Posted by Else on July 22, 2001, at 16:03:21
In reply to Re: Dopamine function in Social Phobia » Else, posted by Mitch on July 22, 2001, at 12:54:14
I don't see myself as unsociable really. In fact, most of the time I HATE being alone and I don't need a drug to make me enjoy other people's company. The main problem, as I see it, is inhibition (at least in my case). I am chronically inhibited and this goes for decision-making and social behavior. It takes me forever to make up my mind about the most unsignficant things because I worry so much (I also have GAD). When applied to social behavior, this inhibition translates into social phobia (for example; trying to figure out the EXACT right thing to say and then worrying that it was a bad idea afterwards). It's like, when you're manic (I've been hypomanic), decision making is a snap but when you're depressed deciding whether you want 1 or 2 creams in your coffee is difficult. It's the same thing for me except I don't really feel depressed. Or maybe I've been feeling this way for so long I don't interpret this as depression. But I picture some sort of decision-making aptitude continuum, where at one end you are paralysed by doubt and incapable of even getting out of bed (psychological akinisia, the link to Parkinson's is weak but interesting) and at the other, you do a lot of stupid things because every idea you get seems brilliant (as is the case in psychotic mania). Both stimulants and sedatives (including alcohol) have this dishinibitory effect which is what I need. I find the two drug types complete rather than antagonize each other.
The tranquilizers help with the anxiety caused by the stimulants and the stimulants help with the cognitive dullness produced by the tranquilizers. Of course, any anti-drug ayatollah will tell you that's the worst possible combination and leads to ADDICTION. I contend it's the best. There used to be this drug in the 60's called Dexamyl which was a Dexedrine/Amytal combo. Switch the Amytal to something less lethal like say Valium or Klonopin and were on to something. The pharmaceutical companies have known this a long time but they are such good corporate citizens (ahem), they would never produce another drug like this one. But a long-acting drug like this one is what a lot of people need. It has been shown that people with SP have lowered dopamine levels when compared to normals. Why not use anti-parkinsonnian drugs? I know some doctors already do. I hope word gets around.> I have SP and bipolar. From all my drug experiences and their effect on SP I would agree that meds that boost dopamine do help with SP, but they only seem to help "one-side" of the SP. That is, SP can or is a two-fold problem. You fear social situations (avoidance) and possibly you aren't *interested* in them either (no desire to *approach*). I have troubles with both of these (esp. when depressed).
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> The dopamine boost helps with interest-that is you WANT to do things and be around other people, but *activating* meds that boost DA like Adderall/Wellbutrin i.e., can make you MORE panicky (which can worsen *avoidance*). I found that low-dose Adderall combined with a low-dose atypical antipsychotic (in my case Risperdal and then Seroquel) worked rather well, but then you run the risk of tardive dyskinesia, and I got dystonia from Risperdal.
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> I wonder if a combination of Adderall (to increase approach) with Klonopin (to reduce avoidance) would be workable?? I have never been on those two simultaneously. Both are controlled substances-I am sure you would get a lot of raised eyebrows from pharmacists with that combo.
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> > I have been reading some vague observations about poor dopaminergic function in SP and a corelation between introversion and low dopamine levels but I can't find anything to really sink my teeth into. Would this mean stimulants would be helpful for SP (sorry if I'm a hundred years late on this, maybe I am).
poster:Else
thread:71110
URL: http://www.dr-bob.org/babble/20010720/msgs/71391.html