At the 81st Annual Golden Globe Awards on January 7, 2024, the talented actor and media personality Robert Downey Jr. won a best supporting actor award for “Oppenheimer”, the hit 2023 movie that chronicled the life of J. Robert Oppenheimer, an American theoretical physicist credited with being the “father of the atomic bomb” for his role in the Manhattan Project — the World War II undertaking that developed the first nuclear weapons ^[1].

What stood out to me when I came across the acceptance speech that RDJ gave for this award, was his mention of beta-blockers in subtle reference to his nerves. See for yourself:

Robert Downey Jr. Golden Globe speech where the actor mentions using beta blockers for stage fright

“Yeah, yeah, I took a beta-blocker so this will be a breeze”

That throwaway line in his speech has caused a ton of people to email me asking about beta blockers, what they are and how (if?) they work? I’ve talked about beta-blockers extensively on PerformanceAnxiety.com but I figured this is a fantastic chance to summarize what the prescription medications are, why so many actors and celebrities seem to use beta-blockers for their anxiety (Khloé Kardashian being another celeb example!) and what the downsides & side-effects are. Ultimately, we will figure out if beta blockers are actually an effective tool to fight anxiety.

What Are Beta-Blockers?

Although it’s hard to completely pinpoint, it is said that a 1965 article in a medical journal/magazine called The Lancet about the use of Beta Blockers to help with stage fright and performance anxiety is what has caused the popularity of a heart medication drug amongst musicians, actors, public speakers, surgeons, and people of all kinds who regularly face down anxiety.

The late Oboist and ‘Mozart in the Jungle’ author, Blair Tindall, wrote about beta-blockers in a 2008 article for the Guardian newspaper ^[2]:

Beta blockers are not recreational drugs. They do not affect cognitive abilities, but instead block adrenaline-like chemicals in the human system. For a violinist, this means performance can feel like practice, with no bouncing bow or slippery fingers.

Called beta-adrenergic blocking agents in full, beta blockers are a class of pharmaceutical drugs that block the release of adrenaline hormone (also known as epinephrine) in the body ^[3].

Doctors typically prescribe beta-blockers to help with heart and blood pressure issues; including abnormal heart rhythm, high blood pressure, angina, glaucoma, and other (mostly cardiac) conditions ^[4].

Why Are Robert Downey Jr. and other celebs using beta blockers for anxiety?

When consumed, beta-blockers relax the load on the cardiovascular system by blocking the release of adrenaline, a stress-related hormone. Adrenaline typically binds to adrenergic receptors in the heart, called beta receptors ^[5]. As a result, the heart has to pump blood with greater force, which causes blood pressure and heart rate to go up.

What beta blockers are doing is blocking the release of adrenaline into the system in the first place, meaning the stress hormone cannot bind to beta receptors in the heart and the heart can maintain its typical (non-stressed and steady) workload, which also keeps blood pressure steady (explaining why beta-blockers are normally prescribed for people with high blood pressure and hypertension).

Actors and performers like Robert Downey Jr. are using beta-blockers ‘off-script’ (meaning for a purpose other than what it was initially developed for) in order to stave off adrenaline release into their systems. But they are not worried about hypertension or high blood pressure; instead they are concerned with stopping the performance anxiety symptoms that adrenaline directly causes! Too much adrenaline leads to a stress-response in humans, so if we can block adrenaline release we can typically remain physically (and often mentally) calm, which then allows performers to get through their speeches or high-pressure engagements while keeping their natural stress response at bay ^[4].

What are the most popular Beta Blockers?

Here is a list of the most popular beta-blockers available in the US today. If you’re considering any of these beta-blockers, or any other medications for performance anxiety, you must speak to your doctor before you begin taking them. This is especially critical if you’re currently on any other medications, to avoid any negative interactions:

• Propranolol
• Metoprolol
• Acebutolol
• Carvedilol
• Atenolol
• Bisoprolol
• Nebivolol

Propranolol (generic name Inderal) is the most common beta blocker when it comes to people using them for anxiety symptoms. Propranolol is also the most commonly prescribed beta blocker in the US, overall.

There are other medications that people commonly use off-script for anxiety, like Clonodine, Gabapentin and Depakote, but these are not technically beta-blockers so are not covered here.

Side-effects of Beta-Blockers

As long as they are only used occasionally, beta-blockers are considered to be relatively safe with minimal risk of side effects (Note: this is not medical advice, please consult a medical professional before using beta-blockers or any prescription drug!)

Problems can arise, however, if beta-blockers are needed in order to be able to perform, as this is when frequent usage can happen. When consumed frequently, beta-blockers can have a risk of dependency, and withdrawal could cause other unforeseen problems like high blood pressure.

So, beta-blockers are considered safe to use when a quick and temporary solution is needed, but it might be a good idea to start incorporating some natural alternatives to beta-blockers when looking for a more long-term or frequent solution to performance anxiety.

My most recommended alternative to beta-blockers for anxiety purposes is PerformZen supplement, which we reviewed here.

Instant All-Natural Performance Anxiety Relief

PerformZen is a natural supplement uniquely crafted to overcome stage fright and performance anxiety so you can perform at your best on demand!

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Other celebrities using beta-blockers for anxiety

There are several celebrities who have recently talked openly about their use of beta-blockers in order to fight off their anxiety symptoms, besides Robert Downey Jr. Some popular examples include:

Katy Perry

The singer, songwriter & American Idol host talked about her use of beta blockers to help with her anxiety and stage fright during an interview with Cosmopolitan magazine. She stated that she “had a crippling fear that she would let everyone down, and so she used [beta blockers] to overcome performance anxiety” ^[6].

Katy Perry made it abundantly clear that her stage fright does not come from lack of preparation, but from a fear that “fans will rush the stage or that I’ll vomit on stage during a performance”

The singer feels intense pressure to ensure that she fends off competition from rivals in the music industry ^[7]:

“I have to take beta blockers [before each show], I get so nervous. [I think] that I have to get through this; I can’t let these people down, but mostly I can’t let myself down. I’ve been given a great opportunity and there are 500 bitches behind me who will snatch my weave off my head if I don’t kick-ball-change through this two-hour show.”

Whitney Cummings

The comedian Whitney Cummings, in an interview with Everyday Health, talked about her chronic migraine issues and how it led to her discovering beta-blockers to manage her anxiety that would come with her worry about said migraines ^[8]:

[The migraine attacks] started when I was a kid. I remember going to Disneyland, and being the person who ruined the trip because Whitney has to go to the car and put a pillow over her head. A trip to Six Flags amusement park had to be cut short because Whitney has a migraine. I feel like I was always the bummer in my childhood.

…A big one of my migraine triggers is an increase in adrenaline and cortisol — which comes from stress, which we all have. It’s a neurological imbalance.

…Sometimes the stress leading up to something can trigger the migraine, and even the stress of anticipating a migraine can bring one on.

…I take beta-blockers now, which help hugely. I didn’t find out about them until about three years ago. I know if I have a big meeting, or a big audition, or a big performance, or anything where I know I’m going to be nervous, I just take one preemptively, so that I’m not blasting my brain with adrenaline.

My goal is to keep my neurochemicals, my hormones, and my blood sugar levels as consistent as possible.

Shawn Mendes

While on a global tour, Canadian singer Shawn Mendes did an interview with Capital FM where he stated that he was finding his continuous performances difficult. He said he got so nervous for his live shows that he “needed medication to calm him for over a year” ^[9].

Here’s the social media post where Shawn Mendes opens up about his struggles with anxiety and pre-show nerves ^[10]:

.@ShawnMendes opens up to his fans about his anxiety, revealing that today is the first show in one year that he hasn't taken medicine to help him calm down. pic.twitter.com/GwbWOBDJtJ

— Pop Crave (@PopCrave) April 6, 2019

Do Beta-blockers work for anxiety?

Despite only a few celebrities being open about their stage fright & anxiety issues, it is clear that people within show biz are suffering from these issues and some, like Robert Downey Jr are (very) familiar with the use of beta-blockers to help overcome them.

There is definitely a little comfort to be had in knowing that even the most successful actors, singers and performers – the very people we think of as the most confident – also face the same self-doubt and insecurity that the rest of us do.

It’s clear that beta-blockers are one solution to anxiety issues, and we have written about beta blockers for anxiety use before. If you are looking for an alternative to beta-blockers for your own performance anxiety, however, check out our article covering natural beta blocker alternatives here.