Feeling anxious before a big job interview? Worried about giving a speech? Nervous about your first date?
The solution, some digital startups suggest, is beta blockers, drugs that slow the heart rate and lower blood pressure, masking some of the physical symptoms of anxiety.
Typically, a trip to a doctor’s office is required to get a prescription, but many companies are now connecting patients with doctors for quick virtual visits and delivering medications to people’s homes.
“No more ‘shivers and sweats,'” one online ad promised. “Quick and easy in 15 minutes.”
That worries Dr. Yvette I. Sheline, a professor of psychiatry at the Perelman School of Medicine at the University of Pennsylvania.
“The first question is: What happened to this person?” Dr. Schelling said. Are they depressed in addition to being anxious? Do they suffer from chronic anxiety, or just temporary stage fright? “You don’t want to end up prescribing the wrong medication,” she added.
Additionally, while beta blockers are generally considered safe, experts say they can have unpleasant side effects and should be used with caution.
What are beta blockers?
Beta blockers such as propranolol hydrochloride It has been approved by the U.S. Food and Drug Administration for chest pain, prevention of migraines, involuntary tremors, and cardiac arrhythmias.
Some drugs are still used to treat high blood pressure, although they No longer considered first choice treatmentprimarily because other drugs are more effective at preventing strokes and death.
Beta blockers can relieve physical symptoms of the “fight or flight” response to stress, such as tremors, sweaty palms, or a racing heart, but they are not FDA-approved to treat anxiety disorders.
Doctors have been using them for decades to treat problems outside of their approved uses, including issues like stage fright.In recent years, celebrities have loved Robert Downey Jr. and Khloé Kardashian say the drugs have helped them overcome performance anxiety.
How do they work?
When we begin to feel anxious or stressed, our bodies produce adrenaline to prepare us for perceived danger. This hormone signals us to make our heart beat faster and narrows our blood vessels to redirect blood to vital organs like the heart and lungs. Breathing quickens and we start to sweat.
Beta blockers work by “blocking” the effects of epinephrine. They make the heart beat slower and with less force, which helps lower blood pressure.
But if you’re feeling particularly anxious, “your mind will still be racing, and you’ll still be ruminating and worrying,” says Regine Galanti, a psychologist in Cedarhurst, N.Y., who oversees Treating patients with anxiety disorders.
In other words, beta blockers don’t address the root cause of your fear. “If it became once a week, ‘Oh, I’m just having trouble with this course. I’m going to take a beta blocker every time. I’d ask, ‘What’s the long-term goal here?'” she added.
Dr. Joseph Bienvenu, a professor of psychiatry at the Johns Hopkins University School of Medicine, said patients typically only take a few pills in specific situations where performance anxiety may arise. But some online companies give out as many as 48 at a time.
are there any side effects?
Yes. Beta blockers can make people feel dizzy.other potential side effects These include fatigue, cold hands and feet, difficulty sleeping, and nightmares. They can also cause stomach problems, such as nausea or diarrhea, and occasionally breathing difficulties.
That’s why some doctors tell their patients to avoid taking these medications for the first time on the day of a big event.
Dr. Bienvenu recommends that patients first try the drug on weekends or “when you have nothing else to do.”
“I just want people to know how this is going to affect them,” he said.
Is it okay to take them on a potentially scary task, such as a large presentation?
Maybe. But experts recommend seeing your GP first.
Beta blockers may not be recommended for certain people with diabetes, low blood pressure, or bradycardia (i.e., slow heartbeat), or for people with asthma or other lung disease. Certain medications, including some cholesterol and cardiovascular medications, can interact with them.
Arthur Kaplan, a professor of bioethics at New York University Grossman School of Medicine, said online doctors don’t have your complete medical history and haven’t examined you in person.
He added that without a physical exam, some patients may not know they have underlying problems such as irregular heartbeats. If they have questions after getting a prescription, they may not know who to call.
“You need to manage these medications,” he said.
Experts say that for people who often face anxiety-inducing tasks like public speaking, try breathing techniques or exposure therapywhich involves directly confronting what makes us desire to break out of patterns of fear and avoidance.
“Masking your anxiety symptoms doesn’t teach you how to control them,” says Dr. Galanti.
