Beta-blockers used by musicians, athletes, students to enhance performance

Twelve minutes into her audition at prestigious Roosevelt University in Chicago, pianist Karina Kontorovitch's worst nightmare came to pass. She couldn't remember what to play next in Dmitri Shostakovich's Prelude and Fugue No. 15.

So she went back a few measures to redeem herself, only to get stuck in the same spot. Very upset, she thanked the panel and walked out.

A year later, after getting into Northwestern University's Bienen School of Music as a graduate student, she was introduced to a "little orange pill" that she says helped launch her professional career.

While beta-blockers have long been known as effective treatments for heart failure, many conservatory students and professional classical musicians use these drugs to relieve performance anxiety induced by their highly competitive and "no-room-for-error" line of work.

At the Curtis Institute of Music in Philadelphia, professor Hal Robinson praises beta-blockers as a great mechanism for anxiety relief and has no problems with students using them. But another professor, Joseph Silverstein, compares them to legalized steroids for the classically trained.

Beta-blockers are at the center of a growing debate about the use of prescription drugs to enhance performance. An estimated 20 percent of American high schoolers told interviewers for the 2009 National Youth Risk Behavior Survey that they were taking the drugs for nonmedical uses.

Beta-blockers, along with the stimulant Ritalin and some medicines for Parkinson's disease, are now considered "smart drugs" because some people believe they can boost alertness and improve test performance for high school and college students.

A 1991 study investigated beta-blockers' effectiveness on SAT performance for 32 students who had test anxiety. When given beta-blockers an hour before taking the SAT for the second time, the study found, the students scored an average 130 points higher than their drug-free first round. The normal increase would be about 30 points out of 1,600 total, the paper said.