this after every pitch he might not do as well because of this habit if you will.

Here's some food for thought for possible new beta blocker users, one common side effect of beta blockers is impotence.

The antidote to nerves are knowing what you are doing, having a solid technical foundation, practicing scales and arpeggios in every key, bow distribution and division on every note, and knowing how to practice without tension which carries over into great proportions during high pressure situations.

Drugs are not the answer to playing at a higher level. You mention Michael Rabin, His real problem was his intake of barbiturates which led to his downfall in performance and later inevitably his death. I seriously doubt Rabin could have been a better player as you suggest had he taken beta blockers. He was great as is.

Cheers,
Buri

The solution for nerves is not as simple as you think. Solid technique, practice, etc. is not going to cure nerves. It may help you feel more in control when the nerves come, but it's not going to stop them.

Szerying may very well have benefited then from Inderol as it is a mild drug that simply blocks the adrenal receptors (or something like that). It can be taken while on other meds too (always check of course).

As for Nomar Garciaparra. I think this is a weak comparison to using beta-blockers. It better compares to the pre-performance rutine most performers go through before getting on stage (for me: pray, check zipper, deep breaths with eyes closed, play the beginning of the piece in my head, begin). It has nothing to do with habit, and everything to do with mental preparation.

A side effect of beta-blockers is impotance, but not continuing impotance. (In advance: Pardon me but I don't know how to put this in more "family terms" than this) Apparently one is unable to "get it up" while the beta-blocker is still regulating blood pressure. I don't know if , as I've not conducted any such...*ehem* experiment. Personally, that is something that I'm not thinking about anyway as I'm on stage. Once it's out of your body, systems are a go.

Your suggestions on practice habits are GREAT! Habits that I endorse and make use of every day. Everyone should practice scales every day in every key, practice without tension, etc. etc. But that will not help Everyone.

Michael Rabin did have issues with drugs, and perhaps had he not had those issues he might not have been deathly afraid of the stage in his later years. Perhaps I should not have included Rabin in my list as he had problems above and beyond what beta-blockers might have fixed.

You comments don't offend me at all. You are entitled to your opinion. I just think that you might consider taking a more open mind to this issue as you may some day have a student who, despite all other efforts, has problems with a shaky bow arm, or stage fright, etc.

Like I said before, I wouldn't recommend it to anyone if they don't need it or haven't tried everything else (considering of course that they must already have a solid and developing technique etc.) Not everyone needs it, but some people do. Had I continued in your line of thought, I would now be a musician miserably on my way to making a great living doing something else like anesthesiology.
Preston

You could view it either way concerning Szerying's pre concert drinking ritual. Your opinion is certainly plausible. I personally think though that that account of Szerying really shows the destructiveness of relying on a harmful substance even to a person of Szerying's calliber whether it be alcohol or some other drug in order to perform better.

I think Rabin as Preston mentioned was beyond the help of any beta blocker to prevent his further performance decline which was due to his drug abuse.

Preston many professional musicians agree with you on beta blockers. I heard on the radio the other day that 40% of musicians in top professional orchestra in this country use beta blockers. I know a friend of mine who played in the NY Phil used Inderol for the audition.

I don't really agree with you on Garciaparra though, ( thank God the Sox won tonight btw) what he does after every pitch is totally habitual and certainly there is a correlation in my opinion to this and his mental preparation for the next pitch. I remember the umps a few years ago getting on his case when MLB was trying to speed up the game for better audience. I don't think that quite worked!

Nate

Preston

It is probably fair to say that most people who are out there taking professional orchestra auditions have tried inderol. Professional orchestra auditions take a tremendous amount of preparation and time and money to go play a first round that can be as short as one or two minutes on a bad day. If taking inderol (under a doctors supervision) helps anyone play at their normal level under those terribly unnatural circumstances, then go for it.

I didn't know about Szerying's pre-performance drinking. I have many of his recordings and absolutely love them. His Bach Sonatas and Partitas are more gorgeous and awesomely powerful than any other performance of them by anyone else that I've heard. It would have been a shame for these performances, and all of his others, to never have happened- a great loss for me and every other listener in the world. One could argue that if he couldn't handle the nerves, he didn't belong on the stage, that other "steelier" violinists would have stepped up to the plate, but I reiterate, there is simply no one that could play like he did.

Now for the parallel with performers who take beta blockers: If they are able to play beautifully in their practice rooms, it would be a shame for a physical problem like shaking to keep them from sharing that beauty with the rest of the world. As far as I'm concerned, there is no such thing as too much good music in the world, or too many good musicians. I would not feel at a "disadvantage" if there were other violinists performing with beta blockers while I performed without them. In fact, hearing a good concert always inspires me to better my own playing, so the more good musicians the merrier.

Of course, out of concern for the health of those who take beta blockers (side effects, etc.), I'd be very wary of endorsing it, and would even recommend against it unless absolutely necessary. However, I also don't see this as a moral issue, and don't agree with those who think that beta-blocker users do not belong on stage.

http://www.ethanwiner.com/BetaBlox.html

While beta-blockers will attenuate the symptoms of anxiety, possibly a course of treatment that addresses the underlying causes might be effective?

"If you can't take the heat, then stay out of the kitchen."

Sincerely,
Skowronski: Classical Recordings

what is missing here is probably empathy.

there may be some who abuse meds for one reason or another, but many people regain function in this society (or resume performing career) with the help of pharm agents. if you are not taking meds, good for you. if others do, it is none of your business.

instead of making collective effort to boost the value of classical music, you guys fight among selves over an issue that is best addressed by profs.

go back to your violin practice please.

Next.....we choose to simply ignore your supercilious "none of your business" remark.

Finally, "to boost the value of classical music,"
we will now proceed to engage in fierce violin practice,,,,,with a chilled, very dry Martini at our side. Cheers!

Thanks for your input.
S:CR

in fact, your explanation is pretty silly and unprofessional.

It kept her off the stage for years one time.
Supposedly she has discovered something that helps. Get the answer here:

http://www.contactmusic.com/news.nsf/article/simon%20spanks%20away%20her%20stage%20fright_1006576

As for Vincent S's ".....what degree of fun or joyful music making can be anticipated by an individual if his/her rate of excitement and drive so necessary to produce 'sparks' is slowed down? Its smacks of too much whoa and not enough giddy-up!" remark, there can be such a thing as too much giddy-up, to the point where your hands will hardly let you hold onto the instrument. If you take a reasonable dose (Normally what's needed is about 1/5 of that recommended for heart/ high blood pressure patients), all it does is calm you down a bit. The effect is similar to NOT drinking 2 cups of strong coffee. It's not a lobotomy.

And yes, it's a good idea to have a checkup first. There's always a chance you could have some condition you don't know about & a reaction you'd never expect. I told my doctor "I'm a musician, I get performance anxiety [described the symptoms], and I'd like some Inderal." He checked me out & said OK. I didn't have to lie or get it off the internet.

It doesn't help everybody, for example if your problems are not physical symptoms; and I think there are people whose nervous systems just don't respond to it (the way some cats don't respond to catnip); but I highly recommend it to people who have trouble dealing with the physical symptoms of nervousness.

Listen, don't knock anything until you try it. And if you have a bad experience, please share it with us. However, do realize that NO medication is perfect on everyone. Some people will work well with inderol, some won't. Then again, some people work well by eating lots of bananas and some don't. Just be open minded and don't judge those who have used them- you'd be surprised how many musicians out there have big-time chamber or orchestral jobs and have used them as well.

Okay, that's enough information...

"Beta-blocker's shouldn't be used in the long run partly becuase its REALLY bad for your health, but as somebody said before vitamin C mixed with other vitamins like vitamin A and B(a for eyesight and B for energy) these should be normal suppliments(tablets) that are crushed into a powder(via mortar & pestle or taking tin-foil and wrapping the tablets in it and crushing it with a heavy object) and mixing it into a clear, liquid. If you developed a dependence( relatively likely over a period of time usally close to 8 months to a year(depending on weight)) it is possible to increase the dosage to 1.5 tablets up to 2 tablets per 3 days. It is EXTREMELY imperative that you DO NOT take more than 2 tablets per 3 days you devlop vitamin poisoning. If you take to much vitamin A which can result in birth defects, liver problems,
reduced bone mineral density that may result in osteoporosis, coarse bone growths, hair loss, excessive skin dryness/peeling , if you take to much vitamin B the oppostises of beriberi and pellagra(to many symtomns to list), if you take to much vitamin C it can cause acute induced scurvy(exactly what the lack of vitamin C causes aswell), frequent and uncontrollable bowel movements, and anascrobemia. Vitamins are not addictive. Dependencey doesn't mean that the substance you are taking is addictive it just means that your body builds up a slight immunity to the vitamin. Ofcourse I highly advise you only take the mixture a day or two before you have the preformance."

I don't know what the usual dose of beta blocker is for performance problems, but I kept cutting my (Dr. prescribed) pills until I found that 5 mg (1/4 of a 20 mg Inderal pill) 40 or more minutes before a solo performance was all I need. I've been using these things for 30 years for about 12 -15 solo or chamber music performances annually. Before that, I had about 26 years during which less and less of my bow was useful in performance (jsut fine in pactice or orchestra concerts). Now I revel in taking it all the way to the frog in performance - just to prove I can do it.

Until I was 17 I never had a problem and was completely startled the first performance when my bow started to shake; I had no different psychological sensations than I had for the previous 4 years of public performances. From then on it just got worse and worse - until Inderal entered my life.

The pills seem to retain their effectiveness for years - but it could just be that I really don't need them any more - I've heard of such people, but I'm taking no chances. I'm on regular asthma meds, so I'm very careful to use as little Inderal as possible. I do feel something that I don't like if I take them for performances on contiguous days.

With the fear of fear gone, performances are pretty much "no worries!"

I love violin, as much (maybe more) than I love Ms. New York--but at least she now knows it. Even through an unbelievable journey, it has been my
Inderal.

One thing that has helped by shaking bow arm is pumping iron to develop upper-arm muscles, triceps and biceps. My doctor explained that weaker upper-arm muscles can put too much a load on the elbow joint, causing shaking. The pumping iron seems to work!

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