Posted by Ritch on February 20, 2003, at 13:47:48
In reply to Pdoc appt.-Maoi or Lexapro or Straterra, posted by Peter on February 20, 2003, at 3:26:05
> Hi all:
> Just saw my pdoc. Because the lamictal is failing to alleviate my social anxiety, avoidant behaviour, and apprehension, it looks like I might have to start up another trial of an antidepressant next week. Since I've tried practically every SSRI already, with only temporary benefits, we were discussing the possibility of my going on an MAOI like Nardil-which I know is the best for social phobia. But he thought it best for me to try either strattera or lexapro first, knowing my hypochondriacal tendencies (I'll be all paranoid about the possibility of a hypertensive crisis with an MAOI). I don't understand his reasoning for straterra, but he claims it's a great drug and the fact that it doesn't affect serotonin might be good for me and have less of a chance of inducing alcohol cravings and making me ultra-impulsive like the SSRI's did after using them a few months. But, straterra is marketed for ADD, although I know it's an NRI like Roboxetine (sp?), which was an effective AD when it was still on the market. The thing is, I'd really be taking the AD more for anxiety/social phobia than for depression; supposedly, the lamictal would help with my depression as my body gets used to the 100mg+ range.
> Question: If, as my pdoc has said before, TCA's are known to not be effective for social anxiety, how on earth could he claim that Straterra would be effective for it? He claimed out of the blue that they're realizing that SP has more to do with NE and DA than serotonin, and both TCA's (most of them) and strattera deal with NE, not serotonin. So how could he say on the one hand that TCA's don't work for SP, while also saying that straterra does? I don't understand that.
> Also, as far as SSRI's go, any good experiences with Lexapro alleviating social anxiety? As well or better than Zoloft per chance? And how is it better than celexa? Does the isomer change really limit the drug's side-effects?
He may be tinkering with the idea of getting you off Adderall onto Straterra for your ADHD, and then see if the switch gets your anxiety down (and keeps your cravings under control). If that works (or partially works) he might then consider adding the Nardil since it would probably be much safer to try adding Nardil to an NE reuptake inhibitor like Straterra than it would be to risk adding it to a moderately high dose of a stimulant.