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Social anxiety and Marplan effectiveness

Posted by Jon21 on September 25, 2003, at 14:18:54

In reply to My social anxiety, posted by jb on November 29, 1999, at 12:29:00

Hi,I have had social anxiety and depressive episodes since I was 14 and am still looking for a tolerable and effective treatment regimen.

Clonazepam (Klonopin, Rivotril)has been by far the most effective drug for SA - I felt an almost 100% remisson in the early days (I've been taking approx. 4mg daily for 18 months).

I returned to college last month after a year out and found my concentration was too poor to cope with the demands of intensive study. I reluctantly decided that a reduction in clonazepam was necessary. I'm now down to 2mg after 1 month tapering (a little too fast I know, but I need my concentration back ASAP).
[BTW clonazepam isn't licenced for anxiety here in the UK, but somehow I managed to convince a locum doctor to prescribe it and other doctors have repeated my prescription ever since!]

I've taken the benzo's:

Lorazepam - very good, but not disinhibiting like clonazepam; diazepam - not good, just made me very drowsy; and alprazolam (Xanax) - which seemed to have no effect on me at all!

Also, I've been on:

ALL the SSRI's - I'm extremely sensitive to them, I could only tolerate citalopram, which kept depression at bay, but did not help with social anxiety.

Effexor - terrible time getting on it, and withdrawal worse than benzo's; Mirtazapine, Trazodone and Dothiepin (a TCA). Most recently I tried moclobemide (a RIMA), which gave me an energy boost during the first two weeks then faded away, I was taking 600mg. No Side effects (except aggravated insomnia initially), but it seems, no effect either :-(

After a washout of two weeks I was ready to try tranylcypromine (Parnate), only to find when I handed the prescription in at the pharmacy Parnate is temporarily (or possibly permanently) unavailable for reasons unknown. Are any other Brits also having this problem? I read about a problem with the Nardil supply in the US recently, but not Parnate.

So I'm given the choice: Nardil or Marplan, or go back to moclobemide (*NOT* an option). From what I've read about Nardil, I want to stay well away from it for as long as possible.
Very little seems to have been written about Marplan, but from what I *CAN* find there's nothing bad, and some quite reassuring experiences regarding its tolerability and efficiency in SA.

Does anyone have any more info on these topics, thanks?




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