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Psychiatry · Anxiety disorders
Sample itemA musician has marked tremor, palpitations and sweating only before public performances, with no symptoms otherwise. Which drug is most suitable for situational use?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Propranolol
Performance anxiety is a limited form of social anxiety in which the symptoms are largely adrenergic. A beta-blocker such as propranolol taken before the event blunts tremor and tachycardia. Generalised social anxiety disorder is treated with SSRIs and cognitive behaviour therapy.
Option by option
A. Haloperidol
Haloperidol is an antipsychotic with no role in situational anxiety.
B. Fluoxetine
Fluoxetine takes weeks to act and is used for generalised social anxiety, not for as-needed use.
C. Propranolol (correct)
Correct. Beta-blockade controls the peripheral autonomic symptoms of performance anxiety.
D. Buspirone
Buspirone also takes weeks to work and is not useful for single events.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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