Do beta blockers work 4 public speaking phobia?

Postby Invisible_man » Wed Jul 21, 2010 2:17 pm



OK, here is my story which seems pretty common on these forums,


basically I am a very sociable person and enjoy talking with people face to face, I also don't mind face-to-face meetings where we all debate and i can contribute as much or as little as I choose. Or even presenting over an audio conference call.


Though I do have a specific social anxiety disorder around public speaking at work, whether it being a presentation or just 5mins of only myself talking in a meeting.


I have been avoiding presentations etc for years, though also I have been to toastmasters which has helped but I soon get comfortable talking at the toastmasters meetings, though as soon as there is a work meeting I am back to square one.


when doing around the table introductions at work, just before it is my turn my heart pounds out of my chest and I start sweating and all the rest.


My main fear is people seeing my fear, I am not afraid of standing in front of people if I didn't have to talk, my fear stems from a time when I did have to talk and my voice quivered so everyone knew that I was very nervous. I am at the age now (32) where I should be confident with speaking and my job requires it.


Please hold off on the replies of 'practice, practice, practice' and breathing techniques, hypnotherapy etc... As I class myself as a veteran of pubic speaking phobia. Anyone who has this will naturally practice like crazy before hand, and I have tried hypnotherapy and breathing techniques etc.. I have read multiple books about changing beliefs and imagining presentations going well etc, though still I am here writing this...

I think part of the problem is that I don't get to do presentations at work often, it is very very rare, but when I do I would panic.


I firmly believe that practice is the key.. i.e. if you are scared of spiders, get closer and closer to one over time, you should eventually be able to hold one, then the fear should go away (right?)... though I can't do that.. I can talk to people in toastmasters etc, though it is presenting to my work colleagues/management I think that causes the fear, but I can't practice that.

Though anyway, has anyone tried beta blockers and found that they stopped a trembling voice? I know they lower heart rate etc.. but does this actually improve the voice/shortness of breath and handshake etc???

The way I see it is if I can present without showing the fear, as that is what I fear, the fear should subside (I hope!). anyway just another attempt to banish this in my long quest.
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Postby simonr » Thu Jul 22, 2010 2:36 pm


Beta blockers work by reducing the reception of some of the hormones which stimulate anxiety and so on. It might be worth a try.

That said, I'm always more inclined to help my clients look at why they're not coping with speaking in public. As you say, it's not easy if you don't do it often, as it's hard to practice - and you've correctly outlined one of the problems with TM... it only works when things are working (and even then not all time) because it doesn't make any attempt to get at the bigger picture, just encourages people to follow a set of guidelines (which, to be fair, work for most people).

You mentioned you've tried breathing techniques and so on. To be honest, I don't know what to suggest after that. If you've tried them and they've not worked (as opposed to tried them but couldn't work them, if you see what I mean) then there's probably a bigger issue that just the 'typical' presentation anxiety and I'd hesitate to give advice in public, on limited information. If it's important to you, I'd suggest you looked for a professional trainer/coach in your area.

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Postby Invisible_man » Fri Jul 23, 2010 8:56 am

Thanks for the reply simonr. Professional coaching is something that I have never considered, but wil look Into it.

I am very interested in peoples experience with beta blockers, as I have got some and have not yet had the chance to try them out.

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Postby simonr » Fri Jul 23, 2010 9:09 am

I might know someone (unlikely, 'cos it's a big world, but you never know!) :)
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Postby Invisible_man » Fri Jul 23, 2010 2:26 pm

I am in london
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Postby Wizard_of_trance » Thu Jul 29, 2010 7:35 pm

Fear is a learned reaction. Most of the time it is learned at a very young age and once learned, it can be with us for life unless addressed.

Hypnosis allows us to change how we feel about things. Fear is a feeling that is changeable.

There are several different methods that are very effective to help reduce or totally remove a fear; the most common are: Fast phobia cure, regression to cause, the blowout, or even the "remove the unwanted feeling" technique.

I have helped several people in toastmasters overcome their fear of public speaking. Help is available if you find a hypnotist who does fear removal.

I hope this helps you
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Postby remoh » Thu Aug 05, 2010 1:32 am


I just stumbled across your post and your situation sounds VERY similar to my own. I've struggled with fear of public speaking for years although I'm generally not too shy in most other ways.

...still, I think the profound fear of introductions does push things in the direction of real Social Anxiety, even if it's a mild case. I have a hard time introducing myself in almost any situation and the symptoms are consistent with a phobia.

Maybe the reason Toastmasters hasn't worked is that the underlying fear is really a fear of judgment and not simply fear of being embarrassed in front of a large group. I believe their is a difference in the way a SA sufferer would interpret a potential failure and it goes way beyond feeling silly. (Please note, however, that I'm not an expert on this subject)

Anyway, I'm responding because I've been on beta blockers for about 2 years now and I can vouch for their effectiveness. I actually went on the drug to treat benign heart PVCs only to find out later that it also works for performance anxiety. Lucky break, I guess.

Currently I take 50mg a day of Atenolol to treat the PVCs. When I know that I'm going to speak in front of a group, I take an extra 50mg and it DOES make a big difference.

Leading up to the event, I still feel like I'm gonna melt-down but the physical symptoms never materialize. No pounding heart or shaky voice. Within 5 minutes or so of starting I'm generally very calm and relaxed (although it was always really only the first few minutes that got me bad.)

I guess I just need to learn to trust that the medication will do it's thing at this point. I don't believe there's been an incident yet when it didn't work and the only side-effect is a feeling of fatigue for the first couple hours.

I hope this answers your questions. If not, feel free to ask anything.

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Postby Invisible_man » Thu Aug 05, 2010 8:01 pm

Thanks for the reply Remoh,

it is very reassuring to know that these pills help.

Your situation does sound very similar to my own, as also with me it is the first 5mins of talking that is the worse, then as if by magic I totally relax.. Though come the next time round I am back to square one. BUT if I have too many physical symptoms during that first 5mins I loose control completely and can't snap out of it.

I think I can cope with the feelings if they don't show, though I do need to try and take every opportunity to speak to try and get some practice instead of avoiding things.

This is so difficult to overcome as for one, you don't get any chance to practice regularly, and two, you have to perform to an audience whilst having these feelings!..

thanks again,

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Postby Lola62 » Sun Aug 08, 2010 5:14 pm

Hi Lee,

I've suffered with a public speaking phobia, including the pounding heart rate that you mentioned when you have to introduce yourself to a group of people, for the past 32 years (I was 16 when it started and I am 48 now). My main symptoms are a pounding heart rate which can lead to hyperventilation.

Last year my mum died and I wanted to read a tribute at her funeral. I asked my doctor for some beta blockers as a previous doctor had prescribed some and I found them very effective. I took 40mg of propanolol on the morning of the funeral (about an hour before I was due to read) and I had absolutely no problem with the reading. I was still nervous before I stood up, but that dissipated once I realised that my heart rate wasnt going to race away.

Good luck and I hope this helps,

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Postby GraHal » Fri Aug 13, 2010 10:20 pm

Hi Lee

You could have been describing my problem exactly. I am socially relaxed, can be life and soul etc, but presentations and even that few mins 'round the table introductions' and my heart is pounding, my mouth goes dry and my voice shakes and my lips / jaw even become like sort of locked.

I put it down to an exaggerated 'fight or flight' syndrome generating huge amounts of adrenaline and hence the effects. I can be (at times) okay until seconds before and then BAM!! that's it, heart pounding etc.

BUT NOT ANY MORE!!!!!!! Ha ... since I took the beta blocker propanol!!!!!!!!

I do not take propanol at all except for a meeting (where I have to speak for 5 mins or so with all the others listening and staring at me) or presentation etc. I take one only about 2.5 hrs before the meeting (not less than 2 hrs, 3 hrs is okay also). Result ... still feel a bit butterflyish in the tummy but - since the first time I used propanol - I have the confidence that my heart is not going to pound and so the other problems (see above) disappear also.

Second time I used propanol for an 'interview presentation' I got feed back that I was almost 'talking down' to the panel as if i was their boss.. Didn't get the job Ha Had to moderate my performance after that.

Had dreaded having to speak at my daughter's wedding for years. but it happened recently ... I actually enjoyed it. After years of the 'problem' the beta blocker propanol is liberating. Apparently propamol is the best (could be the only?) beta blocker that is advised for our type of anxiety problem.

About third tme I used (only ever used about 6 or 8 times) I ran across the car park after work and then realised why I was puffing and blowing so much ... my heart rate would not keep up with the exertion and supply the extra oxygen, so remember this Lee.

Hope this helps? If you want to ask me anything. go right ahead?

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Postby wastika » Tue Sep 14, 2010 7:58 am

I've public speaking problem and propranolol helps a lot.
in my country (Indonesia) they don't sell Inderal anymore, so I change to generic with less effect.

the problem, it takes about 1 hr for it to works (40mg). but since it is also influencing the lung, I have short breath after 3-4hrs taking it that makes my voice even worse. and also if too often taking it, I got a very bad fatique.

anyone experience same problem?
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Postby mdhaine » Sun Sep 19, 2010 1:59 pm

Hello all,

As far as Beta blockers go, even if they do work, do you want to be relying on drugs to overcome speaking anxiety?

I have been doing toastmasters for some time and it has helped a lot, however there are a few problems with it. You get comfortable with a certain group of people and thats it, and if your in a big club like i am; speech opportunities are few and far between.

I am starting a program similar to toastmasters only done at home through webcams. You can actually see the other people there as you are speaking and completely simulates public speaking. You can attend different meetings to continually speak to strangers and you can attend as many meetings as you like; meaning you can practice a whole bunch just before a presentation.

If anyone is interested, please let me know and i will get some more info to you.
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Postby skyskysky » Sat Oct 02, 2010 8:04 am

Dear Invisible Man

Your post struck a chord with me and I am therefore writing about my experience for the very first time - and my message is a hugely positive one thankfully.

I had a terrible public speaking experience as a youngster - you know the symptoms...blushing, heart racing, loss of control of breathing, shaking limbs, wobbly voice etc.

Now imagine that happening as a young teenager in front of your friends - who gleefully wouldn't let me forget it for the next few years. My phobia was created and boy did it stick. Just the thought of any type of presentation/speech etc would keep me awake for weeks and would invariably lead me to avoid the situation somehow. It was DEVASTATING for me - I was generally confident in other areas of life but my real life experience of loss of control in front of others meant that no matter what anybody said to me about 'oh it'll be OK' just bounced off me because I had a real life experience to call back on and prove to myself that it certainly would NOT be OK.

I left academic courses later in life because I found that they entailed presenting and I stayed very much in a non threatening role at work. I felt humiliated inside - I'm a big bloke - and felt that my reaction was childish and emasculating but completely out of control. The day I 'confessed' this problem to my wife was humiliating.

Over the years I had just about every type of talking therapy known to man and spent a significant 4 figure sum in total - ranging from hypnotherapy to ETF therapy to CBT to NLP. I have tapped my face and my hands a million times, I have butterfly hugged myself half to death and I have spilled my inner weakness to therapists up and down the country whilst reciting positive affirmations. Each therapist believed they were the answer and for a while I was wildly optimistic with each one of them - but - I never got rid of that black cloud that followed me around in relation to public speaking. None of the promised improvements by the various therapists materialised no matter how badly I wanted them to.

I went to toastmasters and that DID help - but as you said - when I then tried to replicate my infant confidence at work I would fall to pieces and completely regress in terms of confidence. I was at a dead end - a total road block and for a very level headed guy in all other walks of life I was even starting to entertain some very worrying lines of thought - way out of proportion. I would actually think through the pros and cons of having a car wreck rather than arriving at a conference (where I wasn't even speaking!!).

One day I mentioned the problem to a friend who lives away (I was too ashamed and embarrassed to mention it to close friends). His answer was so matter of fact and down to earth that it shocked me. He simply said - 'life's too short to be worrying about $%£& like that - I have the same problem so I just take a propranolol before each relevant event...job done'.

I'd never heard of the pill. I was very sceptical and thought there was no way a little pill an hour before a presentation was the answer - after half a life time of worry and high blood pressure and huge amounts of money spent on talking therapies and hundreds of hours sat in little rooms being hypnotised or talking about my childhood surely there wasn't a magic pill? And if there was then surely one of the many therapists I had seen would have at least mentioned it at some stage??

My doctor willingly prescribed me with propranolol to be taken as and when needed. The first time I took 1 tablet (10 mg) about 30 mins before a meeting where I knew I had to be ready to talk a lot if I was going to be taken seriously going forward. I simply could not believe the difference. My body flet like somebody had just gently applied the brakes. My mind was still sharp - but my main fear - my fear that my body would let me down with shakes, breathlessness, wobbly voice etc etc simply didn't materialise. I was stunned, totally stunned. Because my body was not reacting like it usually did in those circumstances my confidence soared. I found myself talking and talking and talking - almost simply for the joy of it! Years and years of worry went out of the window.

In other meetings, when it came to opportunities when I could speak because I had something useful to say - but usually I would just keep quiet or I would try to articulate what I wanted top say but would only get out perhaps 20% of what I wanted to before I dried up/blushed/shook etc - well now before I realised it I was speaking aloud and the key was I was relaxed enough to think about what I was saying as I was saying it and to develop arguments on my feet - all because the beta-blocker wasn't allowing my adrenaline to dominate the experience.

Seriously - whilst I'll never be Tony Robbins or the like - my career has taken off and I have been to places and done things that I never imagined I would - because I have now had the confidence to go for positions and promotions that previously I wouldn't have gone near because of the fear that st some stage I'd need to speak to a group.

Hey, I still worry about presentations (but that has subsided with each one I give) but I always have the confidence that my little white pill will be by my side (I carry a couple in my wallet for emergency public speaking) - and that has changed my life.

So when I hear people say that you just need to battle through it then they very clearly have not been to the very dark place that I have been.

And when I hear some people (generally therapists who have a service to sell) caution that I really don't want to be reliant on drugs - well the truth is I simply couldn't care less about taking a tiny white pill prior to a 'performance' - and the truth is that propranolol for a reasonably fit & healthy adult taken irregularly with the oversight of your doctor is harmless. How many of those people cautioning people about propranolol smoke or drink alcohol? I take it, it works and I have left a problem that dominated my life for so long behind because of it.

Good luck.
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Postby jsmith1984 » Tue Nov 09, 2010 2:42 am

Just want to say a huge thanks to everyone on this thread (and especially SkySkySky for his post which was a very polished, helpful and informative entry indeed!).

The experiences described relate very similarly to my own life. I have not been through counselling (though would easily have qualified) but did end up on propranolol with palpable benefit. I just take 40mg/day now with an extra one during public speaking events. It does succeed in dampening down the adrenergic response signficantly so that the usual alarming and irrational symptoms are reduced to a point where they allow one to get on with talking without feeling like jumping out the nearest window.

Thanks for sharing your experiences.


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Postby AMG1970 » Thu Jan 20, 2011 9:42 pm


OMG - like I'm reading about myself. How can I get propanol - my doctor is reluctand to give me medication, I'm currently having CBT. I agree with the principles, but ubsure it will work for me. I don't do "the fear" often enough - may e 4 times a year. If i could just take something as & when needed, I would be happy!! Is it safe to order online ? advise gratefully received :oops:
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