Cardiac Meds Abused

Call it the forgotten Ritalin. Just as this hyperactivity treatment
quickly became a drug of abuse for ambitious students scrambling to get
straight A's, the cardiac meds known as beta-blockers are becoming a
panacea in the white-collar world. Their magic power: suppressing the
heart-pounding, sweat-drenched fight-or-flight response that office life
often provokes.

Tim Graham is a successful Chicago-area professional whose career
in product development was almost derailed by anxiety. Before
presentations at work, he was a wreck. His legs quivered, his hands got
cold and clammy, he had trouble speaking. Luckily, he found help in the
form of the beta-blocker propanolol. "From the get-go, it worked like a
charm," Graham says. He appreciates what he calls the "neck-down"
activity of the pills -- no foggy thinking or sleepiness, just a calm sense
that he has control of his body.

Beta-blockers have been around for decades to treat problems like
angina and high blood pressure, but since prescribing these drugs for
anxiety remains an "off-label" use, many physicians don't think to recommend
them. More than 100 million prescriptions were written for the drugs in
2002, but it's impossible to tell how many pills went to cardiac patients
and how many to jittery executives. Diane Nichols, a Manhattan clinical social
worker who teaches musicians how to manage stage fright, says the pills
are common among her students. "It's kind of like breath mints, at
least among some of the orchestras," she says. But casual use or
drug-sharing can be dangerous, Nichols warns. Although rare, they can cause side
effects, like weakness. And asthmatics shouldn't take them.

Conrad Swartz, chief of psychiatric research at Southern Illinois
University School of Medicine, thinks beta-blockers are underprescribed.
Doctors overlook them in favor of more psychoactive -- and expensive -- drugs
such as selective serotonin reuptake inhibitors. Since no drug company
has tried to get FDA approval to promote beta-blockers as an anti-anxiety
drug, many doctors don't know about the medicines, Swartz says. "Doctors
don't use what they were not trained in."