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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by jacquie on April 14, 2001, at 21:08:01
I previously posted regarding the Zoloft which I
struggled to take and ended up not taking. I like
Wellbutrin 150mg daily, due to increase by another
100 next week. I take it at 5:30 am right now and still
get early morning awakening at around 4:30. That's okay.
Assuming it doesn't get worse when I increase dose by
100mg and end up arising at 2am. Doc has suggested Paxil
versus upping Wellbutrin (tried Paxil, tried Celexa
tried Zoloft...all past tense) Is there anyhting other
than an SSRI that can be used with Wellburin to lessen
my social anxiety and general anxiety during the daytime?
I take Klonopin at night for sleep, prefer to leave that
for the p.m., SSRIs are not doing for me. He does not
like Serzone ...hisleast favorite. And I figured I
needed to do a little more research before I approach
the subject on the return call. There must be something
that eases the social aspect and the struggle I have
to make decisions. This is where the anxiety really sets
in. Those 2 areas. Any advice is graciously appreciated
and accepted. I also feel like the 150 mg Wellbutrin has
been losing its effectiveness. I have been on it for
2 weeks now. Just doesn't seem to have the kick it used
to have. Does this render me with a different diagnosis?Thank you,
Jacquie
Posted by vlvtelvis on April 15, 2001, at 1:24:03
In reply to Wellbutrin ????? for daytime anxiety/social also, posted by jacquie on April 14, 2001, at 21:08:01
Aside from benzodiazapines and booze, Paxil and Celexa have been the only meds to touch my SP.
It's my understanding that the irreversable MAO-I's are qutie effective for SP, but you can't take anything else with them. Unfortunatly, Mannerix hasn't been shown to be effective for SP. The individuals on a SP forum i was on a while back seemed to be having the most luck with Parnate and Nardil. I personaly treasure cheese more than I do most people, so giving it up in order to be comfortable around people wouldn't be worth it for me. Behold the power of cheese.
If blushing and shaking is a problem, beta-blockers can help. The only one I tried (tenormin, i think) gave me wierd mood swings.
I seem to remember Wellbutrin loosing its "kick" somewhat right as it really started to become effective, ironicly enough. It also became easier to sleep on.
As far as SSRI's go, they didn't really let me fuction in society without wanting to go hide until I hit pretty large doses. I was at 40mgs of Paxil with good results for a couple of years. I'm now on 30mgs of Celexa and doing ok with it as well.
SSRI's are probobly your best shot. How high did you go on doses before?
You might wanna check out alt.support.social-phobia on usenet. It was a fairly decent forum when I was there a couple of years ago, and I managed to learn quite a bit.
Good luck.
> I previously posted regarding the Zoloft which I
> struggled to take and ended up not taking. I like
> Wellbutrin 150mg daily, due to increase by another
> 100 next week. I take it at 5:30 am right now and still
> get early morning awakening at around 4:30. That's okay.
> Assuming it doesn't get worse when I increase dose by
> 100mg and end up arising at 2am. Doc has suggested Paxil
> versus upping Wellbutrin (tried Paxil, tried Celexa
> tried Zoloft...all past tense) Is there anyhting other
> than an SSRI that can be used with Wellburin to lessen
> my social anxiety and general anxiety during the daytime?
> I take Klonopin at night for sleep, prefer to leave that
> for the p.m., SSRIs are not doing for me. He does not
> like Serzone ...hisleast favorite. And I figured I
> needed to do a little more research before I approach
> the subject on the return call. There must be something
> that eases the social aspect and the struggle I have
> to make decisions. This is where the anxiety really sets
> in. Those 2 areas. Any advice is graciously appreciated
> and accepted. I also feel like the 150 mg Wellbutrin has
> been losing its effectiveness. I have been on it for
> 2 weeks now. Just doesn't seem to have the kick it used
> to have. Does this render me with a different diagnosis?
>
> Thank you,
> Jacquie
Posted by SalArmy4me on April 15, 2001, at 4:36:33
In reply to Wellbutrin ????? for daytime anxiety/social also, posted by jacquie on April 14, 2001, at 21:08:01
I read somewhere in the Tips about gabapentin being used for Social Anxiety. That would be a marvelous solution if it works, because gabapentin has few side-effects and works on pain also. My bias: I take gabapentin to get rid of the anxiety caused by Visken.
Posted by jacquie on April 15, 2001, at 6:09:51
In reply to Re: Wellbutrin ????? for daytime anxiety/social a » jacquie, posted by vlvtelvis on April 15, 2001, at 1:24:03
Thanks for responding. Well, Paxil was too sedating,
Zoloft was a kick in the gut (even on a mere 12.5mg)
and Celexa probably would have been so-so if I had stayed
on a low dose. It was the only one I took for
three months up to 40mg, but I had micro awakenings,
then bruising, and that flat, remove the alpha waves
type feeling, jaw clenching, neck pain, tremor, But it did help with the social
part. I have all the social anxiety problems physical
to the others. Fear, ect. Avoid shopping centers
if there are too many people in parking lot...the
list is infinite. The MAO stuff scares the daylights
out of me because of all the restrictions, like you
I like cheese far too much and with my anxiety issues
probably like it more than people as well! Being hyper
sensitive to drugs is making this a rough choice.
Wellbutrin is a SDRI, what is a SNRI and would that
help do you think??"Booze and Benzos"....has a catchy little ring to
it don't you think?....Thanks mucho,
jacquie
Posted by SalArmy4me on April 15, 2001, at 7:44:30
In reply to Re: Wellbutrin ????? for daytime anxiety/social a » vlvtelvis, posted by jacquie on April 15, 2001, at 6:09:51
--I took Tranylcypromine for three months last year.
Dangerous?
Yes, there is a chance of a hypertensive crisis in which blood pressure increases so rapidly that a huge headache occurs. The chance of a hypertensive crisis from eating foods with tyramine is 6% from the last study done on it; modified to only 3% with the application of a special diet. These are pretty low percentages. But even if such a hypertensive crisis occurs, a simple dose of oral nifedipine will stop it immediately... The truth is that most hypertensive crises are mild, if they even occur.
Actually, there is more of a chance of _low_ blood pressure (orthostatic) with MAOIs than with the opposite. This may sound like a terrible illness, but it is merely annoying and does not cause any damage to the body. It may make you dizzy when you go from lying down to standing upright. It is easily remedied with a high sodium diet.
http://www.dr-bob.org/tips/split/Orthostatic-hypotension-on.html
If a first or second-line antidepressant fails for you, you should consider an MAOI (Phenelzine, Tranylcypromine, or the now available isocarboxazid. MAOIs are the only medications that work onA disadvantage of MAOIs is that they can have severe interactions with other medications. Sometimes a Serotonin Syndrome or Neuroleptic Malignant Syndrome occurs. But to avoid such reactions, all you have to do is remember to ask your doctor before taking any medication with an MAOI. Or, you can use Dr. Koop's Drug Checker at www.drkoop.com.
MAOIs are perfectly safe, that is why they are still used after 40 years of existence. They just require that you get used to the idea of taking them and not erroneously think that they will kill you. Point in case: Nobody ever sees an article about someone dying from an MAOI in the paper.
Other stuff: http://www.dr-bob.org/tips/split/Orthostatic-hypotension-on.html
http://www.dr-bob.org/tips/split/MAOI-diet-update.htmlBlood & Fire: The Salvation Army USA West
Posted by jacquie on April 15, 2001, at 8:28:08
In reply to I think you should consider MAOIs, they're safe » jacquie, posted by SalArmy4me on April 15, 2001, at 7:44:30
Hey there,
Thank you so much for all your info! That's alot!
Loving research, I am certain it will satisfy
that ache. Yes, I do fear MAOI (not sure of order)
Just because of all the precautionary stuff.
I don't real cheese anymore (predominantly vegetarian
who wants to cut fat out of diet. And cheese is
deadly, for me anyway). I am going to look into
the sites you suggested and then painstakingly
write a letter to my psychiatrist. He is pushing
on the SSRIs and it dawned on me that this family
of drugs is very much like my own family, headache,
nausea, tremors,insomnia, upset stomach...I'll
exclude sexual dysfunction...but had I stuck around
long enough it probably would have affected that too!
If I put it in terms of humor I can tolerate
things better, even if it is dark humor...anger
sideways they call it. Anyway, I thought about
Xanax, who wouldn't...but I already take klonopin at
night, so taking xanax during the day to alleviate
anxiety and social anxiety probably wouldn't be
the best alternative.Thank you for everything-
Best,
Jacquie
--I took Tranylcypromine for three months last year.
>
> Dangerous?
>
> Yes, there is a chance of a hypertensive crisis in which blood pressure increases so rapidly that a huge headache occurs. The chance of a hypertensive crisis from eating foods with tyramine is 6% from the last study done on it; modified to only 3% with the application of a special diet. These are pretty low percentages. But even if such a hypertensive crisis occurs, a simple dose of oral nifedipine will stop it immediately... The truth is that most hypertensive crises are mild, if they even occur.
>
> Actually, there is more of a chance of _low_ blood pressure (orthostatic) with MAOIs than with the opposite. This may sound like a terrible illness, but it is merely annoying and does not cause any damage to the body. It may make you dizzy when you go from lying down to standing upright. It is easily remedied with a high sodium diet.
> http://www.dr-bob.org/tips/split/Orthostatic-hypotension-on.html
> If a first or second-line antidepressant fails for you, you should consider an MAOI (Phenelzine, Tranylcypromine, or the now available isocarboxazid. MAOIs are the only medications that work on
>
> A disadvantage of MAOIs is that they can have severe interactions with other medications. Sometimes a Serotonin Syndrome or Neuroleptic Malignant Syndrome occurs. But to avoid such reactions, all you have to do is remember to ask your doctor before taking any medication with an MAOI. Or, you can use Dr. Koop's Drug Checker at www.drkoop.com.
>
> MAOIs are perfectly safe, that is why they are still used after 40 years of existence. They just require that you get used to the idea of taking them and not erroneously think that they will kill you. Point in case: Nobody ever sees an article about someone dying from an MAOI in the paper.
>
> Other stuff: http://www.dr-bob.org/tips/split/Orthostatic-hypotension-on.html
> http://www.dr-bob.org/tips/split/MAOI-diet-update.html
>
> Blood & Fire: The Salvation Army USA West
>
This is the end of the thread.
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Dr. Bob is Robert Hsiung, MD,
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