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Re: Social phobia - side effects of Celexa

Posted by Rick on August 17, 1999, at 20:23:44

In reply to Social phobia - side effects of Celexa, posted by Douglas Thomas on August 16, 1999, at 18:40:15

Apparently side effects (including sexual) sometimes go away after awhile, but sometimes they don't. And while SSRI's often casue sexual dysfunction, you just can't generalize across patients as to which SSRI is going to cause the most (and least) problems. It's all all trial and error, and waiting long enough to see if effects go away. "Supposedly" Celexa is less *likely* to lead to lack of orgasm, but I've heard lots of complaints. (And if they don't, there are always augmentation strategies that may help).

I have had horrible generalized social anxiety "forever". After MAOI Nardil did some great, but very inconsistent, things for me, it then pooped out entirely in four weeks (AND left me completley incapable of orgasm; converted me from hypertensive to hypotensive(!!), etc.).

Snipping out some interim details to cut to the chase, I convinced my pdoc to let me try Klonopin (I had used Xanax on an as-needed basis, but it was very sedating and only moderately helpful). The idea was that, after a ten-day washout from Nardil, I would try another AD. I was going to try for Celexa or Serzone (virtually NEVER causes sexual dysfunction, and has been shown as useful for Social Phobia in Medline abstracts).

But I was doing so well on low-dose Klonopin that we decided to forego an AD completely. I also take 5mg of Selegeline (selective MAOI requiring NO food restrictions at that dose), and about a week ago added 5mg Visken ( aka Pindolol, a dopamine-enhancing beta-blocker hypertensive) since my heart rate and BP were kind of high.
As a non-selective beta blocker, Pindolol is also good for providing a "calming" effect in performance sitautions like presentations or big meetings, not that I need it very much with the incredible Klonopin.

Now, compared to the AD days, I am 90% free of social anxiety. No desire to be a social animal, but people don't make me nervous and I am not avoidant. I talk a lot more, and rarely suffer the shaky, halting voice or pounding heart that was so familiar before. I've had a few MINOR relapses (especially when extremely hungry and/or tired), but adjusting the timing of my 2mg daily Klonopin has helped smooth those out.

Ahhh, and the sweet release from AD side effects (Nardil had many more than I mentioned above)! By gradually dosing up the Klonopin, starting with .5mg at bedtime (in case it made me sleepy), it caused virtually no sedation problems as my body adjusted. Unlike with some AD's, I enjoyed the full effects of the Klonopin in less than a week.

Physically, I just feel, well, normal! Mentally (with regard to social anxiety), I'm an 85-90% new man, at least for now. And, my God, the cognition enhancement! The ideas just FLOW at work! I don't know if that's due to Selegeline's reputed cognition enhancement, or Klonopin's releasing my mind from its focus on anxiety. Whichever, I like it!

And look at this history with regard to sexual function:
Before meds: Fine (normal)
After 3 weeks of Nardil: Orgasm impossible
Today: Fireworks and skyrockets! It's
amazing! I've read that Klonopin can
have increased libido as a possible
side effect, but this goes way beyond
that. My profuse apologies for being
too explicit, but the sexual sensations
are physically overwhelming. It must be
the Selegeline (possibly potentiated by the K and/or V), which I read -- and my
pdoc confirmed -- can act as an

Regardless of everything I've discussed above, it's the Klonopin that is -- at least thus far -- my "near"-wonder drug. I can't believe I had to talk him into letting me try it (BTW, he is NOT anti-Benzo; he's just not a Klonopin fan!)

> I have been suffering from mild social phobia for the last 20 years. It usually manifests itself by sweating in certain social situations when I am the center of attention. I had learned to live with it(mostly through avoidance), but finally after a particularly bad/embarrassing episode, I decided to seek professional help. I was prescribed Paxil and took 10 mgs a day for a week then 20 mgs daily for a week. The sexual side effect of extrememly delayed ejaculation or even no orgasm was unacceptable, and my doctor said this type of side effect usually doesn't subside. I was then prescribed Celexa in hopes of alleviating the sexual side effect. This is my third day of 10 mgs of Celexa. I amm supposed to gradually increase the dosage. I was wondering if anyone out there has any experience with Celexa or any other ssri as part of a treatment plan for social phobia. Also, is anyone taking Celexa without experiencing similar side effects ?




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