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Re: New Medications for Social Phobia

Posted by Terry on April 6, 1999, at 10:49:57

In reply to Re: New Medications for Social Phobia, posted by Elizabeth on April 6, 1999, at 1:07:58

Elizabeth -- I would think that MAOIs like Nardil wouldn't be used first-line anymore for social phobia (or any other indication, for that matter) because of the many interactions with other drugs and foods associated with them. My understanding was that because of those side effects, most docs now prefer to use MAOIs second- or third-line for depression and other indications. I know when I read throught the list of interactions for Nardil, I thought there was no way I'd take it, even if it was the most effective drug in the world. Also, why would you take a benzodiazepine for social phobia? I wasn't aware there were studies of those drugs for that indication, or were they done long ago before the SSRIs? Terry

> Paxil worked, according to one study.
> This is not saying much compared with the abundant evidence that Nardil, an older drug, works far more often than Paxil did in this study! However, Paxil - or any of the other SSRIs (e.g., Prozac, Luvox) - might be a better first choice since they have fewer side effects (usually). Tricyclics do not work.
> Benzodiazepines - Klonopin and Xanax have been studied, Ativan and (probably) others would work too - are another option.
> If you find at least two SSRIs and two benzos don't help (with adequate trials), I'd say Nardil (or another MAO inhibitor) is probably the best option, though others may disagree. There just isn't much compelling evidence to support the use of anything else.
> I'm not sure where you would go to find a good doctor in your area, but I tend to think that the best places to look are university-affiliated hospitals. (Ask for a specialist in anxiety disorders.)
> Good luck! :-)




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