Best archer, or best archer under pressure?

Over at the Atlantic, Carl Elliot has a very interesting article about beta blockers as a performance... enhancer?! Beta blockers are used to treat hypertension and cause a reduction in heart rate (as well as the heart's response to exercise). The natural assumption would be that this would lead to a decrease in aerobic capacity because of the reduction in cardiac output... however a (very) limited search suggests the evidence is pretty equivocal whether that's the case in a healthy athlete. Regardless, I know that I wouldn't want to be on a beta blocker if I was about to run the 100m dash.

However, Dr. Elliot's point isn't about the affect on heart rate that beta blockers have... it's the affect on the effects of anxiety.

In the mid-’70s, a team of British researchers tested the effects of a beta blocker on the performances of skilled violinists and other string musicians. They made sure that the musicians were playing under maximally stressful conditions by booking them in an impressive concert hall. They also invited the press to attend, and recorded all the sessions. The musicians were asked to perform four times each, twice on placebo and twice on beta blockers, and their performances were scored by professional judges. Not only did the musicians tremble less on the beta blocker, they also performed better. Usually the improvement was minimal, but for a handful of musicians it was dramatic.

From a competitive standpoint, this is what makes beta blockers so interesting : they seem to level the playing field for anxious and non-anxious performers, helping nervous performers much more than they help performers who are naturally relaxed. In the British study, for example, the musician who experienced the greatest benefit was the one with the worst nervous tremor. This player's score increased by a whopping 73%, whereas the musicians who were not nervous saw hardly any effect at all.

And then on to the crux of his argument:

Beta blockers are banned in certain sports, like archery and pistol shooting, because they're seen as unfairly improving a user’s skills. But there is another way to see beta blockers—not as improving someone’s skills, but as preventing the effects of anxiety from interfering with their skills. Taking a beta blocker, in other words, won’t turn you into a better violinist, but it will prevent your anxiety from interfering with your public performance. In a music competition, then, a beta blocker can arguably help the best player win.

Pretty interesting take. He goes on to talk about shooting in basketball under high pressure, and how it would seem like cheating if we could make everybody clutch. However, because of the possible aerobic capacity effects mentioned above, I would think a better example would golf. That's a sport where people would flip out if somebody was taking a pill to calm their shaking hands and make their palms not sweat as they came up to the final putt on the 18th hole.

At this point, I think I have to say that dealing with the effects of anxiety is a big part of any sport, and I have a hard time not seeing a pill that helps with it as cheating.