Xanax and propranolol before diving?

[bluebanded goby]

Every now and then I give public talks. Because I get quite a bit of stage anxiety, I have prescriptions for xanax and propranolol which I take together before giving a talk. I only take these medications at these times (once every few weeks), and don't have anxiety particularly in any other area of life.

It turns out that this Saturday I'm scheduled to give a talk at about 12 noon, and then about 3-1/2 hours later am scheduled to do a couple of dives as part of an advanced open water class. I've done a search to see if there are any concerns about taking these medications before diving, and the only thing I see is that xanax as a benzodiazapine has a sedative effect. I do get a little drowsy after taking it, and generally end up taking a nap after giving a talk. If I rest up adequately after the talk and before heading for the beach, and feel rested and alert when I get there, can I go ahead and do these dives as scheduled? Is there anything to be concerned about with propranolol lowering blood pressure? Can it have any possible effect on nitrogen in the blood, DCS, etc? Or would I be better off trying to reschedule either this talk or the diving so that I'm not doing both on the same day? Thanks for any input on this.

 

[scubadoc]

Hello bb goby!

If I were you I'd postpone either the talk or the dive, especially since you state that these drugs usually make you drowsy enough to have to take a nap.

We don't really know what the effects of depth/pressure would have on the combination of Xanax and propranolol. We do know that Xanax can cause ATAXIA, DIZZINESS, DROWSINESS, LIGHTHEADEDNESS and SLURRED SPEECH - things that would definitely be adverse to diving. Add a little nitrogen at depth and you have a prescription for disaster.

Propranolol is a beta blocker which, in addition to being an anxiolytic due to it's ability to block the effects of adrenalin-like drugs and hormones, also has the effect of blocking the ability of the body to respond to stressful situations and exercise. Should this occur while diving, the person might be unable to have his/her heart respond by a necessary increase in blood pressure and heart rate, resulting in failure underwater.

People take both of these drugs and dive; however, the drugs are taken on a chronic basis and the individuals have become acclimated to the effects of the drugs and know what their functiuonal capacities are. This would be different from your situation. Best advice would be for you not to dive until the effects of these drugs have dissapated.

 

[bluebanded goby]

Hi Scubadoc,

Thanks for the informative reply. Even before I read it I came to the same conclusion -- so I arranged for a friend to do the talk for me this time, leaving me free to dive. I'd just as soon not introduce any factors that might impair my mental sharpness.