Posted by Chairman_MAO on November 25, 2005, at 13:14:40 [reposted on November 25, 2005, at 23:27:56 | original URL]
In reply to Self Isolation, posted by daniel v on November 25, 2005, at 10:20:24
I can empathize with you, and hate to hear of people feeling this way. First off, you must somehow enter into therapy with someone who is competent to effectively treat such a problem completely, IMHO. I know this can be hard if you want to isolate, but the caring vibes alone can sometimes help such problems.
That said, it seems drug therapy is often essential for many people (such as myself). The best combination for social anxiety (which I imagine would work for panic just as well) is MAOI opioid. I recommend trying 1mg/kg phenelzine (Nardil) for 6-8 weeks; you most likely will have a dramatically positive response. Stick with it; the side effects take months to go away, but most usually do. Any other ones CAN be dealt with using additional medication. Do NOT abandon Nardil for any reason until you have waited at LEAST 3-4 months for side effects to abate. Do not consider the sexual dysfunction intractable until you have tried testosterone as an antidote. In my case, Nardil is the ONLY drug out of all of them (including other MAOIs) that provides complete relief. I don't really have much of a life without it, so being testosterone-dependent and having to take a sleep aid for the rest of my life in addition to Nardil is really nothing compared to what life is like without it. If I want to have children, I may have to dump the testosterone, though, and that worries me.
Buprenorphine is, IMHO, the best opioid to use for psych purposes (cannot overdose on it, limited abuse potential, kappa antagonist, long half-life, etc). Opioids are anxiolytic, anti-panic, and help tremendously with phobias. If you truly cannot tolerate Nardil, isocarboxazid (50-80mg/day) or tranylcypromine (1.5-2mg/kg often works better than the more common 0.7mg/kg for anxiety/phobias) could work.
Best of luck,
--cm
poster:Chairman_MAO
thread:582263
URL: http://www.dr-bob.org/babble/social/20051120/msgs/582266.html