That's why Sarah Tuck, a veteran flutist with the San Diego Symphony, takes them to stave off the jitters that musicians refer to as "rubber fingers."
"When your heart is racing and your hands are shaking and you have difficulty breathing, it is difficult to perform," said Tuck, 41, who discovered them when she began performing professionally 15 years ago.
A survey she conducted a decade ago revealed one-quarter of flutists used the pills before some or all of their performances or in high-pressure situations like auditions. She believes use is now more widespread and estimates that three-quarters of musicians she knows use the drugs at least occasionally.
Prescriptions for Inderal and other beta blockers can be readily obtained from physicians. Tuck said some doctors had told her they used the drugs themselves to calm their own nerves before making presentations at medical meetings. Musicians say their drug use is all aboveboard.
"It's not like we're sending our clubhouse attendants to BALCO to get us our Inderal," said double bassist Bruce Ridge, 44, referring to the Bay Area Laboratory Co-Operative that allegedly provided slugger Barry Bonds and other athletes with performance-enhancing drugs.
But cosmetic neurology, as some call it, has risks. Ritalin, Adderall and other ADHD drugs can cause headaches, insomnia and loss of appetite. Provigil can make users nervous or anxious and bring on headaches, while beta blockers can cause drowsiness, fatigue and wheezing.
One Stanford University study found that low doses of Aricept improved the performance of healthy pilots as they tried to master new skills in a flight stimulator, but the side effects -- dizziness and vomiting -- were less than desirable in a pilot.
No one has conducted thorough studies about how brain-boosting drugs would affect healthy people after weeks or months of use, said Dr. Anjan Chatterjee, a neuroscientist at the University of Pennsylvania.
Negative consequences may not be limited to people who popped the pills.
Martha J. Farah, a bioethicist who teaches undergraduates at the University of Pennsylvania, said she was beginning to detect resentment toward students who used the drugs from classmates who did not. She has wondered whether improving productivity through artificial means also might undermine the value of hard work.
