Effect of β Blockade on Singing Performance

Abstract

The symptoms associated with performance anxiety, or the so-called stage fright syndrome, are similar to those of alpha and beta adrenergic stimulation. Suppression of symptoms and improvement in instrumentalist's performance after beta blockade suggest that this modality would be of benefit for singers as well. To evaluate the dose-effect relationship of beta blockade upon singing performance and the possible effect of these agents upon performance maturation, we studied 34 singing students during end of semester juries, using a double-blind crossover paradigm. Students performed once with either placebo, 20, 40, or 80 mg of nadolol, and again 48 hours later, with placebo. There was a significant dose-related, limiting effect upon intraperformance cardiac rate. A small, but statistically significant, dichotomous effect upon performance rating was noted: low-dose nadolol tended to enhance performance, whereas larger doses impaired performance. We conclude that the effects of low dose beta blockade upon singing are minimally helpful and high doses may detract from performance ability.

Beta-Adrenergic Blockade and Voice: A Double-Blind, Placebo-Controlled Trial

“…It remains, however, that statistically significant findings were limited to an increase in jitter following treatment with propranolol. The paucity of significant findings observed between conditions 4 and 3 is in keeping with the outcomes of other studies 4,7,16,[18][19][20] examining the effect of beta-blockade on voice. Collectively, the outcomes of these studies demonstrate no trends toward either improvement or deterioration of the voice after beta-blockade.…”

“…9,[12][13][14] It is not uncommon for speakers and singers to use betaadrenergic blockers, unprescribed and prescribed, to combat the symptoms of stage fright. 4,7,15 Although it would seem intuitive to expect a reduction in anxiety secondary to central nervous system-mediated effects of beta-blockade, peripherally mediated effects on objective measures of voice remain largely unquantified. Perception of vocal quality has been used as the outcome measure in studies of beta-blockade and voice.…”

“…Perception of vocal quality has been used as the outcome measure in studies of beta-blockade and voice. 4,7,[16][17][18][19][20] In keeping with the findings of stress effects on voice, the outcomes of studies examining vocal quality following beta-blockade are conflicting.…”

“…Performance quality has been reported to improve 16,19,20 or improve or decline according to dosage. 4 Degree of preperformance anxiety has been determined to have influenced perception of improvement or deterioration in performance. 18 In addition, performance quality has been reported to remain unchanged following beta-blockade.…”

Noradrenergic blockade and numeric working memory in humans

“…Consistent with the results of our study, cognitive functions were improved in propranololtreated subjects with high-anxiety and impaired in low-anxiety subjects that were required to give a brief speech (Hartley et al, 1983). A dichotomous effect was also observed upon professional singing with low doses of the peripheral β-blocker nadolol enhancing performance, whereas higher doses impaired singing performance (Gates et al, 1985). The findings of this study suggest a feedback of blood pressure changes on central emotional processing as proposed by the 'somatic-marker hypothesis' (Damasio, 1994).…”