Posted by zeugma on January 16, 2003, at 20:20:17
In reply to Re: I want to talk talk talk talk talk talk » utopizen, posted by Jumpy on January 16, 2003, at 14:13:30
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> > It's important to remember that social anxiety is somewhere between the panic end of the spectrum and the calm end of the spectrum, so what sometimes works for GAD in some, like trycillics or Buspar, don't have a chance at social anxiety.
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> But the diagnosis of Social Phobia and GAD often get mixed up with one another .... one may have GAD but get diagnosed with SP or vice versa. I have seen patients with dx of sp respond to TCAs.Yes, Jumpy, that's a good point. I have been dx with GAD, but it has been manifesting itself lately as Social Phobia. I didn't have panic attacks, but I was afraid to see people who live in my building, so I would take garbage out in the middle of the night, use the stairs instead of the elevator, etc. My pdoc let me use the sample of Buspar he'd given me over the summer, when apparently his enthusiasm for it was a lot higher than it has been lately. Basically, I said I had the samples and they were gonna expire next month so I intended to use them if he didn't absolutely contraindicate it (I also take nortriptyline, an extremely low dose because I'm very sensitive to medications.) Well, within a day I was feeling better. Now, my dx is pretty complex: severe inattentive ADD, GAD, major depression; and only the nortriptyline had helped even a little.
It's my understanding though that TCA's are often more effective in severe melancholic depression. That is if you're sleepless and have poor appetite. I think it has a lot to do with body type too- I'm very skinny and can't gain weight to save my life. I was on a stimulant a number of years ago to treat my ADD, and lost 10 pounds and was ordered to go off it immediately. So, Tepiaca, the right medication can have to do with a lot more than just a generic 'dx.' There are factors like body type and and whether you can sleep at night to take into account. If I wasn't on a TCA, I would need a third medication just to get to sleep before 4 a.m.
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poster:zeugma
thread:136057
URL: http://www.dr-bob.org/babble/20030113/msgs/136173.html