STRESS: MOM - Physical Aspects of Stress

Question 1

Beta Blockers Official Name

Answer 1

Beta Adrenoceptor Blocking Agents

Question 2

What do beta blockers do to receptors?

Answer 2

Block receptor sites for adrenaline & noradrenaline hormones

Question 3

Effects of using beta blockers

Answer 3

• Results in usual physical stress response to be dampened
• Breathing & heart rate is not increased = individual is calmer

⭐USEFUL IN ACUTE STRESS SITUATIONS⭐

Beta blockers are primarily prescribed for heart conditions (e.g. to lower blood pressure)

Question 4

How do beta blockers work?

Answer 4

Beta blockers have an antagonist action, meaning they work by reducing the activity of the sympathetic nervous system therefore reducing subsequent symptoms

⭐Masks outward signs of anxiety - physical symptoms⭐

• E.g. public speech: individual will no longer experience outward signs which may disrupt their performance such as shaking / sweat / change in pitch

Question 5

Different types of beta blockers

Answer 5

Non-selective / selective
N/S - Propranolol: blocks adrenaline & noradrenaline in the heart & other areas
- block beta1 & beta2 receptors: affect the heart, kidneys, liver & other areas
S - Atenolol: affects mostly the heart therefore lesser affect on other parts of the body
- block beta1 receptors: mostly affect the heart & cause reduced cardiac output

Question 6

Off-label use of beta blockers

Answer 6

Primarily prescribed for conditions such as high blood pressure & angina

Prescribed for ‘off-label’ anxiety conditions
Manufacturer has not applied for license for beta blockers to be used to treat anxiety
- Drug has not undergone clinical trials to test whether it is safe & effective when used for anxiety
- A doctor can prescribe beta blockers for anxiety if they feel the benefits outweigh the risks for the individual
- Typically prescribed at a lower dosage than that used for cardiac problems

Question 7

Beta blockers use by musicians

Answer 7

Number of musicians claim to take beta blockers for their calming effect in order to:
- Reduce stage fright
- Make them more able to perform under pressure

Lockwood (89) - Studied over 2000 musicians in major USA symphony orchestra - found that 27% used beta blockers & 17% used beta blockers on a daily basis
Tindall (04) - Suggests higher percentage of musicians in recent years

Question 8

Beta Blockers in sport

Answer 8

Can be used by sportspeople as a performance enhancer due to:

• Aids the heart
• Have a relaxing effect on muscle function
• Reduce anxiety

Beta blockers banned by the World Anti-Doping Agency in 2010 for all Olympic sports

2015 - South Africa’s top ranked amateur golfer Christiaan Bezuidenhout tested positive for beta blockers & faced a 2 year ban from the sport
- Appealed & explained beta blocker use was for an anxious stutter and not competitive advantage

Question 9

An alternative drug therapy for beta blockers

Answer 9

Benzodiazepines: Librium / Valium

Works by increasing the effect of the gamma-aminobutyric acid (GABA) neurotransmitters
- GABA increases the flow chlorine ions into the neuron [Makes it difficult for other neurotransmitters to stimulate it]
- Increases the action of GABA @ those receptors therefore have a calming effect on the whole brain

ONLY used for those suffering from short-term severe stress / anxiety problems

• Highly addictive
• Several side effects (drowsiness / impaired judgement)
  
  • Careful warning must be given to individuals when prescribed for stress

Question 10

Physical aspects of stress :)

Answer 10

Neftel et al.

Schwabe

Question 11

Physical aspects of stress :(

Answer 11

Long-term effectiveness = questionable
Side Effects
Dependency / Side effects in use & in withdrawal

Question 12

Physical aspects of stress - Neftel et al.

Answer 12

Benefits performance & reduces self-reported stress

Question 13

Physical aspects of stress - Shwabe

Answer 13

Research suggests beta blockers may prevent stress