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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by DN on August 7, 2001, at 9:37:12
Alcohol helps my social anxiety, but not in the way you would think. After a night drinking my social anxiety is decreased significantly for the entire next day. I'm not still drunk. Why does alcohol affect my body in this way and what possible medication can mimic this affect. I've asked this question before with little response. If anyone has any ideas, please let me know. Thanks in advance for the response.
Posted by SalArmy4me on August 7, 2001, at 9:40:52
In reply to social anxiety/Cam or anyone, posted by DN on August 7, 2001, at 9:37:12
I am a fan of gabapentin for many disorders. Gabapentin might have the same effect without the high or danger resulting from alcohol:
Pande, Atul C. MD, FRCPC et al. Treatment of Social Phobia With Gabapentin: A Placebo-Controlled Study. J of Clin Psypharm. 19(4):341-348, Aug 99.
{NOT FROM MEDLINE}
"This study has shown that gabapentin produced a significantly greater decrease in the symptoms of social phobia than did placebo as measured by the LSAS. Treatment response seemed to be influenced by age and gender, an observation for which only speculative explanations can be offered. Because women exhibited greater responses to placebo, the drug-placebo treatment difference was smaller for women than for men. Despite the influence of these variables, gabapentin seems to have anxiolytic activity, which confirms the anxiolytic profile seen in preclinical behavioral experiments."
Posted by jason60 on August 7, 2001, at 10:15:39
In reply to Re: social anxiety/Cam or anyone » DN, posted by SalArmy4me on August 7, 2001, at 9:40:52
I have had the same type of effect from Alcohol with SP. I now take neurontin(Gabapentin) and xanex for social phobia (it works).
I have used Alcohol in the past for anxiety but this created many more problems then just SP.
I can't drink anymore.> I am a fan of gabapentin for many disorders. Gabapentin might have the same effect without the high or danger resulting from alcohol:
>
> Pande, Atul C. MD, FRCPC et al. Treatment of Social Phobia With Gabapentin: A Placebo-Controlled Study. J of Clin Psypharm. 19(4):341-348, Aug 99.
> {NOT FROM MEDLINE}
> "This study has shown that gabapentin produced a significantly greater decrease in the symptoms of social phobia than did placebo as measured by the LSAS. Treatment response seemed to be influenced by age and gender, an observation for which only speculative explanations can be offered. Because women exhibited greater responses to placebo, the drug-placebo treatment difference was smaller for women than for men. Despite the influence of these variables, gabapentin seems to have anxiolytic activity, which confirms the anxiolytic profile seen in preclinical behavioral experiments."
Posted by Cam W. on August 7, 2001, at 10:27:19
In reply to social anxiety/Cam or anyone, posted by DN on August 7, 2001, at 9:37:12
DN - Even though you are not drunk, you still have alcohol in your system over the next day, just under the level of where you notice it. The alcohol leaves your body slowly, so it could be the residual alcohol, acting as an agonist at the GABA-receptor complex that is giving you this effect.
When you stimulate the GABAergic neurons, you slow impulses in other neurotransmitter systems, and it is the slowing of electrical transmission in the dopamine neurons, more than in your serotonin neurons, that may be alleviating your social anxiety. Increased serotonin neurotransmission seems to help in social anxiety.
So, there are two ways to attack social anxiety. You could take a drug that increases serotonin neurotransmission, like the SSRIs (eg. Paxil and several others) and/or you could take a drug that increases GABA neurotrans mission like BuSpar or the benzodiazepines (eg. Xanax and several others).
The benzodiazepines work at the GABA-receptor complex, but at a different site than alcohol. Combining the two increases the electrical transmission in GABA neurons, and if increased too much, this can lead to death from respiratory depression (stop breathing).
I hope that this is of some help. - Cam
Posted by DN on August 7, 2001, at 10:48:28
In reply to Re: social anxiety/Cam or anyone » DN, posted by Cam W. on August 7, 2001, at 10:27:19
> DN - Even though you are not drunk, you still have alcohol in your system over the next day, just under the level of where you notice it. The alcohol leaves your body slowly, so it could be the residual alcohol, acting as an agonist at the GABA-receptor complex that is giving you this effect.
>
> When you stimulate the GABAergic neurons, you slow impulses in other neurotransmitter systems, and it is the slowing of electrical transmission in the dopamine neurons, more than in your serotonin neurons, that may be alleviating your social anxiety. Increased serotonin neurotransmission seems to help in social anxiety.
>
> So, there are two ways to attack social anxiety. You could take a drug that increases serotonin neurotransmission, like the SSRIs (eg. Paxil and several others) and/or you could take a drug that increases GABA neurotrans mission like BuSpar or the benzodiazepines (eg. Xanax and several others).
>
> The benzodiazepines work at the GABA-receptor complex, but at a different site than alcohol. Combining the two increases the electrical transmission in GABA neurons, and if increased too much, this can lead to death from respiratory depression (stop breathing).
>
> I hope that this is of some help. - CamThanks for all the response and yes it was helpful.
Posted by paxvox on August 7, 2001, at 11:31:08
In reply to Re: social anxiety/Cam or anyone, posted by DN on August 7, 2001, at 10:48:28
> > DN - Even though you are not drunk, you still have alcohol in your system over the next day, just under the level of where you notice it. The alcohol leaves your body slowly, so it could be the residual alcohol, acting as an agonist at the GABA-receptor complex that is giving you this effect.
> >
> > When you stimulate the GABAergic neurons, you slow impulses in other neurotransmitter systems, and it is the slowing of electrical transmission in the dopamine neurons, more than in your serotonin neurons, that may be alleviating your social anxiety. Increased serotonin neurotransmission seems to help in social anxiety.
> >
> > So, there are two ways to attack social anxiety. You could take a drug that increases serotonin neurotransmission, like the SSRIs (eg. Paxil and several others) and/or you could take a drug that increases GABA neurotrans mission like BuSpar or the benzodiazepines (eg. Xanax and several others).
> >
> > The benzodiazepines work at the GABA-receptor complex, but at a different site than alcohol. Combining the two increases the electrical transmission in GABA neurons, and if increased too much, this can lead to death from respiratory depression (stop breathing).
> >
> > I hope that this is of some help. - Cam
>
> Thanks for all the response and yes it was helpful.Having people like Cam W. and SalArmy4me available to not only give out advice, but back it up with scientific refernce, has been of great value to me (and obviously quite a few others). Thanks you'all! I am good at researching things on the net, but they can pop back a response in a nanosecond! I do, however, feel that if enough of us "regular" people share our personal experiences in as close to objective format as possible (considering we ARE talking about our subjective experiences) that this forum can be an excellent, excellent resource. I have only known about this site for a week or so, and I have already been enlightened. I hope that I can offer as much as I have gleaned!
Posted by Elizabeth on August 7, 2001, at 16:06:29
In reply to social anxiety/Cam or anyone, posted by DN on August 7, 2001, at 9:37:12
> Alcohol helps my social anxiety, but not in the way you would think. After a night drinking my social anxiety is decreased significantly for the entire next day. I'm not still drunk.
Sounds to me like you don't metabolise alcohol normally.
> Why does alcohol affect my body in this way and what possible medication can mimic this affect.
Benzodiazepines would be my choice; there's ample evidence supporting their efficacy in generalised social phobia. Klonopin and Tranxene are probably the most long-acting ones. Neurontin might be a good alternative, although it remains to be seen whether it's as effective as benzos are for SP.
-elizabeth
Posted by 16# on August 8, 2001, at 2:02:54
In reply to social anxiety/Cam or anyone, posted by DN on August 7, 2001, at 9:37:12
> Alcohol helps my social anxiety, but not in the way you would think. After a night drinking my social anxiety is decreased significantly for the entire next day. I'm not still drunk. Why does alcohol affect my body in this way and what possible medication can mimic this affect. I've asked this question before with little response. If anyone has any ideas, please let me know. Thanks in advance for the response.
I am 35 years old and since I was 14 I drank to relieve social anxiety. As I grew older, my anxiety grew worse. Frequently, I would drink alone to relieve the constant anxiety that I constantly felt. When I was diagnosed as BPII I thought that the greatest challenge for me would be to quit drinking (which is really essential if you have such a persistent mood disorder).
All of that has changed in the past three months since I have been on Neurontin. It relaxes me to the point that I don't even think about drinking. My anxiety level is way down overall. I have not noticed any untoward side effects. Not everyone is as fortunate as I have been with this drug. I probably should have been on an anxiolytic many moons ago but doctors look upon those as "party" drugs, it seems. And instead push the SSRIs, all of which I've tried, and none of which have had the efficacy of Neurontin w/o the side effects.
So I think that Neurontin might mimic the effect that you are trying to capture. Worth a try. Best of luck to you.
Michelle
Posted by DN on August 8, 2001, at 13:15:01
In reply to Re: social anxiety/Cam or anyone, posted by 16# on August 8, 2001, at 2:02:54
>Thanks for all the great response. This information has been very helpful.
Alcohol helps my social anxiety, but not in the way you would think. After a night drinking my social anxiety is decreased significantly for the entire next day. I'm not still drunk. Why does alcohol affect my body in this way and what possible medication can mimic this affect. I've asked this question before with little response. If anyone has any ideas, please let me know. Thanks in advance for the response.>
> I am 35 years old and since I was 14 I drank to relieve social anxiety. As I grew older, my anxiety grew worse. Frequently, I would drink alone to relieve the constant anxiety that I constantly felt. When I was diagnosed as BPII I thought that the greatest challenge for me would be to quit drinking (which is really essential if you have such a persistent mood disorder).
>
> All of that has changed in the past three months since I have been on Neurontin. It relaxes me to the point that I don't even think about drinking. My anxiety level is way down overall. I have not noticed any untoward side effects. Not everyone is as fortunate as I have been with this drug. I probably should have been on an anxiolytic many moons ago but doctors look upon those as "party" drugs, it seems. And instead push the SSRIs, all of which I've tried, and none of which have had the efficacy of Neurontin w/o the side effects.
>
> So I think that Neurontin might mimic the effect that you are trying to capture. Worth a try. Best of luck to you.
>
> Michelle
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