Posted by kate9999 on April 20, 2001, at 3:18:37
In reply to Social Phobia - Jimmy's Algorithm, posted by jimmygold70 on April 19, 2001, at 9:13:30
I don't know if I'd wait so long to try Nardil - particularly if you're talking severe generalized sp, (or especially with atypical depression).
Also if Nardil side effects are too much, maybe switch first to Parnate - my experience was though I had side effects with both, they were very different side effects, so it would be worth the switch - since I think the RIMAs are maybe less effective.
> My algorithm - GAD+SP
>
> 1. SSRI (Celexa is my favorite) for 2 months
> 2. Doesn't work - raise the dose to the MAX
> 3. Didn't work as well, wait for a month
> 4. Partial response - Add buspirone up to 60mg/day
> 5. Insufficient response: Swith to Effexor
> 6. Partial response - raise dose to the MAX
> 7. Insufficient response - Switch to Klonopin
> 8. Insufficient response to Klonopin - switch to Nardil, up 90mg/day
> 9. Too many side effects on Nardil (though full response) - Swith to Manerix / Aurorix
> 10. Too many side effects Klonopin (though full response) - Swith to Nerontin
> 11. No or little response to the above - RECONSIDER DIAGNOSIS OF SOCIAL PHOBIA
>
> Note that there is no perfect treatment for Social Phobia. The more severe condition you are in, the more response you're gonna get. 30% reduction in symptoms is fair.
>
> Also, many other conditions occur with or mimic Social Phobia: Avoidant/Schizoid PD, Borderline PD (!), PTSD to name a few.
> My 2 cents.
>
> Jimmy
poster:kate9999
thread:60399
URL: http://www.dr-bob.org/babble/20010417/msgs/60545.html