Posted by Rocket Jackson on November 6, 2002, at 23:39:57
In reply to Re: social phobia » Rocket Jackson, posted by Kari on November 3, 2002, at 10:20:14
> Hi Rocket,
> Thanks for your response.
> You say Welbutrin made you anxious. Have you ever tried an SSRI? If your problem is mainly anxiety, perhaps that would work better for you than a dopamine agonist. Were you prescribed Provigil for SP?
> I suffer from SP as well as depression, OCD and ADD. I am also either schizoid or schizotypal and don't know how much of the SP can be explained by the personality disorder.
> So far I haven't come across anything really effective for social phobia. Nardil helped for several days but then made it worse. A combination of an SSRI and Klonopin helped some but the Klonopin had to be stopped since it worsened my depression. Perhaps taking an SSRI with an anti-psychotic would work but it seems to be too risky (not only depression but also an increased risk for TD). Provigil sounds interesting but taking it would probably necessitate adding a DA blocker as well.
> I'm glad you had a positive experience with the combo and hope it keeps up.
> Take care,
> Kari.
>Hi Kari,
Thanks for the post. No, I haven't actually tried an SSRI, and probably most likely never will. I just really have a problem with the side effects so many people seem to be experiencing, namely the sexual problems and weight gain. So I guess I'm going for the sort of "circuitous" route in finding an effective med(s) other than an SSRI.
My decision to try Provigil for SP was based on some anecdotal evidence from this forum a while back (chad I think?). He suggested a reasonable synergism between it and Klonopin that really made sense, so I thought I'd give it a try. And luckily I have a doc whose willing to try different meds out with me no matter what their "official" FDA indications.
Your situation certainly seems to provide quite a dilemma in terms of treatment options. Though I'm definitely not a psychiatrist, it does sort of seem like your SP might be a manifestation of one of the personality disorders. The reps of the newer antipsychotics such as Geodon (ziprasidone) claim that they have lower incidences of some of the nasty side effects like TD, but who knows. But the problem there is in addition to DA blockade, it also antagonizes serotonin, which would obviously adversely affect your OCD, depression, and possibly SP. I would be very interested to hear what a doc might say in regards to a combo of one of the newer antipsychotics and an SSRI. Perhaps I'll run that by one of my attendings when I rotate through inpatient psych in December.
Thanks again for your post. I truly hope you'll be able to find a good regimen to help alleviate your problem. Keep us all posted!
Rocket
poster:Rocket Jackson
thread:126124
URL: http://www.dr-bob.org/babble/20021101/msgs/126758.html