Posted by SLS on January 21, 2016, at 6:54:47
In reply to Re: SSRI even worth the try for severe social anxiety?, posted by john locke on January 20, 2016, at 22:18:54
> > > Thanks. Doesn't Paxil almost guarantee anorgasma to some extent, though? I couldn't live with that if it were bad enough.
> >
> > Paxil is generally the worst SSRI when it comes to producing weight-gain and sexual side effects. I'm not sure how often anorgasmia occurs.
> >
> > Anorgasmia is a common complaint with higher dosages of Nardil. However, for those who stick with it, the ability to orgasm often returns after 3 months or so.
> >
> > Most people forget that Nardil had been used for OCD prior to the availability of Anafranil and Luvox. You need to be patient when treating OCD. You might find that the depressive symptoms resolve before the obsessive ones do.
> >
> > Do you experience intrusive thoughts?
> >
> >
> > - Scott
> >
> >
> Thank you Scott. If intrusive thoughts means that the same thoughts/worries come into my head over and over again, then yes. For example, I have spent much of the last few weeks feeling crippled and helpless by the worry that I had set myself up for "drug-induced drug-refractoriness" with Nardil as you had explained to me is a phenomenon with psychiatric drugs that is not uncommon at all. This is because I did a short, 3.5 week Nardil trial (which ended about 3 weeks ago) before getting scared and backing out. I know its a largely irrational worry, especially since, if I do try Nardil again, it wont be until September 2016, but the thought that there is a chance that I have screwed myself over is still there, and it just won't leave.
>
> Its weird. If i catch myself having not worried about this for a little while (due to the fact that I am worried about other things that don't scare me quite as much), I'll be both pleased with myself for not thinking about it, but also kind of mad at myself for having let my guard down. I really can't get out of my head.I don't think those qualify for intrusive thoughts. They are not alien to you. They are more like ruminations or obsessiveness.
Are you a perfectionist?
Perfectionism is a no-no for depression and obsessiveness. Perfectionism is mostly learned. It can be unlearned. I was successful at doing this. I guess it is a desensitizing process of sorts.
I would not worry about refractoriness to Nardil. You were not on it long enough.
If you wish to keep Nardil for later, you can first try Paxil or Effexor. Although not indicated for OCD, several clinical studies of Effexor reported positive results. You might consider going for Effexor first, Paxil second, and then to Nardil if necessary. Effexor is more often effective for depression than is Paxil. Paxil is generally more apt to produce weight-gain and sexual side effects, although these do not occur with everyone. I don't remember experiencing these things when I took Paxil 30 mg/day. I would say that Paxil is more of a sure-thing for anxiety disorders when compared to Effexor. OCD usually responds to higher dosages taken for longer periods of time.
These are my impressions only:
1. Effexor
++++ depression
+++ GAD
++ social anxiety
++ OCD
+ weight-gain
+ sexual side-effects2. Paxil
+++ depression
++++ GAD
+++ social anxiety
+++ OCD
++++ weight-gain
+++ sexual side-effects3. Nardil
++++ depression
+++ GAD
++++ social anxiety
++ OCD
+++ weight-gain
+++ sexual side-effects (sometimes transient)
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1085601
URL: http://www.dr-bob.org/babble/20151225/msgs/1085626.html