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Re: Marplan survey

Posted by JohnB on December 2, 1999, at 23:07:08

In reply to Marplan survey, posted by Elizabeth on December 2, 1999, at 20:51:27

Hi, Elizabeth. I've been on Marplan for about a month, but have only recently moved up from 40 mg/day to 80 mg/day, as I, too, was not experiencing any therapeutic effect at 40 mg. It's still too early to tell if 80 mg/day is going to work. I'll let you know in a few weeks. I guess there's always the potential of augmenting with pindolol or something else.

On a side note, I'm tired of trying new meds. I really haven't found anything other than Nardil and Klonopin to be effective, yet Nardil's side effects were terrible . . . . . and yet, it worked so well. Argh!!! Also, my psychodoc and I have been experimenting with too many meds recently - gabapentin, buspirone, celexa, remeron, bupropion/parnate combination, Klonopin/Pindolol/Buspar combination, ad nauseum. I feel like a laboratory guinea pig.

By the way, I haven't tried Serzone (generic name Nefazodone), though some people have indicated that it is effective. The recent research on Medline, particular a study by Van Ameringen, et. al, seem to suggest that it's effective. The Van Ameringen study seems to have had the highest sample size of any research I've been able to find. The authors refer to a 69.6% rate for "moderate or marked improvement," but I'm not sure what this means. In most studies, the authors seem to reference only % marked improvement. I don't want "moderate improvement." Been there, done that, as the saying goes. I've copied and pasted the article's medline abstract, below.

In the meantime, I promise to post if I stay on Marplan long enough at 80 mg/day to see if it's effective. As you can see, I'm losing my patience in trying to find something therapeutic, yet without intolerable side effects. In fact, I'm thinking of having a serious discussion with my psychdoc about seeing what antidotes might be available for Nardil induced weight gain and sexual dysfunction. Perhaps amantadine or bromocriptine . . . . . . . . . Better get back in my laboratory cage.

See you. JohnB :)

Nefazodone in social phobia.

Van Ameringen M, Mancini C, Oakman JM
Anxiety Disorders Programme, Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada.

BACKGROUND: A variety of drug treatments have been shown to be effective in the treatment of social phobia. This study attempted to assess the efficacy of nefazodone, a new novel serotonergic drug, in the treatment of social phobia. METHOD: Nefazodone was administered to 23 patients who had a primary DSM-IV diagnosis of social phobia, generalized type (diagnosed by the Structured Clinical Interview for DSM-IV), in a 12-week open clinical trial. Treatment began at 100 mg of nefazodone daily and was increased according to clinical response and side effects. Patients completed self-report measures at baseline and at weeks 4, 8, and 12. These measures included the Fear of Negative Evaluation scale, the Social Avoidance and Distress scale, the Social Anxiety Thoughts Questionnaire, the Fear Questionnaire, the State-Trait Anxiety Inventory, the Beck Depression Inventory, the Social Adjustment Scale Self-Report, and the Sheehan Disability Scale. Clinicians completed the Liebowitz Panic and Social Phobic Disorders rating form and the Brief Social Phobia Scale. RESULTS: Twenty-one of the 23 patients completed the 12-week trial. Sixteen (69.6%) were considered responders (moderate or marked improvement), and 7 (30.4%) were considered to be nonresponders (minimal improvement or no change in symptoms). Measures of social anxiety, social phobic avoidance, depression, and social functioning showed a statistically significant change at endpoint. CONCLUSION: These findings support a role for nefazodone in the treatment of social phobia, generalized type. Controlled studies will be required to further investigate this preliminary finding as well as to compare nefazodone with other pharmacologic treatments of social phobia.

Publication Types:

Clinical trial
PMID: 10084635, UI: 99182126




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