I have anxiety giving presentations to an audience. What is the best benzodiazepine for this?
Answer:
Benzodiazepines are not actually a preferred medication for performance anxiety, or stage fright. The preferred medication for performance anxiety are beta blockers, like propranolol. The main reasons why beta blockers are preferred over benzodiazepines are that propranolol is effective at reducing the physical symptoms of anxiety by blocking the adrenaline receptors, and propranolol is not an addictive drug, while benzodiazepines have side effects like sedation and tremors, and benzodiazepines are potentially addictive.
But if you and your doctor decide on taking a benzodiazepine for performance anxiety, then the best benzodiazepines are lorazepam (Ativan) and clonazepam (Klonopin). Lorazepam and clonazepam have less addictive potential than diazepam (Valium) and alprazolam (Xanax), as diazepam and alprazolam give a person a euphoric feeling (a ‘high’), thereby increasing the risk of addiction. Lorazepam and clonazepam have less euphoric effects.
If you want anxiety relief for just a couple of hours, then lorazapam is your best choice. For longer anxiety relief, your best choice is clonazepam. But hopefully, you and your doctor will agree that beta blockers are the best choice overall for performance anxiety.
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Dr. Carlo thank you for the above article, it really brings comfort knowing that there are medication to address the anxiety and uneasiness felt anticipating a speech to an audience. I have a monthly board meeting that I have to report to board members and the anxiety just builds up and builds up just thinking about it. I was prescribed alprazolam .5 mg and I took it about 2 hrs (6:30pm) before my presentation (8:30pm) and I still felt a bit anxious to a point that I had to sneak another 1/2 pill as my turn was coming up. My voice was shaky, felt my heart race up and I still felt bad. The next morning (5:30am) I didn’t like the feeling I felt from taking the 1 1/2 pills. My anxiety is only based on me having to speak to the board of directors or me required to speak in a formal setting, to a group of people. Other than that, I don’t have other anxiety attacks or anxiety issues. I just need help for several hours.
Go to your doctor and try propranolol for stage fright.