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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 k23d on July 10, 2002, at 20:03:42
Hi Folks,
I've read extensively through the archives but still need further convincing I'm doing the right thing so please bear with me for one more go around this discussion.
I'm a socially anxious individual in my late 20's who's been living with the problem since my teens but only come to realise what it was about 2 years ago.
Since then I've tried everything from NLP, Hypnosis, meditation, lot's of excercise and some yoga (both of which help), Cog Behavioural therapy and finally about 3 months ago got on the paroxetine (20mg daily in the morning).
My issues could be described as a generalised social anxiety with some specific performance phobias that accelerate me to panic. As far as I am aware or have been diagnosed I have no other comorbid conditions other than a generalised anxiety but it's kind of just driven by my social anxiety anyway.
I want off the paroxetine due to the side effects, mainly as follows:
Lethargy
Lack of motivation
Lack of concentration
Loss of libido
Loss of orgasm
Weight gain
Emotional dulling in non anxiety situations
Poor memory
Losing wordsThe paroxetine has helped in general social interaction but doesn't help in panic inducing situations. Propranolol 75mg has helped moderately but not fully.
Anyway my doc has suggested venlafaxine as the next treatment but I'm not keen mostly due to the side effects profile and possible withdrawal issues.
Thinking of this treatment plan:
Continued CBT
Start klonpin 1.5mg div to 3xdaily
Start provigil or dexadrine (unsure of dosage)
Maybe wean off paroxetine and start serzoneAnyone have any suggestions/words of support. I've bought the report from the Journal of Clinical Psychiatry (www.psychiatry.com) titled "Advanced and emerging treatments in social phobia" and read a few other research papers.
Is there any other resources people can suggest either to support my treatment plan above or to suggest a new one. Particularly with a focus on medical papers I can give my doc.Thanks for any support folks.
k23d
Posted by ross on July 10, 2002, at 21:06:09
In reply to Social Anxiety Meds Discussion, posted by k23d on July 10, 2002, at 20:03:42
have you tried the MAO Nardil? it is very effacious in treating social anxiety and phobia. i did not have much luck on it though. weird because all the studies point to Nardil as king for social phobia. i was up to 75mgs a day. i could tell you this if you take Nardil you will not have any anxiety. its the ultimate anxiety med. Serzone is just starting to be mentioned as possibly helping SP. perhaps due to its sedating effect. i have SP and am taking 80mgs of Celexa and 45mgs of remeron and it seems to help alot. also try the AP like Zyprexa. it is really hit or miss and with all the therapy and meds if you have a severe enough case there sometimes is no relief and that plainly sucks. dont try Provigil it is a waste. and if you start on stimulants you will become hooked and thats not worth it. Lexapro is due out second week of august and we will see if this is the 2nd coming of Prozac. there is mucho hype to this med relieving all types of anxiety disorders. best of luck
ross
Posted by k23d on July 10, 2002, at 22:07:40
In reply to Re: Social Anxiety Meds Discussion, posted by ross on July 10, 2002, at 21:06:09
Hi Ross,
Firstly, thanks for your quick reply. I haven't tried Nardil although I have heard it's effective. I am a bit concerned about the dietary restrictions and risks associated with this class of drug.
As far as getting "hooked" on a stimulant, I'm pretty sure there's strong withdrawal with all of the SSRI's, MAOI's and SNRI's but tapering seems to work for most people. Open to further advice or references in this area.
One of the things I don't want to become is slower cognitively as a by-product of my med. That's one of the things paroxetine has done to me. It's great to not feel as anxious generally but I can't be bothered doing anything and I'm more anxious in performance situations because I stress out about being slower.That's why I was considering benzo/stimulant combo and with an SSRI/SNRI thrown into the mix to work on my thinking patterns / serotinin reuptake. Really I don't know whether a stimulant is what I really need. Perhaps a dopamine reuptake inhibitor or a dopamine agonist would do the job of making me more outgoing and cognitively quicker.
Further discussion appreciated.
Thanks again,
Jacob> have you tried the MAO Nardil? it is very effacious in treating social anxiety and phobia. i did not have much luck on it though. weird because all the studies point to Nardil as king for social phobia. i was up to 75mgs a day. i could tell you this if you take Nardil you will not have any anxiety. its the ultimate anxiety med. Serzone is just starting to be mentioned as possibly helping SP. perhaps due to its sedating effect. i have SP and am taking 80mgs of Celexa and 45mgs of remeron and it seems to help alot. also try the AP like Zyprexa. it is really hit or miss and with all the therapy and meds if you have a severe enough case there sometimes is no relief and that plainly sucks. dont try Provigil it is a waste. and if you start on stimulants you will become hooked and thats not worth it. Lexapro is due out second week of august and we will see if this is the 2nd coming of Prozac. there is mucho hype to this med relieving all types of anxiety disorders. best of luck
> ross
Posted by Seamus2 on July 10, 2002, at 22:18:29
In reply to Social Anxiety Meds Discussion, posted by k23d on July 10, 2002, at 20:03:42
"specific performance phobias "
Sounds like a job for Inderal or another beta-blocker, COMBINED with some graduated desensitization exercises.
Posted by k23d on July 10, 2002, at 23:13:16
In reply to Re: Social Anxiety Meds Discussion, posted by Seamus2 on July 10, 2002, at 22:18:29
I take a beta blocker already called betaloc (propanolol). I take 75mg about 1 hour before performance situations. It helps but not as much as I'd like it to. Also, it does nothing for the anxiety related thoughts prior to or during the situation which muddle my thinking.
Jacob> "specific performance phobias "
>
> Sounds like a job for Inderal or another beta-blocker, COMBINED with some graduated desensitization exercises.
Posted by rainbowlight on July 11, 2002, at 2:22:34
In reply to Social Anxiety Meds Discussion, posted by k23d on July 10, 2002, at 20:03:42
I too have alot of social phobia problems and severe anxiety. The only one that has worked wonders for me is a small dose of Zoloft. It really takes the edge off and it has worked much better for me than Paxil. Paxil made me very lethargic and unmotivated. Seroquel or Risperdal help alot of people with anxiety also.
Posted by Kari on July 11, 2002, at 12:50:43
In reply to Social Anxiety Meds Discussion, posted by k23d on July 10, 2002, at 20:03:42
Klonopin along with an SSRI had an effect on my social phobia for a period of time. I had to stop the klonopin due to worsening of depression and panic attacks and a second attempt several years later (klonopin only) no longer had this effect on the social anxiety. I guess a combination of meds is sometimes needed.
Posted by fairnymph on July 11, 2002, at 19:23:23
In reply to Re: Social Anxiety Meds Discussion, posted by Kari on July 11, 2002, at 12:50:43
I doubt you will be able to get a doctor to prescribe a stimulant/benzo combo...esp considering the abuse potential for both drugs.
Also, IMO, stimulants are NOT good for anxiety.
Have you considered perhaps a wellbutrin/serzone or trazadone combo? I think the idea of something stimulating along with something sedating to balance it out is a good one, but an amphetamine and a benzo are NOT the right combo in my opinion...
~fairnymph
Posted by Mimi on July 16, 2002, at 19:20:55
In reply to Social Anxiety Meds Discussion, posted by k23d on July 10, 2002, at 20:03:42
k23d,
Buspar has worked wonders for my social anxiety. Klonopin was way too sedating.
MimiHi Folks,
>
> I've read extensively through the archives but still need further convincing I'm doing the right thing so please bear with me for one more go around this discussion.
>
> I'm a socially anxious individual in my late 20's who's been living with the problem since my teens but only come to realise what it was about 2 years ago.
>
> Since then I've tried everything from NLP, Hypnosis, meditation, lot's of excercise and some yoga (both of which help), Cog Behavioural therapy and finally about 3 months ago got on the paroxetine (20mg daily in the morning).
>
> My issues could be described as a generalised social anxiety with some specific performance phobias that accelerate me to panic. As far as I am aware or have been diagnosed I have no other comorbid conditions other than a generalised anxiety but it's kind of just driven by my social anxiety anyway.
>
> I want off the paroxetine due to the side effects, mainly as follows:
> Lethargy
> Lack of motivation
> Lack of concentration
> Loss of libido
> Loss of orgasm
> Weight gain
> Emotional dulling in non anxiety situations
> Poor memory
> Losing words
>
> The paroxetine has helped in general social interaction but doesn't help in panic inducing situations. Propranolol 75mg has helped moderately but not fully.
>
> Anyway my doc has suggested venlafaxine as the next treatment but I'm not keen mostly due to the side effects profile and possible withdrawal issues.
>
> Thinking of this treatment plan:
> Continued CBT
> Start klonpin 1.5mg div to 3xdaily
> Start provigil or dexadrine (unsure of dosage)
> Maybe wean off paroxetine and start serzone
>
> Anyone have any suggestions/words of support. I've bought the report from the Journal of Clinical Psychiatry (www.psychiatry.com) titled "Advanced and emerging treatments in social phobia" and read a few other research papers.
> Is there any other resources people can suggest either to support my treatment plan above or to suggest a new one. Particularly with a focus on medical papers I can give my doc.
>
> Thanks for any support folks.
> k23d
This is the end of the thread.
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