Re: Re: Re: Re: Re: Nerves?!


[ Follow Ups ] [ Post Followup ] [ TubeNet BBS ] [ FAQ ]

Posted by Wade on December 24, 2003 at 11:19:30:

In Reply to: Re: Re: Re: Re: Nerves?! posted by thomaji on December 21, 2003 at 23:53:06:

thomaji

I found this for you on a trumpet player's web page. Please note that he states that Inderal does nothing to alter the state of your mind. It only removes many of the physical side-effects of severe nerves. This allows you to cope with your fear without those side-effects, which allows you to focus more on you actual playing. But you are still scared. You will play no better than you normally do. Beta Blockers just allow folks with SEVERE, DEBILITATING nerves to relax enough to play without having to battle dry mouth, sweaty palms, and a rapid heart rate.

Regards,

Wade

____________________________________________________________________

A Physician Discusses Inderal
Edward A. Wolff, III, M.D.


[Dr. Wolff happens to be a trombone player, and is therefore quite interested and has contributed articles on this subject to the ITA Journal (International Trombone Association).]

"Inderal is a proprietary name for the medication propranolol, which is a short-acting beta-blocker. The body has beta receptors in various tissues: heart, lung (smooth muscles surrounding the airways) and blood vessels, as well as others. Our autonomic nervous system is divided into the sympathetic and parasympathetic systems. The sympathetic nervous system is that which fires up when we are aroused and excited–it is the "fight or flight" system that equips us to do either. When we are excited, nervous, frightened, angry, ecstatic, or any other emotion of arousal, the sympathetic nerves fire and release epinephrine (adrenalin) and norepinephrine (noradrenalin). These chemicals act on the nerve/tissue interfaces at beta (and alpha) receptors to bring about the responses we associate with emotional arousal states: dilation of pupils, fast heartbeat, tremor, sweaty palms, dry mouth, etc.

Beta-blocker medications competitively block these receptor sites so that the adrenalin cannot exert its effects so strongly. The heartbeat stays slow and regular, the hands don't shake, the palms stay warm and dry, and the mouth stays moist. Inderal and other meds like it do not dull the mind or make you feel less nervous, angry, etc.–they just block the peripheral effects of such emotions on the body. In turn, when you are going into a performance situation and you are less worried about sweaty palms, tremor and dry mouth because you have taken some Inderal, you may in turn be less nervous overall, since you feel you have more control over your physiologic responses to your emotional state. Hence, hopefully, a better performance.


I recommend doses from 10 to 40mg about 45-60 min prior to a performance. This dose lasts 2-6 hours and is associated with few if any side effects that I know of. You do not "feel different" on the medicine per se, you just remain more physiologically stable in the face of stress, with your mind clear to focus on what you are doing. Some precautions: if you have asthma, heart failure, or bad circulation you want to avoid this medicine or take it only with extreme caution, as it can worsen these conditions. If used for prolonged periods of time and at high doses (up to 320mg per day) people can experience vivid unpleasant dreams and men can experience erectile dysfunction (impotence)–reversible upon discontinuation of the drug. These are of little concern to those of us using small doses once in a while."


Is It Addictive?


Propranolol is not physically addictive, but my feeling is that it can lead to psychological dependency. I think it is smart to use it to win an audition, then in the orchestra if you need it, but stop using it when you get tenure. I find it sad that some musicians rely on it in the day-to-day performance of their jobs, and are driven to this state by their own overperfectionism–the inability to accept their performances for what they are.


To be fair, I know many players who swear that without Inderal they could not have made a career in music. However, I can not help but believe that what they need are natural means of converting nervous energy into excitement about performing. I think meditation is one good way to do this.


Follow Ups: