![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 45. This is the beginning of the thread.
Posted by Rocket Jackson on November 1, 2002, at 19:29:33
Have any of you tried the Klonopin/Provigil combo for social anxiety? Because, wow! I'm getting great results so far! I take 1g Klonopin and 100mg Provigil in the morning, and within about 45-60 min I really start feeling the effect. But it does seem to wear off a bit by early afternoon, so I'm contemplating a strategy to possibly take half of both these doses in the early afternoon for a "refill." Have any of you had positive/negative/neutral experiences with this combo?
Of course, my main concern at this point is whether it will "poop out" soon. It almost seems too good to be true so far. I'm considering giving myself a few days/weeks of "holidays" from the meds to prevent any possible tolerance from developing to the combo. Perhaps I'll fill these gaps with Neurontin or Gabatril and see how this goes. I'll let you all know! :)
Just wanted to share this positive experience and see if anyone else has had the same. Thanks for any input!
Rocket
Posted by disney4 on November 1, 2002, at 21:13:32
In reply to Klonopin/Provigil combo for SP!, posted by Rocket Jackson on November 1, 2002, at 19:29:33
Does this combo provide relief from depression too?
Posted by chad_3 on November 1, 2002, at 22:14:42
In reply to Re: Klonopin/Provigil combo for SP! » Rocket Jackson, posted by disney4 on November 1, 2002, at 21:13:32
What?
Klonopin for social anxiety?
Provigil?
Have you ever heard of Paxil Rocket?
Check with Action Jackson - he knows a lot about SP.
Chad
> Does this combo provide relief from depression too?
Posted by chad_3 on November 1, 2002, at 22:18:23
In reply to Klonopin/Provigil combo for SP!, posted by Rocket Jackson on November 1, 2002, at 19:29:33
Check with Rick and Ray on that also, there have tried it I think.
Also I heard of a few people, I think it was KregPark, and possibly a guy "Rick0001"
I'm not positive - but maybe do a search of P/B fo all of these people.
Good luck Rocket!
Chad2
> Have any of you tried the Klonopin/Provigil combo for social anxiety? Because, wow! I'm getting great results so far! I take 1g Klonopin and 100mg Provigil in the morning, and within about 45-60 min I really start feeling the effect. But it does seem to wear off a bit by early afternoon, so I'm contemplating a strategy to possibly take half of both these doses in the early afternoon for a "refill." Have any of you had positive/negative/neutral experiences with this combo?
>
> Of course, my main concern at this point is whether it will "poop out" soon. It almost seems too good to be true so far. I'm considering giving myself a few days/weeks of "holidays" from the meds to prevent any possible tolerance from developing to the combo. Perhaps I'll fill these gaps with Neurontin or Gabatril and see how this goes. I'll let you all know! :)
>
> Just wanted to share this positive experience and see if anyone else has had the same. Thanks for any input!
>
> Rocket
Posted by chad_3 on November 1, 2002, at 22:24:18
In reply to Klonopin/Provigil combo for SP!, posted by Rocket Jackson on November 1, 2002, at 19:29:33
Rocket -
what do you think of (for SP)
1) Boospar
2) Gabatrel
3) Gaba
4) Celexa
5) Nardill
6) Xanax
7) GHB
8) ExstacyHave you tried any of these for SP?
Thanks in advance!!
Chad2
> Have any of you tried the Klonopin/Provigil combo for social anxiety? Because, wow! I'm getting great results so far! I take 1g Klonopin and 100mg Provigil in the morning, and within about 45-60 min I really start feeling the effect. But it does seem to wear off a bit by early afternoon, so I'm contemplating a strategy to possibly take half of both these doses in the early afternoon for a "refill." Have any of you had positive/negative/neutral experiences with this combo?
>
> Of course, my main concern at this point is whether it will "poop out" soon. It almost seems too good to be true so far. I'm considering giving myself a few days/weeks of "holidays" from the meds to prevent any possible tolerance from developing to the combo. Perhaps I'll fill these gaps with Neurontin or Gabatril and see how this goes. I'll let you all know! :)
>
> Just wanted to share this positive experience and see if anyone else has had the same. Thanks for any input!
>
> Rocket
Posted by chad_3 on November 1, 2002, at 22:28:15
In reply to Klonopin/Provigil combo for SP!, posted by Rocket Jackson on November 1, 2002, at 19:29:33
I just rembermber a post of Provigil + L-DOPA (I think? - not sure about l-dopa though)
Someone told me vigra + sexcstacy is gud club drug and socaiblizerr also...
Tried em bud?> Have any of you tried the Klonopin/Provigil combo for social anxiety? Because, wow! I'm getting great results so far! I take 1g Klonopin and 100mg Provigil in the morning, and within about 45-60 min I really start feeling the effect. But it does seem to wear off a bit by early afternoon, so I'm contemplating a strategy to possibly take half of both these doses in the early afternoon for a "refill." Have any of you had positive/negative/neutral experiences with this combo?
>
> Of course, my main concern at this point is whether it will "poop out" soon. It almost seems too good to be true so far. I'm considering giving myself a few days/weeks of "holidays" from the meds to prevent any possible tolerance from developing to the combo. Perhaps I'll fill these gaps with Neurontin or Gabatril and see how this goes. I'll let you all know! :)
>
> Just wanted to share this positive experience and see if anyone else has had the same. Thanks for any input!
>
> Rocket
Posted by chad_3 on November 1, 2002, at 22:30:14
In reply to Klonopin/Provigil combo for SP!, posted by Rocket Jackson on November 1, 2002, at 19:29:33
Rokit -
No but heard of moderate - good/poor result tho!
> Have any of you tried the Klonopin/Provigil combo for social anxiety? Because, wow! I'm getting great results so far! I take 1g Klonopin and 100mg Provigil in the morning, and within about 45-60 min I really start feeling the effect. But it does seem to wear off a bit by early afternoon, so I'm contemplating a strategy to possibly take half of both these doses in the early afternoon for a "refill." Have any of you had positive/negative/neutral experiences with this combo?
>
> Of course, my main concern at this point is whether it will "poop out" soon. It almost seems too good to be true so far. I'm considering giving myself a few days/weeks of "holidays" from the meds to prevent any possible tolerance from developing to the combo. Perhaps I'll fill these gaps with Neurontin or Gabatril and see how this goes. I'll let you all know! :)
>
> Just wanted to share this positive experience and see if anyone else has had the same. Thanks for any input!
>
> Rocket
Posted by viridis on November 2, 2002, at 0:19:13
In reply to Klonopin/Provigil combo for SP!, posted by Rocket Jackson on November 1, 2002, at 19:29:33
I can see how that would work -- I took 1 mg Klonopin and 100 mg Provigil together for a while. But the diagnosis was different -- panic disorder, ADD, and major depression. Klonopin was (and continues to be) great for panic/anxiety, but Provigil didn't really do it for ADD. However, Provigil was stimulating without added anxiety, and did make me more assertive (which I imagine -- for someone with SP -- could equate to greater confidence in social situations).
Now I take K and Adderall. The Adderall is better for me for focus/concentration and has an additional calming effect at low doses (as well as being a great antidepressant). My pdoc says that Provigil is very hit-or-miss for various conditions, with certain people responding extremely well. He considers it very safe, alone or together with benzos. It's great that this combo is working for you!
Posted by Kari on November 2, 2002, at 7:27:25
In reply to Klonopin/Provigil combo for SP!, posted by Rocket Jackson on November 1, 2002, at 19:29:33
Interesting- thanks for the idea.
BTW, does provigil act as a dopamine agonist?
Posted by Kari on November 2, 2002, at 7:36:46
In reply to Klonopin/Provigil combo for SP!, posted by Rocket Jackson on November 1, 2002, at 19:29:33
Are there different types of social phobia? For instance, can it be assumed that the SP suffered by schizoids or schizotypals would be helped by reducing dopamine, while the more "purely anxious" types would necessitate an increase in this neurotransmitter? I know it isn't that simple, but...any thoughts on this?
Thanks.
Posted by Rocket Jackson on November 2, 2002, at 11:30:07
In reply to Re: Klonopin/Provigil combo for SP! » Rocket Jackson, posted by disney4 on November 1, 2002, at 21:13:32
> Does this combo provide relief from depression too?
Ya know, that's a great question. Though I don't exactly suffer from depression, I have felt a mild depressive effect from the Klonopin, especially as it wears off 5 or 6 hours after I have taken it. At that point I then feel as if it's almost harder to be social than before I took it!
That's where I think the Provigil is really helping me. It seems to be acting synergistically somehow, mostly by balancing out the depressive/fatiguing side effects of the K. But by itself, I can't really say if Provigil has AD effects. I've taken it alone and really don't feel much of anything. But since I don't believe I suffer from depression, my experience on this might not help much.
Rocket
Posted by disney4 on November 2, 2002, at 11:37:43
In reply to Re: Combo relief from depression, posted by Rocket Jackson on November 2, 2002, at 11:30:07
I may up my intake of salmon oil first. I have been taking 1 - 1000 mg Salmon oil cap daily for 180 mg EPA and 120mg DHA, which is not enough, according to the studies. The studies are some what contradictory though, and DHA may be better for the depression, and EPA for the mood stabilization effect. I am doing more research before I decide which way to go.
Thanks!
Elsie
Posted by Rocket Jackson on November 2, 2002, at 11:38:53
In reply to Re: Klonopin/Provigil combo for SP!, posted by chad_3 on November 1, 2002, at 22:14:42
>Klonopin for social anxiety?
>Provigil?
>Have you ever heard of Paxil Rocket?
>Check with Action Jackson - he knows a lot about SP.I detect a little sarcasm here, so I'll respond with a little of my own. How dare you bring Action Jackson into this conversation. This is quite possibly the best film of all time (with the possible exception of Rocky III). What was the academy thinking by not nominating this one? Carl Weathers was amazing. And that's certainly no SP there! :)
And yes, I have certainly heard of Paxil. But I value my sex life and lean physique to even consider taking it. As a medical student, I cringe every time I see the doctor prescribe it to his patients. And they both wonder why on the three month follow up there is such a huge weight gain and rise in BP? Go figure...
Take care,
Rocket "no relation to Action" Jackson
Posted by Rocket Jackson on November 2, 2002, at 11:50:26
In reply to Rocket - you know if boospar work for SP !, posted by chad_3 on November 1, 2002, at 22:24:18
> Rocket -
>
> what do you think of (for SP)
> 1) Boospar
> 2) Gabatrel
> 3) Gaba
> 4) Celexa
> 5) Nardill
> 6) Xanax
> 7) GHB
> 8) Exstacy
>
> Have you tried any of these for SP?
>
> Thanks in advance!!
>
> Chad2
>Sorry Chad2, but I unfortunately don't have too much personal experience with the meds you listed. From what I hear from some of the Psychiatrists I have rotated with, Buspar is essentially "about as effective as water" in their opinion. But I've heard the same said about Neurontin, so I might take some of these doc's opinions with a grain of salt.
As for Gabatril, I'll let you know in the next couple of weeks, as I've just had it prescribed to me. I attended a Psychiatry conference a few months back (put on by the Cephalon reps I might add), at which the topic was Gabatril and its effectiveness in generalized anxiety disorder. The physician had nothing but wonderful things to say about it. In a few of his own small clinical trials, he reported some very positive results with few side effects. But the key, he pointed out, was the fact that it must be taken in FAR lower dosages than those used in the adjunctive treatment for epilepsy. He's been using between 4 and 8mg (rarely up to 12 mg) in his studies, and advising that it be taken before a meal to minimize the nausea and dizziness. I got the feeling he was using it religiously himself!
I'll be trying it in the next few days, so I'll keep you up-to-date with my results. I'm also trying Neurontin for the first time, but will leave this for after my Gabatril trial. I'm looking for something to take for maintenance during Klonopin/Provigil holidays. We'll see!
Good luck!
Posted by Rocket Jackson on November 2, 2002, at 11:57:03
In reply to Re: Klonopin/Provigil combo for SP! yes!, posted by chad_3 on November 1, 2002, at 22:28:15
> I just rembermber a post of Provigil + L-DOPA (I think? - not sure about l-dopa though)
>
> Someone told me vigra + sexcstacy is gud club drug and socaiblizerr also...
>
>
> Tried em bud?
>Sorry, but I haven't tried these. But the theory on the Provigil and L-Dopa is an interesting one. Since it appears that Dopamine agonists might be effective, the L-Dopa just might work, just as long as it's administered with the carbidopa to prevent peripheral decarboxylation. Maybe I should sneak some of grannie's Parkinson's pills to see? :) (just kidding, of course ;))
And viagra plus ecstasy? What a wild trip that would be, huh? But I think I'll leave that experiment for someone else. :)
Take care,
Rocket
Posted by Rocket Jackson on November 2, 2002, at 12:00:25
In reply to Re: Klonopin/Provigil combo for SP! » Rocket Jackson, posted by viridis on November 2, 2002, at 0:19:13
> I can see how that would work -- I took 1 mg Klonopin and 100 mg Provigil together for a while. But the diagnosis was different -- panic disorder, ADD, and major depression. Klonopin was (and continues to be) great for panic/anxiety, but Provigil didn't really do it for ADD. However, Provigil was stimulating without added anxiety, and did make me more assertive (which I imagine -- for someone with SP -- could equate to greater confidence in social situations).
>
> Now I take K and Adderall. The Adderall is better for me for focus/concentration and has an additional calming effect at low doses (as well as being a great antidepressant). My pdoc says that Provigil is very hit-or-miss for various conditions, with certain people responding extremely well. He considers it very safe, alone or together with benzos. It's great that this combo is working for you!Hi Viridis,
Thanks for the info. I'm definitely glad you've found a combo that is working for you! As we all know, it sure can be tough sometimes. But I'm happy for ya and wish you all the best!
Rocket
Posted by Rocket Jackson on November 2, 2002, at 12:03:02
In reply to Re: Klonopin/Provigil combo for SP! » Rocket Jackson, posted by Kari on November 2, 2002, at 7:27:25
> Interesting- thanks for the idea.
> BTW, does provigil act as a dopamine agonist?Hi Kari,
That's a great question. I wish I had the answer! From my research, it appears to be unclear how this works, other than in general as a CNS stimulant. Kinda scary that we have no idea where they're going in the brain and how they work! But if I find out something, I'll be sure to post it.
Take care,
Rocket
Posted by Rocket Jackson on November 2, 2002, at 12:14:48
In reply to social phobia, posted by Kari on November 2, 2002, at 7:36:46
> Are there different types of social phobia? For instance, can it be assumed that the SP suffered by schizoids or schizotypals would be helped by reducing dopamine, while the more "purely anxious" types would necessitate an increase in this neurotransmitter? I know it isn't that simple, but...any thoughts on this?
> Thanks.Hi Kari,
I definitely think you're right on on your theory. It makes sense that that there are different types of SP, even with observation of myself and posts from others on this forum. "Depressive" SP seems to be pretty common, for which the SSRIs would theoretically work quite well in, plus the dopamine agonism as you mentioned. But I could see it getting pretty complicated in cases where SP coexists with such disorders as schizoid and schizotypal PDs. I'm sure dopamine would need to be blocked in certain areas of the brain but unaffected/stimulated in others.
As for me, I think I have the "purely anxious" type of SP. For this reason I gave Wellbutrin a try, as its mechanism of action appears to include a reuptake inhibition of dopamine. But I experienced zero benefit from it (I actually think I was more anxious, and even quite irritable :)) But I'm considering a trial with something like selegiline or the like in the future. We'll see!
Just curious: do you have SP? What seems to be working best for you?
Take care,
Rocket
Posted by disney4 on November 2, 2002, at 13:11:04
In reply to Re: Klonopin/Provigil combo for SP!, posted by Rocket Jackson on November 2, 2002, at 12:03:02
I also take Neurontin for bipolar disorder, and my Dr mentioned a possible switch to the Gabatril. I have read some really strange reports on this site, and am afraid to make the switch, although I have read some very positive reports as well. I know people all respond differently, but I think the Neurontin is inherrantly safer than the Gabatril, due to the way its metabolized. What is your opinion on this?
Elsie
Posted by BK on November 2, 2002, at 13:17:31
In reply to Re: social phobia, posted by Rocket Jackson on November 2, 2002, at 12:14:48
Rocket,
I've really enjoyed your messages! I suffer from SP, depression and ADD -a real nice combination as you can well imagine. The only medication that provided any relief was Nardil, albeit only for four months. After which time it completely pooped-out and actually made me more anxious. Since that time, about 15 years ago, I've tried just about everything out there. I recently tried Paxil CR and it made me anxious and I just couldn't focus or concentrate on anything. I stopped it after only 1 week. I almost always give a drug a full two months to be certain that I've given it sufficient time to work.
Anyway, the Rocket combo seems something worth investigating. I've tried Provigil it didn't really seem to help. I've thought about using Klonopin and will give it a try independently and then try augmenting with Provigil. Thanks again for sharing your experiences.
Posted by Rocket Jackson on November 2, 2002, at 14:11:29
In reply to Re: Klonopin/Provigil combo for SP!, posted by disney4 on November 2, 2002, at 13:11:04
> I also take Neurontin for bipolar disorder, and my Dr mentioned a possible switch to the Gabatril. I have read some really strange reports on this site, and am afraid to make the switch, although I have read some very positive reports as well. I know people all respond differently, but I think the Neurontin is inherrantly safer than the Gabatril, due to the way its metabolized. What is your opinion on this?
> ElsieHi Elsie,
I, too, am a little confused on the Neurontin vs. Gabatril issue. There seems to be way quite a lot more anecdotal information out there on Neurontin than with Gabatril.
The info I received from a doc at a Pysch conference a few months back on Gabatril made it seem as if this is the new "wonder drug" for anxiety. He, in fact, was of the strong opinion that Gabatril is much cleaner than Neurontin due to its precise mechanism of action (GABA reuptake inhibition) and fewer "dirty" effects on other parts of the system. He also harped on the dosing issue in that Gabatril is only once, possibly twice per day as compared to Neurontin's multiple regimen. But he couldn't emphasize more the importance of the lower doses that are sufficient for anxiety treatment. He has found that the optimum ranges for anxiety are between 4-8mg (sometimes up to 12mg), and that it should be taken with food to alleviate the nausea and dizziness that seems to be common. So I'm gonna try it and find out! I'll let you know!
Of course, I have no stake in either one of the drugs (re-reading my post makes me look like a Gabatril rep :)), so I'll be as candid as possible with my experiences. I'm actually hoping the Gabatril will work so I won't have to take it as many times per day. But ultimately whatever works will have to do!
Please keep me up-to-date if you decide to make the switch to Gabatril. I definitely understand your reluctance to switching. Hopefully one will hit the spot!
Take care,
Rocket
Posted by Rocket Jackson on November 2, 2002, at 14:20:32
In reply to Re: social phobia, posted by BK on November 2, 2002, at 13:17:31
> Rocket,
>
> I've really enjoyed your messages! I suffer from SP, depression and ADD -a real nice combination as you can well imagine. The only medication that provided any relief was Nardil, albeit only for four months. After which time it completely pooped-out and actually made me more anxious. Since that time, about 15 years ago, I've tried just about everything out there. I recently tried Paxil CR and it made me anxious and I just couldn't focus or concentrate on anything. I stopped it after only 1 week. I almost always give a drug a full two months to be certain that I've given it sufficient time to work.
>
> Anyway, the Rocket combo seems something worth investigating. I've tried Provigil it didn't really seem to help. I've thought about using Klonopin and will give it a try independently and then try augmenting with Provigil. Thanks again for sharing your experiences.
>Hi BK,
I hope this combo ends up working for you. Don't you hate the whole "poop out" phenomenon? I'm afraid that what I find to be working now will eventually poop out as well. But hopefully taking it off and on might keep my brain "guessing." We'll see...
I think you'll most likely see some benefit from the Klonopin alone, but hopefully it won't end up exacerbating your depression. It sometimes makes me feel depressed a little later in the day if I take it in the morning, but this may be just an early side effect that my body will eventually get used to. The problem is, I'm trying not to take it daily just in case it doesn't work in the future like it does now. But there's quite a few posters out there for whom daily Klonopin for years has maintained its positive effects. I'll keep my fingers crossed! But for now the Provigil is definitely balancing it out.
Best of luck with your drug "trials." :) Please let me know how it turns out.
Take care,
Rocket
Posted by jyl on November 2, 2002, at 16:25:40
In reply to Re: social phobia, posted by Rocket Jackson on November 2, 2002, at 14:20:32
i tried paxil
trazodone
now on effexor-150mg
cant seem to find any sort of relief from this hell...
no side effects..
no nothing!
jyl
Posted by chad_3 on November 2, 2002, at 18:31:18
In reply to Re: Klonopin/Provigil combo for SP!, posted by Rocket Jackson on November 2, 2002, at 12:03:02
Rocket -
I noticed some sort of interaction between provigil and klonopin also. Provigil seems to act kind of like a serotonin 3 agonist, and partial da agonist.
The PDR does state Provigil antagonizes Clozapine. I noticed that provigil - like wellbutrin and dhea - also reduced the effectiveness of Propecia I was taking. This was couple years ago - i do not care for dhea but think that wellbutrin and provigil would more likely have potential utility in polypharmacy - all just IMO since you bring up 2 useful meds I think for SP - especially the radically awesome Klonopin.
Later dude - keep up the good work Doc - you add something new to the crew here!
Chad
http://www.socialfear.com/
Posted by Rocket Jackson on November 2, 2002, at 21:33:07
In reply to Provigil partial synergy with Klonopin, posted by chad_3 on November 2, 2002, at 18:31:18
> Rocket -
>
> I noticed some sort of interaction between provigil and klonopin also. Provigil seems to act kind of like a serotonin 3 agonist, and partial da agonist.
>
> The PDR does state Provigil antagonizes Clozapine. I noticed that provigil - like wellbutrin and dhea - also reduced the effectiveness of Propecia I was taking. This was couple years ago - i do not care for dhea but think that wellbutrin and provigil would more likely have potential utility in polypharmacy - all just IMO since you bring up 2 useful meds I think for SP - especially the radically awesome Klonopin.
>
> Later dude - keep up the good work Doc - you add something new to the crew here!
>
> Chad
> http://www.socialfear.com/
>
>
>Hi Chad,
Thanks for the info. I'm always fascinated with this kind of stuff, particularly from experienced and knowledgeable posters such as yourself. Considering Wellbutrin's mechanism of action, I was hoping it, along with Klonopin, would prove to be an effective combo. But it sure did nothing for me personally. In fact, I found myself much more irritable and anxious, the latter which certainly didn't benefit the SP all that much. :) And I even felt as if the WB was antagonizing the Klonopin to some extent, as I wasn't experiencing near the benefit as I was with K alone. Perhaps this combo might work for others.
And by the way, your website is great! It's nice to see an informative site out there on this frustrating condition. You, too, keep up the great work!
Rocket
P.S. I know I've read this in previous posts, but what do you find is working best for you at this point?
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.