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Re: Any SSRI/other? good as Nardil for Social Phobia?

Posted by Adam on November 3, 1999, at 19:05:12

In reply to Any SSRI/other? good as Nardil for Social Phobia?, posted by JohnB on November 3, 1999, at 9:49:22

Mirtazapine (Remeron) might be an option. It blocks certain alpha-adrenergic receptors which can lead to enhanced release of norepinepherine
and serotonin (in that order). It also blocks certain serotonin receptors (5-HT2 and 3), which, according to some, are associated with the
sexual side-effects of serotonergics, while leaveing 5-HT1 alone (that one, I guess, must be stimulated to achieve a good antidepressant effect
via enhanced serotonin levels). It also binds histamine receptors, and it is thought that this combined antihistamine and serotonergic effect
might make mirtazepine a bit of an anxiolytic. Unfortunately, this histamine receptor blockage also leads to weight gain, which I know you
don't want. I think weight gain might be easier to prevent than sexual side effects.

I'm not aware of any studies of mirtazepine as a treatment for social phobia, but perhaps it might work, given its serotonergic/anxiolytic
properties. I personally found it too sedating, but some tolerate it well, I guess. I never slept better, that's for sure.

As for reboxetine, I've read it seems to enhance social _functioning_ (motivation, ability to feel reward and so on), but I've not heard it was
used for social phobia. Perhaps indirect effects on serotonin release might be a factor, if this is true...

> hi, i suffer from pretty severe social phobia. argh! i've found the most effective drug has been nardil, but weight gain and sexual dysfunction drove me crazy. currently taking marplan (50 mg/day), but it doesn't work nearly as well. parnate didn't work for me either. WOULD LIKE TO KNOW IF ANY OF THE SSRI'S OR OTHER DRUGS (VENLAFAXINE, SERZONE, ETC) WORK AS WELL FOR SOCIAL PHOBIA, AND WITHOUT THE WEIGHT/SEXUAL SIDE EFFECTS. i also take klonopin, which is effective, but pretty sedating and just destroys my short-term memory. in fact, the other day, i couldn't remember an assignment my boss had given me in a meeting which occured one hour earlier!!!!!!!!!
> i guess an alternative could be to supplement nardil with burpropion or something else to reverse the sexual dysfunction and weight gain. anyone with experience, here?
> maybe a second alternative is taking zoloft/buspar combination - maybe this is worth a try (?) saw where someone mentioned it being activating, and without the sexual/weight problems. just don't know if it's effective for severe social phobia.
> please help. feel i've run out of options.
> thanks. johnb




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