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To: Adam

Posted by JohnB on November 18, 1999, at 23:11:04

In reply to Re: My newly prescribed "social phobia" meds - fyi, posted by Adam on November 18, 1999, at 17:43:45


I think you have much of the theory down cold - activate presynaptic and postsynaptic 5HT1A (by the 5HT1A agonist Buspirone)in the presence of the presynaptic 5HT1A antagonist Pindolol. Result is a rapid and posibly potentiated effect of Buspirone, as well as augmentation of the anxyiolytic effect of Clonazepam. As both Pindolol and Buspirone do not affect 5HT2 (at least not to any significant degree), there's really no 5HT2 antagonism to guard against. Sertraline could certainly be augmentation therapy for my social phobia, possibly potentiated or at leasted hastened in its effect by Pindolol, by I'd like to stay away from its weight gain side effects. Further, I'm fairly sensitive to sexual dysfunction caused by changes in 5HT2. However, higher dose Buspar (45-90 mg/day), which frequently causes nausea, may be mitigated by low dose mirtazapine, which has a small 5HT3 component, or the very expensive ondansetron 5HT3 antagonist.

I was primarily thinking of selegiline, 5 mg tid dosing, to further address Clonazepam congitive side effects, as well as to enhance sexual arousal, stimulation, and time to orgasm. I'm still only partially recovered from Marplan induced anorgasmia.






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