Posted by Rick on November 4, 1999, at 15:07:14
In reply to Any SSRI/other? good as Nardil for Social Phobia?, posted by JohnB on November 3, 1999, at 9:49:22
Why would you discontinue the Klonopin? I have pretty severe SP myself, and have tried Nardil, Xanax, Selegiline, BuSpar, and Klonopin. And, by far, the most relief (a huge amount after two months) has come from the Klonopin. And with NO side effects except a few NICE ones.
You didn’t say if you also suffer depression; in that case you may NEED an anti-depressant, and might as well ignore the rest of my post. But if SP is your overwhelming concern (as it was for me), read on.
There is a good possibility that what you perceive as negative Klonopin side effects are actually coming from the combination and (documented) interaction of this med and Nardil. Your sedation on 2.0 mg. Klonopin would probably be far less taking it solo than in combo with the Nardil. (But don’t expect a quick change, since the MAOI can stay with you quite awhile after quitting. For instance it took me almost four weeks after discontinuing Nardil before I was able to have an orgasm...and a pepperoni pizza.)
Also keep in mind – as documented in the “Tips” section of this site - that MANY psychotropics can cause short-term memory loss, including the SSRI’s. I would imagine the same is true for MAOI’s, and again the Nardil/Klonopin combo could be potentiating this effect. So, reiterating, don’t be so quick to blame the Klonopin, but do expect the memory effects to continue for a few weeks even if you DO follow my suggestion and try dumping the Nardil half of your regimen.
Xanax made me feel drugged and sedated. It was much less “smooth” feeling than Klonopin, and had to be taken more frequently. (I take Klonopin upon waking, three hours later, and four hours after that – currently about 1.5 to 2.0 mg total per day. I also take a tiny amount of the beta blocker Pindolol (2.5 mg. twice a day) which seems to smooth out any remaining tidbits of social anxiety and helps keep down my heart rate/BP.)
With Klonopin and NO antidepressant, I simply feel normal, alert, and have plenty of energy; the only difference is – for example -- that I can stand in front of a room of staring faces and feel almost totally relaxed instead of falling apart. To me, it’s amazing, a godsend. And I’ve had no adverse side effects (other than a little sedation the first few weeks and when I took too much in a single dose or for the whole day). Conversely, I’ve had a few truly pleasant side effects like INCREASED libido/sexual sensations (don’t know how common this reaction is) and good sleep. (A dosage-related aside: an article on SP elsewhere in Dr. Bob's site recommends a WAY too high dose of 3-6 mg/day. Taking more than needed DECREASES the effectiveness and increases the possibility of sedation and cognitive problems. I hate to see that article on this site and elsewhere, because this dosage recommendation is probably leading to bad results and turning people off to Klonopin's amazing benefits for SP.)
Good Luck. And if neither this nor other folks' suggestions do it for you, take heart in the fact that LOTS of potential meds are currently being tested for SP and showing initial promise. And there’s always CBT.
Rick
> 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!!!!!!!!!
>
> ALTERNATIVES (?)
> 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
poster:Rick
thread:14476
URL: http://www.dr-bob.org/babble/19991028/msgs/14597.html