Drug info - Propranolol's use for Anxiety/Stage Fright

[Laudaphun]

There seems to be another propranolol thread largely focused on it's use for PTSD or "erasing bad memories" This thread, its for it's use in anxiety, stage fright, and other "non-memory-erasing issues." It is one of those drugs that seems like it could be quite useful but only for certain situations and at the proper dose. SWIM has had a bottle of propranolol for a long while, just never really had the chance to test it out much. One trial was not successful, however it is possible that a reaction with a stimulant may have caused unexpected results? SWIM typically takes methylphenidate or amphetamine for studying. But, has a plethora of other medications for test anxiety. Propranolol was given to SWIM to try but would like to hear others experiences. There was a post on the other propranolol thread about it being combined with clonazepam and the effects seemed to be quite interesting, however there is little else to be found about it other than the plethora of memory erasing pill posts which is what the thread is intended for, however this thread is for it's use in anxiety and other purposes that do not fit the description of the other propranolol thread

[Gradient]

Laudaphun,

Interesting suggestion. My understanding of the way that propranolol exerts its effects is by effectively blocking the protein transcriptions necessary for the expression of the emotional component of a memory related to fear/anxiety/trauma, by selectively blocking beta-adrenergic receptors in the hippocampus and amygdala (probably other places too). Therefore, the compound's efficacy is maximized when a patient is administered the compound, and subjected to an active recall of the memory of concern. When individuals enter this state, memories (or more specifically, the proteins functioning to signal a memory) become 'labile', and vulnerable to alteration by the genetic mechanisms underlying the transcription of the components that comprise the quality of the memory. Therefore, the memory isn't erased, but any kind of emotional association that an individual may have had is alleviated or attenuated by the inhibiting effects of propranolol - it prevents the transcription of those emotional-facets of troublesome memories.

I'm not sure if the compound would therefore be able to combat the immediate anxiety one would experience on stage, due primarily to the fact that the compound can't prohibit the initial transcription of the emotional-association to the memory; only once the memory has been recalled has it been demonstrated to be able to be modified with propranolol treatment.

I'd love to read some member's personal experiences with the compound!

[Joe-(5-HTP)]

I was prescribed propranolol by my doctor who told me to use them for intervention when I was actually having a panic attack itself. I must say that I found it to be of zero use. Apparently it helps with shaking, sweating and other physical signs of a panic attack but not the mental aspect of it which is what I have a problem with.

What you wrote was interesting Gradient- this doctor is kind of a pill popping guy in that he will just prescribe random things. I have told other doctors specific examples of what he prescribed me and what for and they have said "wtf is wrong with him" so perhaps this is just another example of that. I would report him but I suspect if I have a chance at getting prescribed Benzo's from anyone, it is him.

[Jatelka]

The flamingo finds it occasionally useful for situation specific anxiety (ie: Lecturing to a large audience)

As Joe mentions, it deals with the somatic symptoms of anxiety (tachycardia, sweaty palms etc) which feed into the generation of more mental anxiety, which leads to more symptoms, etc etc until a full blown panic attack is created

Thing is, a bird has to have a deal of awareness of, and control over the generation of the anxiety loop. For the flamingo (at least sometimes), this is a helpful aid to breaking the loop

[Laudaphun]

SWIM will experiment with it some and write up a report but typically won't consume a substances until having read enough literature to know enough to feel comfortable taking and knowing what to expect. It seems like somethng that is used to clear physical anxiety? But even SWIM's dr. said it wouldn't affect the psychological aspect much. Commonly known for it's use by actor's for stage fright... He just tossed SWIM a bottle and said to try it for test anxiety. Really, to SWIM it sounds like clonazepam as that is something SWIM uses to combat physical anxiety but it is of little use for mental anxiety. Alprazolam is what she pulls out of her magic hat when really having bad psychological anxieties. SWIM could probably use one now, but doesn't have time to check it's safety in combination with methylphenidate until later today after exams. It did not seem to go well with amphetamine last summer according to SWIM as a trial run on the day before an exam produced palpitations. Normally amphetamines by them self do not in SWIMs case.

Laudaphun added 3 Minutes and 33 Seconds later...

Originally Posted by Gradient

Laudaphun,

Interesting suggestion. My understanding of the way that propranolol exerts its effects is by effectively blocking the protein transcriptions necessary for the expression of the emotional component of a memory related to fear/anxiety/trauma, by selectively blocking beta-adrenergic receptors in the hippocampus and amygdala (probably other places too). Therefore, the compound's efficacy is maximized when a patient is administered the compound, and subjected to an active recall of the memory of concern. When individuals enter this state, memories (or more specifically, the proteins functioning to signal a memory) become 'labile', and vulnerable to alteration by the genetic mechanisms underlying the transcription of the components that comprise the quality of the memory. Therefore, the memory isn't erased, but any kind of emotional association that an individual may have had is alleviated or attenuated by the inhibiting effects of propranolol - it prevents the transcription of those emotional-facets of troublesome memories.

I'm not sure if the compound would therefore be able to combat the immediate anxiety one would experience on stage, due primarily to the fact that the compound can't prohibit the initial transcription of the emotional-association to the memory; only once the memory has been recalled has it been demonstrated to be able to be modified with propranolol treatment.

I'd love to read some member's personal experiences with the compound!

I would as well and will produce one of SWIM's own. I recall that it seemed to have a higher side-effect profile than something more typical. Will double check later, as I've always thought that it had potential to be something worthwhile keeping in one's medicine cabinet.

[Gradient]

Now that I've given this topic some good thought-time (yes...Drugs Forum is beginning to pervade my 'real' life! - Time for an intervention?), this actually represents a pretty damn significant discussion going on in research right now.

For those of us who were required to trudge through introductory Psychology will recall the 20th century's competing theories of emotion - one from James and Lange, while the other from Cannon and Bard. For a quick refresher: James-Lange proposed that emotion was a product of the quality of sensory inputs to the brain; emotions/behaviors are the product of physiological changes as a result of environmental influences. Cannon-Bard, conversely, proposed that behaviors are a function of subjectively percieved emotions prior to the execution of the behavior; the environmental responses that one observes resulting from a given behavior will elicit a unique emotion in the organism. For a long while, psychology was divided as to which was most accurate. As with most similar cases of competing paradigms, a hybrid of the two became the consensus, and has basically (given different iterations) been the convention for a pretty long time.

A few individuals, far more educated than myself, have revealed to me that the James-Lange approach to emotion and behavior has recently experienced a clandestine resurgence. Researchers are giving more credence to the idea that our unconscious perception of sensory stimuli have a dominant functioning role in determining an organism's emotional and behavioral output. Instead of emotions and behaviors hard-wired as a repertoire from which certain emotions are recruited given particular external responses to an organism's behaviors, the primary determinant appears to be at the level of the organism's unconscious sensory perception - and less to do with conscious cognition (more focused on limbic structures than the forebrain). For me, this sort of elucidates the emotional-vulnerability (or general open-mindedness) that generally accompanies the synesthesia associated with psychedelics; due to a heightened sensory-suggestability (cross-sensory firing - 'feeling' a sound), individuals will naturally respond with a different set of emotions and behaviors than they would if sober.

If this current research is correct, then Laudaphun's suggestion of the ability for beta-adrenergic blockers to alleviate anxious responses is likely quite accurate! I find Jatelka's use of the compound to unexpectedly re-affirm the suspicion that the role of unconscious physiological responses guides emotional reactivity with a somewhat dominant role. If the physiological responses responsible for eliciting anxious emotional responses are attenuated (with propranolol), then the unconscious reactivity may also be alleviated - which may serve to inhibit the expression of anxious emotion. This is a very interesting dynamic, and I found this statement to be particularly relevant:

Originally Posted by Jatelka

Thing is, a bird has to have a deal of awareness of, and control over the generation of the anxiety loop. For the flamingo (at least sometimes), this is a helpful aid to breaking the loop

I know this is somewhat unrelated, but since we're speculating here...
I hope, sometime soon, these cognitive 'loops' Jatelka described might be confronted with some nice research. This strikes me as an extremely unique and crucial characteristic of human cognition. I would even propose that understanding this cognitive 'loop' phenomenon, applicable to many other dynamics (addiction, depression, etc...), might be central to most clinical therapies. I've had numerous lovely conversations with a handful of close friends on observing the manifestation of odd cognitive loops upon ingestion of certain psychedelics. For example, one close friend has observed a strange association between hearing a particular sound (running water, for example) coupled to some completely unrelated physical sensation (like tickles moving down the nape of one's neck). Then, upon the conscious realization of the activity of this loop, an emotional output is generated (lets say astonishment and undivided captivation). This, at least for my friend, serves to generate a mesmerized state - my friend will stand for minutes on end, simply appreciating the association experienced between hearing the water flowing, while actually feeling the water flowing down his neck. My point is, without the psychedelic modulation of one's perception of sensory inputs, this enthralled emotional output of appreciation and awe would never have been expressed. Perhaps, then, with more specified modulation of an individual's sensory perceptions, therapies targeted at modifying patient's emotions/behaviors might be rendered far more effective and personalized to the patient.

I know - if there's a clunky-poster award, I deserve it. I tried not to babble on too long, but this has become quite interesting to me (thanks Laudaphun!). I hope at least a few members had the stamina to read through my little schpiel, and welcome any comments you might have - this is an area of research that has NO experts!

[Matt The Funk]

Lately SWIM has only been having physical aspects of anxiety...somehow mental he seems to have overcome anxiety for the most part and it doesn't bother him as much mentally (will probably change soon but not important), would propranolol be a good thing to talk to his psych about? He has gotten off benzos and is only taking gabapentin for his anxiety (which he wants to get off of) but he is curious what exactly would it get rid of? Shakes? Excess sweat? Shallow breathing? etc?

[Mikeymc]

Swim would talk to him. In swims experience propranolol really helps with the intital onset of panic attacks, i.e. heart racing, rapid breathing etc. Swim think this medicine helps with these symptoms further avoiding them to escalate into full blown panic!

[Laudaphun]

SWIM was impressed with a dr. who was willing but highly reluctant to prescribe benzos for anxiety. SWIM was given a bottle of propranolol one tme and really hasn't had the chance to try it out before putting it to the test. SWIM is unsure that it is safe to take alongside some of the other "as needed" medications she has lying around. This is why she has been waiting until she has had time to do proper research upon it's interactions. There was a post by a mod somewhere stating that they had observed it being quite useful when combined with drugs used for the same type of anxiety. SWIM's bottle says "Take 1/2 to 1 tablet for test anxiety"

[Gradient]

I could easily be wrong here (please correct me if I am!), but I don't see any dangerous interaction between propranolol and other anxiolytics like benzodiazepines at recommended doses. Since propranolol acts at ß-adrendergic receptors while benzos act at GABAa, I would actually expect mild doses of both taken concurrently to be extremely effective at alleviating the expression or memory of any anxiety/fear.

If my chimp were considering which compounds to use for test-anxiety, however, he would likely stick to the propranolol alone. While both GABA and adrenergic activity are directly or indirectly related to learning and memory, GABA agonists have been demonstrated to markedly reduce the capability of individuals to learn and memorize. I haven't seen any studies on propranolol's effect on L&M, and if I find any I'll post 'em, but adrenergic-antagonists shouldn't elicit a significant effect upon learning and memory processes; while noradrenergic activity has been demonstrated to enhance an individual's memory, reduction of such activity hasn't been shown to reduce memory. Therefore, if my chimp's goal was to remember as much information as possible without hindering his capabilities to do so by reducing memory, he'd probably take the propranolol alone.

Just my two cents, everyone is different!

[Laudaphun]

In terms of combinations of medications with propranolol SWIM wasn't really referring to benzos as, the point for her is to use propranolol as a substitute for benzodiazepines when possible. Tomorrow, SWIM will be starting a "new" or at least summer job and while at least her anxiety level is mostly mental at the present time, by tomorrow, it will likley manifest itself through a more somatic symptoms. This will likely be a good opportunity to give it a try.