Posted by Rick on September 21, 2002, at 19:49:21
In reply to Re: Paxil - Remeron - Clonazepam Social Anxiety, posted by chad_3 on September 21, 2002, at 4:56:51
> Just wanted to say "Hi". : )
> I agree with you on Klonopin being the single most effective anti-SP med purely working on SP.
> My stance does differ a bit from you though on the idea that most people will do well on 1-1.5 mg/day taken alone. I think comorbidity in SP is the rule not the exception esepcially dysthymia, mild or mildly recurring depression, low energy, and apparently not uncommon is ADD, panic, depression. Usually I think is something in there limiting Klonopin alone.
I agree that most people with SP have some comorbidity, although the amount who don't is far from insignificant. Also, to the extent the comorbidity is another anxiety disorder (except OCD), Klonopin montherapy could be quite effective. E.g., the manufacturer's monograph recommends a Klonopin dose of just 1 mg/day for most people with panic disorder, citing studies that failed to find additional benefit from doses higher than 1 mg.
> And in your case - I think you are simply a fantastic responder in low dose monotherapy to Klonopin - but are the exception not the norm.
Can't agree with you here, at least as far as those with "pure" SP go. There are plenty of people who do extremely well on 1 mg/day. The Davidson vs.-placebo Klonopin monotherapy SP study showed a mean ending dose of 2.4, with doses ranging from .5 mg/day to 3. And that's with a 78% response rate. Also see the below link from an earlier Davidson study that showed that Klonopin SP patients generally lowered their dose as time passed, to an average of about 1 mg/day -- exactly what I'm taking.
> That aside - I agree so much with you on most of your posts that I simply don't contribute. Keep healthy.
Thanks. I agree with most of what you post, too, and always find it insightful, thought-provoking and useful.
> And Rick - I understand your career has gone better and better in past years - are you also married I thought you said that once ...
I'm in a long-term relationship. Without this support and a few key lucky breaks in life, it is more likely my SP would have led to comorbidity (I *do* suffer from some compulsive tendencies, although it doesn't meet a clinical diagnosis.)
> Those are impressive stats for significant generalized SP - and you are a success story. And I do back you 100% on the safety and efficacy of Klonopin - with a few differences and a special regard for Nardil for many who I feel have more symptoms than are treatable by Klonopin alone.
I hope I've made it clear that I know Nardil can be a lifesaver for many Social Phobics with comorbities -- AND, many without. But I still personally feel that there's no need for an AD in someone who's not depressed or dysthmic, and that physically, benzos are about the safest psychotropics out there.
> Stay well - stay healthy! I'm going to Vegas!!!
I love Vegas! Enjoy, and win big!