Posted by Rick on June 3, 2001, at 14:39:38
In reply to Re:SOC PHOBIA COCKTAIL--WOW!!: Survey..., posted by AMenz on June 3, 2001, at 13:30:48
Yes, I'm still on the same cocktail, but with somewhat more Serzone, and only 100 mg Provigil on most days. It's still extremely effective for my non-depressive Social Phobia. (Sure doesn't do anything for my non-SP-related obsessions and compulsions, though!) My only complaints are some dry mouth and some memory problems -- which personal experimentation seems to show is Serzone-driven despite Klonopin's reputation for amnesic effects.
> Thank you for the links and comments. I assume you are still on your initial cocktail. I am considering adding provigil. It does seem bening.
>
>
>
> > P.S.:
> >
> > In the last link ( http://alertpubs.com/august2000psych.htm ), scroll down to the second article, "Stimulant Augmentation in Depression").
> >
> > Rick
> >
> >
> > > AMenz -
> > >
> > > (Quick preview: Of the links I provide here, I think the last one is especially interesting.)
> > >
> > > No, you definitely didn't post more than I "wanted to hear"! Thanks for the detailed Zoloft info.
> > >
> > > You may have already done this search, but I found almost 40 posts in the Psycho-Babble archives that reference personality changes.(Click "search with options" at the bottom of this page and enter "personality changes" in quotes). These are mostly, but not entirely concerning med-induced changes.
> > >
> > > Also try the following Deja-Google link as well, being sure to click "view thread" at the end of each result so that you'll see all the posts:
> > >
> > > http://groups.google.com/groups?q=%22personality+changes%22&hl=en&lr=&safe=off&btnG=Google+Search&meta=site%3Dgroups%26group%3Dalt.support.depression.medication
> > >
> > >
> > > I think I can appreciate what your saying, re the personality change, although my perception of my own Social Phobia treatment is quite different. I see it more as allowing my "real" personality to come through, instead of letting a
> > > chemical imbalance in my brain dictate that I'm going to be too anxious and too pathologically self-conscious to be myself. With this burden mostly lifted, I can now act with others more like I act around the handful of people I've long been pretty comfortable with. Put another way, I'm more open, assertive, enthusiastic, and interested in OTHERS. Obviously, this is well received by people who I see regularly, and yes, once in awhile they may react with surprise. But I'm basically still a low-key guy, certainly no party animal. Funny, you and I were saying very much the same thing, but you seemed to view it in a negative light. Nothing about the change feels at all unnatural to me. Nicely surprising, but not unnatural or fake, either mentally or physically.
> > >
> > > But perhaps for your situation, factors such as depression (and bipolar depression in particular); your own life's experiences and behaviors; and/or ingrained feeling of "weakness" from using meds, lead you to perceive a reduction of deep-seated social phobia as "unnatural". (Sorry for the long, unwieldy sentence!) At the risk of sounding like a broken record (if anyone knows what those are anymore), I'm probably not all that qualified to comment on your situation.
> > >
> > > Most of what I posted re Provigil and bipolarity was from what I read on the net, both previously and after seeing your original post. Here's a link to post results from a Usenet search, mainly from alt.depression.medication and alt.depression.manic:
> > >
> > > http://groups.google.com/groups?q=Provigil+bipolar&hl=en&lr=&safe=off&site=groups
> > >
> > > Also, go to www.google.com, enter the terms Provigil and bipolar in the search box, and you'll find many relevant web pages that support the comments in my last post. Many of these are from "ask the doctor" sections of sites dedicated on bipolarity. I have no idea how credible they are, but again there was very little mention of possible problems with Provigil in bipolarity. There were many mentions of benefit plus quite a few mentioning lack of benefit.
> > >
> > > I find the page below especially interesting, because it provides more detail -- on a patient-by-patient basis, of the participants and meds regimens in the Provigil AD-augmentation study. It specifically cites the lack of cycling problems among the bipolar participants, although we ARE talking about only three individuals here.
> > >
> > > Rick
> > >
> > > Detail on study of Provigil-as-augmenting agent:
> > >
> > > http://alertpubs.com/august2000psych.htm#Stimulant Augmentation in Depression
> > >
> > >
> > >
> > >
> > >
> > >
> > > > Thankx for your response.
> > > >
> > > > First let me answer your quesetions re Zoloft.
> > > >
> > > > Zoloft was titrated up to 100mg (25, 50, 100). At each stage after a couple of weeks it had the desired effect of eliminating completely social anxiety (I don't know if concomitant use of 1mg of Lorezapam daily created a synergistic effect).
> > > >
> > > > After becoming accustomed to the level the social anxiety (milder though) returned and the level was upped the next notch. I assumed that upwards of 100 (don't know 150, 200, whatever the effect might be permanent.
> > > >
> > > > What it did was to take away all fear in social interactions, it became very easy to be nice and supportive to people, to listen to their conversation, to appreciate their jokes, etc. All the things that make people like you and in turn be willing to extend the same to you. (That has been my experience with people) I also became extraordinarily calm. Other people seemed to me overexited, prone to take offense, etc. What a trip!!!
> > > >
> > > > Calm seems to have a great effect on others. I became popular. That was a new experience for me believe me.
> > > >
> > > > Of course the issue with all these medication induced personality changes, is one of identity. Is this me, or am I taking former symptoms as my personality. Who is she, the lady or the tiger? Know what I mean.
> > > >
> > > > I find it interesting that other people on the board have not discussed ( or I have not seen) the issue of identity and medication.
> > > >
> > > > Maybe I've told you more than you wanted to hear.
> > > >
> > > > BTW did you plug provigil in a particular search engine and come up with monographs, or are there sites you can recommend.
> > > > > AMenz -
> > > > >
> > > > > I'm not really qualified to answer your questions. But after sifting through lots of posts on the neton the net, I've only seen one or two cases where someone was concerned about rapid cycling on Provigil, and even then it was conjecture.
> > > > >
> > > > > As with just about any med, some bipolar II users praised modafinil, and others found it ineffective or bothersome. Actually, Provigil seems to disagree with fewer bipolar users than unipolar.
> > > > >
> > > > > Medline shows no study abstracts associating modafinil with crapid cycling, even though I could see how one would wonder. To the contrary, in the small Medline-reported study where Provigil worked extremely well in quickly kick-starting AD's (and alleviating med-induced fatigue as a bonus), almost half of the responders were bipolar patients who had not repsonded prior to augmentation with provigil.
> > > > >
> > > > > Beyond the monographs, I can't find anything relating to movement disorders induced by modafinil, which is not to say it never happens. I'm personally very prone to these kinds of side effects, and haven't had a problem at 100 mg. most days and 200 mg about 25% of the time. Actually the 2% incidence of dyskenesias reported for Provigil is a lot lower than for many meds commonly used in bipolar depression and schizophrenia. I've never seen anyone report a problem. But again the disclaimer: these aren't areas where I feel particularly qualified to comment.
> > > > >
> > > > > BTW, regarding Zoloft treatment of your Social Phobia, how much did you take? How long did it take to start "working wonders"? What else were you taking at the same time? What, if any, were your your primary persistent side effects?
> > > > >
> > > > >
> > > > > Thanks,
> > > > > Rick
> > > > >
> > > > >
> > > > > > Rick I have social anxiety and BPII. Zoloft did wonders for social anxiety but created mixed mania which was unabearable.
> > > > > >
> > > > > > Two questions: does Provigil promote cycling?
> > > > > > Also looked in following site:http://www.nursespdr.com/members/database/ndrhtml/modafinil.html
> > > > > >
> > > > > > As a possible side effect of provigil they mention
> > > > > > oro-facial dyskenesia. This sounds dangerously close to tardive dyskenesia although I have not looked it up.
> > > > > >
> > > > > > Please your thoughts if any on above.
> > > > > >
> > > > > > AMenz
> > > > > >
> > > > > > > Lucy --
> > > > > > >
> > > > > > > Unfortunately, my areas of casual self-study, as well as my self-experience with meds has all been primarily in the area of anxiety. (Although, as you know, many AD's and other meds are useful across different classes of mental disorders.) And while I might call myself "highly informed", I would by no means call myself an "expert", even with respect to anxiety treatment. I personally know almost nothing about Borderline Personality Disorder, although I'm sure there are many Psycho-Babble posters who do.
> > > > > > >
> > > > > > > Klonopin is called Paxam in Australia. I would imagine that generic clonazepam is available to you as well, but this is one drug for which many people swear that the branded version is better -- or at least stronger. I can tell you that, even though I have the generalized form of social phobia, my most dramatic and prompt response to Klonopin was in alleviating what had developed into near-panic when giving presentations. And, as I alluded to before, this relief comes without any sedation, mind-dulling, or "buzz". (Those things may have occurred a bit initially, but quickly went away with daily dosing.)
> > > > > > >
> > > > > > > If your Social Phobia is very strongly tilted towards performance situations, have you tried beta blockers such as propranolol (one of the most common for this purpose) or the serotonin-friendly pindolol? Beta Blockers can be taken on an as-needed basis, and work by directly reducing physical performance-situation symptoms such as a racing heart. For me they weren't anywhere near as effective as daily Klonopin, although they do provide a very calming effect to some people.
> > > > > > > I had been taking pindolol every day with the Klonopin, and found it added a very nice dimension. However, I had to stop taking it, because once I successfully shed 60 pounds the beta blocker made my blood pressure too low. Also, they can cause some fatigue, especially when taken on an as-needed basis.
> > > > > > >
> > > > > > > Of course, you must talk to your doctor, and make sure any combo you take isn't likely to cause unsafe interactions. That said, I'm shocked at how many doctors (at least in this country) both fail to identify potentially dangerous interactions AND claim that some drugs shouldn't be combined when the combination can be perfectly safe and beneficial. I've successfully challenged doctors on such matters several times, armed with info from the net (official monographs,
> > > > > > > articles or Medline abstracts from respected medical journals, drug-interaction dictionaries, and posts from patients).
> > > > > > >
> > > > > > > Good luck to you, and let us know how things work out. If you don't get any further responses form this thread, why not try starting a new thread? There may be some people who never make it to this thread, but who are successfully
> > > > > > > dealing with a combo of challenges which are very similar to your own. In fact, I wish Dr. Bob allowed the subject headings to be longer (read: more detailed) to catch the eye of more readers who have the most relevant advice or experiences to share!!
> > > > > > >
> > > > > > > Say "Hi" to my Aussie uncle for me! Hint: He used to host a popular TV news-magazine there, although if you're young you might not remember it. Oh, and he has an American accent.
> > > > > > >
> > > > > > > Rick
> > > > > > >
> > > > > > > ------
> > > > > > > > Hi Rick
> > > > > > > > I hope you don't mind me posting a request for your knowledgeable feedback about my meds cocktail. I'm diagnosed with borderline personality disorder, i suffer from intermittent extreme rage, complete lack of motivation, depression, social phobia especially with public speaking which has held me back from achieving so much. I have had to quit Uni because of my phobia. I have been on Paxil 20mg and Imovane(zopiclone hydrochloride) to help me sleep 15mg. My psychiatrist has recently put me on depakote to regulate my moods and anger outbursts but I,m worried it worsens my depression which I think it is but it's hard to tell, it's only been 1 month. I'm on 400mg in the morning and 600mg at night. I feel I need to tackle the phobia and depression more than anything else in order to get ahead in life and I'm interested in the meds you mentioned. I am in Australia, do you know if they are available here? Could you please tell me what you think as I value your opinion after reading your other posts! By the way, I totally agree with your views on Paxil withdrawals- absolutely terrifying! and they told me it was non- addictive, yeah right.
> > > > > > > > Look forward to your reply
> > > > > > > > Take care
> > > > > > > > >
poster:Rick
thread:36883
URL: http://www.dr-bob.org/babble/20010530/msgs/65260.html