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.

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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."

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