Knees Weak, Palms Sweaty? Consider a Beta Blocker

There’s an old statistic about public speaking that still makes the rounds on social media every so often. It claims that public speaking is the #1 fear for most Americans, above shark attacks, spiders or tornadoes. The source of that tidbit is a little shady, but it doesn’t change the fact that public speaking is a very real fear for a lot of people. And if you’re someone whose fear goes beyond pre-performance jitters and extends to sweaty hands, shaky knees or a trembling voice, you might want to ask your doctor about beta blockers.

For most people, performing on stage or giving a speech prompts a stress response that may make their heart beat a little faster or make them speak a little louder. But if you experience true performance anxiety, your stress response goes well beyond that. Your stress hormones go into overdrive, and your body reacts in ways that you can’t control. Your voice may quiver or sound strained, you might find it difficult to take a deep breath, and you may feel like you need to vomit or run to the bathroom. Beta blockers work by blocking the effects of the hormone epinephrine, also known as adrenaline, which causes many of those symptoms.

Beta blockers are typically prescribed to treat heart conditions and high blood pressure. And while they weren’t intended to treat performance anxiety, many doctors prescribe them “off label” to manage the condition. For some people, a small dose before a performance or speech prevents their body from an extreme reaction to adrenaline and allows them to perform normally. The medication can be taken 30 minutes to an hour before the performance and lasts for a few hours in your system.

While beta blockers are generally safe, they aren’t right for everyone. It’s important to talk to your doctor before taking any drug. If you have asthma or diabetes, for example, beta blockers may interact with your other medications. And if you already have low blood pressure, beta blockers could bring you to dangerously low levels. Other side effects may include weight gain, dizziness, muscle cramps or even hallucinations.

The bottom line is that if you feel like you can’t control your body’s reaction to a public performance, it can’t hurt to ask your doctor about whether or not beta blockers can help you.