Most of the music-performance trials in these sources tested oxprenolol, atenolol or nadolol, not propranolol. One abstract reports double-blind testing of propranolol, and it does not state the dose. A systematic review abstract on professional musicians points to methodological weaknesses in the studies.
Which drug each study tested
Each abstract tested a different drug, dose or design. The table gives the drug, dose, participants and design as each abstract states them. In a crossover design, each person takes both the drug and the comparison in turn.
| Study | Drug and dose | Participants and design |
|---|---|---|
| Lancet, 1977 | Oxprenolol 40 mg (not propranolol) | 24 musicians; double-blind crossover trial |
| Am J Med, 1982 | Propranolol (dose not stated) and terbutaline | Two trials with a total of 29 subjects; double-blind testing of propranolol; stage fright symptoms evaluated by questionnaire and the State Trait Anxiety Inventory |
| Psychosom Med, 1982 | Atenolol 100 mg or placebo, 6.5 hr before performing | 22 performing string players; performed either in the presence or absence of an audience |
| Ann Otol Rhinol Laryngol, 1985 | Nadolol 20, 40, or 80 mg, or placebo; placebo again 48 hours later | 34 singing students during end of semester juries; double-blind crossover |
Findings that pointed toward better performance
The oxprenolol trial gave 40 mg of oxprenolol to 24 musicians in a double-blind crossover design. Musical performance judged by two professional assessors was found to improve. This was a different drug from propranolol, and the claim used here gives no figure for the size of the improvement.
The propranolol and terbutaline abstract states that the quality of musical performance as judged by experienced music critics is significantly improved, and that this effect is achieved without tranquilization. The statement as reported here does not say which drug, dose or comparison it refers to.
The authors of the atenolol abstract conclude that the drug was at least partially effective as shown by an improvement in technical-motor performance. They also conclude that the beneficial effects of beta blockade in stage fright only involve a peripheral site of action.
Findings that were small, not significant or went the other way
In the same atenolol study, the placebo group showed a significant impairment of technical-motor performance before an audience. The abstract reports a slight but not significant improvement under beta blockade (-7.48%). Heart rate was significantly lower under beta blockade than under placebo (p less than 0.001). The abstract therefore pairs a significant heart rate difference and a performance change that was not significant with the authors' conclusion that the drug was at least partially effective.
In the nadolol study, the abstract reports a small but statistically significant dichotomous effect upon performance rating. Low-dose nadolol tended to enhance performance, whereas larger doses impaired performance. The claim does not say which of the 20, 40 or 80 mg doses counted as low, or how many students took each dose.
What a systematic review says about this research
The abstract of a 2019 systematic review on performance anxiety in professional musicians states that studies showed methodological weaknesses. It names the selection of participants, recording of influencing factors, blinding of interventions, randomization of participants and analysis of comorbidity. The claim used here does not say which individual studies had which weakness.
What this does not tell you
Only one of these abstracts names propranolol, and it does not state the dose. Results for oxprenolol, atenolol and nadolol are not results for propranolol. Each drug was studied at the doses shown in the table, and those doses cannot be carried over to another drug.
The studies are small and old. They enrolled musicians and students and were published between 1977 and 1985. They measured different things: assessor and critic judgments, technical-motor performance, heart rate and performance ratings. Some results were significant and some were not, so they do not add up to one answer.
The claims used here do not report side effects. Nothing here says whether anyone should take, skip or change anything. A licensed provider decides that.