Sometimes I find an overenthusiastic, poorly researched, cheerleading article touting a product as the greatest thing since sliced bread. On June 5, 2019 there was such an article by Zara Stone at Ozy titled This startup wants to make you a better public speaker. It described Kick, which was peddling internet (telemedicine) prescriptions for a beta blocker pill, propranolol.
First, what is a beta blocker? A Mayo Clinic web page
explains that:
Another web page at Medline Plus discusses why propranolol is
prescribed, precautions, and its side effects.
Zara Stone’s Ozy article claims that:
“Public speaking tops the most-feared list for many in
America, affecting 26 percent, according to a 2018 Chapman University survey —
that’s higher than the fear of flying, clowns and animals combined.”
But if you look at the Chapman article listing the fears for 2018
(for which no link was provided in her article) you will find Corrupt
government officials are ranked as #1 (73.6%)
while Public speaking is way down at #60 (26.2%).
She also discussed the Musicians Health Survey that
according to her found:
“66 percent of classical musicians said beta blockers
improved their performance”
But the survey really said that 72 percent tried them, while
6% tried but found them not effective. Of those 66%, 37% tried and found them very
effective, and 29% tried and found them just somewhat effective.
That survey also compared effectiveness for fifteen different treatments in a chart that followed immediately after the one with the 66 percent improvement statistic. I replotted it above. Note that while 92 percent found beta blockers effective - almost exactly as many, 91 percent, found that just experience (desensitization) was effective.
Back on October 25, 2017 there was another far less rosy article
about Kick by Rebecca Robbins at STAT titled Anxious about a big speech? This
startup wants to calm you down – with a cardiac drug you pop like a mint. Her
article notes that other drugs now are prescribed for social anxiety disorder,
not just to block adrenaline. Rebecca quotes Boston University psychologist
Stefan Hoffman as bemoaning:
“Bringing up propranolol is resurrecting a dead body.” and “That’s
a horrible idea. It’s a horrible idea.”
An earlier article from 2011 at the Consumer Reports web
site titled How to treat stage fright quoted Franklin Schneier, M.D.:
“Taken an hour before a performance, beta-blockers will
reliably decrease symptoms like a pounding heart and a trembling voice or hands…But
a moderate level of anxiety energizes a performance, so beta-blockers may
actually reduce performance quality in people who are not very anxious. Also,
people often become psychologically dependent on them and feel they need them
and feel they need one before every performance, rather than learning skills to
manage their anxiety.”
At Slate on June 25, 2019 there was still another article by
Shannon Palus with the cautionary title Beta blockers were a miracle cure for
my stage fright (then they took over my life).
Yet another article by Daniel McGinn on August 4, 2017 in The
Atlantic titled Can this drug cure performance anxiety? included a story about
his having told a friend about beta blockers. That friend wanted to borrow some
of his, but Daniel instead supplied him with some vitamin B12 pills. His friend
then raved that the pills were magic - although they really just were a placebo.
On April 16, 2018 at his Public Words blog Nick Morgan posted
about What to do about public speaking fear when nothing else works, and
mentioned beta blockers.
The image of sliced bread came from Timdogrulez at Wikimedia
Commons.
1 comment:
Your articles are always so interesting and factual. I appreciate the work you do. Seems like so many times folks want the "magic pill" to cure everything and yet they could do that with a little more work, like maybe joining Toastmasters.
Thank you Dr. Garber,
Cleon
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