Psycho-Babble Medication | about biological treatments | Framed
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To: Adam

Posted by JohnB on November 3, 1999, at 22:17:20

In reply to Re: Any SSRI/other? good as Nardil for Social Phobia?, posted by Adam on November 3, 1999, at 19:05:12

> 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...
Thanks, Adam. I have tried Remeron. It might not have been long enough or the right dosage, though. I didn't experience weight gain or sexual dysfunction, but I didn't seem to get any relief from my social phobia. Perhaps it's worth another try at a different dosage (???)

Thanks very much for taking the time and energy to respond. JohnB




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