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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Matty on September 1, 2000, at 12:00:49
Hi, I live in the UK and suffer from social phobia. I have found difficulty obtaining answers to my questions and if anybody out there can help I would be very grateful.
> How long does nardil take to work for social phobia? I have been on it eight weeks now and have still found no relief from my symptoms.
> Does anybody know when pregabalin or pagoclone will become available in the UK? (My psychiatrist, GP and mental health nurse have never even heard of them). Has anyone got any info on their efficacy with social anxiety?
> Has any body got any info on the efficacy of other meds/drugs? Of particular interest to me are adrafinil, deprenyl, GHB, Gamalate B6 and Picamilone - a UK Psychiatrist would never prescribe these meds, or any that is not widely used for depression or anxiety but all traditional antidepressants have not helped me. These drugs however, can be purchased on the net. The first two interest me as my problems seem to stem from my inability to think properly or concentrate when I am spoken to and thus have no reasonable response for people, maybe a bit of cognitive stimulation is what I need. The latter three I see as possible alternatives to benzo's ( my docs won't prescribe benzo's either)
Sorry about the essay but please, please, please, any response would be much appreciated.
Posted by anita on September 1, 2000, at 20:05:43
In reply to social phobia - nardil, pagoclone, pregabalin, posted by Matty on September 1, 2000, at 12:00:49
Hi Matty,
I took nardil for depression and social phobia, and out of the many meds I've tried, nardil worked the best. In the US, nardil is cited as one of the best meds for social phobia, and clonazepam (a benzo) seems to be a close second. For me, Nardil kicked in rather suddenly after 8 weeks, at 60mg. I'd give it another 2 weeks to work, if you can. Then, maybe ask your doc about clonazapam (Klonopin in the US).
I don't know about pregabalin, pagoclone, Gamalate B6, or Picamilone, but I'm curious so I'll see what I can find. Are these the generic names? Deprynel is another MAOI, and I'd think it would help with social phobia. Deprynel and Parnate tend to be more stimulating than nardil. Stimulating drugs, including adrafinil, might be helpful if you feel shy and generally want to talk more with others, but if you experience profound anxiety, these may make it worse. Then again, if you're problem is more with attention and concentration, these may be good for that.
I don't know if I've been of any help...but if you tell me more about your symptoms I can tell you what I know, as I've done some research on it for myself. I tend to be very avoidant, and have found that dopaminergic meds really help me talk more and want to be more involved with people.
anita
> Hi, I live in the UK and suffer from social phobia. I have found difficulty obtaining answers to my questions and if anybody out there can help I would be very grateful.
> > How long does nardil take to work for social phobia? I have been on it eight weeks now and have still found no relief from my symptoms.
> > Does anybody know when pregabalin or pagoclone will become available in the UK? (My psychiatrist, GP and mental health nurse have never even heard of them). Has anyone got any info on their efficacy with social anxiety?
> > Has any body got any info on the efficacy of other meds/drugs? Of particular interest to me are adrafinil, deprenyl, GHB, Gamalate B6 and Picamilone - a UK Psychiatrist would never prescribe these meds, or any that is not widely used for depression or anxiety but all traditional antidepressants have not helped me. These drugs however, can be purchased on the net. The first two interest me as my problems seem to stem from my inability to think properly or concentrate when I am spoken to and thus have no reasonable response for people, maybe a bit of cognitive stimulation is what I need. The latter three I see as possible alternatives to benzo's ( my docs won't prescribe benzo's either)
> Sorry about the essay but please, please, please, any response would be much appreciated.
Posted by Snowie on September 1, 2000, at 20:58:29
In reply to social phobia - nardil, pagoclone, pregabalin, posted by Matty on September 1, 2000, at 12:00:49
Hi Matty,
I've never taken Nardil, but my concern about it is weight gain, and, of course, the food restrictions. Klonopin is a benzo, and since you said your pdoc won't prescribe benzos, you're out of luck there. I've never heard of Pregabalin. There was a discussion a while back about Pagoclone. Here's the link to that thread.
http://www.dr-bob.org/babble/20000729/msgs/41727.html
Guess we'll have to wait a while longer until Pagoclone comes out. What about Neurontin? It helps me with social anxiety, and I don't need nearly as much Xanax when taking it. However, my understanding is that it doesn't work for everybody.
Snowie
> Hi, I live in the UK and suffer from social phobia. I have found difficulty obtaining answers to my questions and if anybody out there can help I would be very grateful.
> > How long does nardil take to work for social phobia? I have been on it eight weeks now and have still found no relief from my symptoms.
> > Does anybody know when pregabalin or pagoclone will become available in the UK? (My psychiatrist, GP and mental health nurse have never even heard of them). Has anyone got any info on their efficacy with social anxiety?
> > Has any body got any info on the efficacy of other meds/drugs? Of particular interest to me are adrafinil, deprenyl, GHB, Gamalate B6 and Picamilone - a UK Psychiatrist would never prescribe these meds, or any that is not widely used for depression or anxiety but all traditional antidepressants have not helped me. These drugs however, can be purchased on the net. The first two interest me as my problems seem to stem from my inability to think properly or concentrate when I am spoken to and thus have no reasonable response for people, maybe a bit of cognitive stimulation is what I need. The latter three I see as possible alternatives to benzo's ( my docs won't prescribe benzo's either)
> Sorry about the essay but please, please, please, any response would be much appreciated.
Posted by AndrewB on September 2, 2000, at 12:15:35
In reply to social phobia - nardil, pagoclone, pregabalin, posted by Matty on September 1, 2000, at 12:00:49
Matty,
I hope the Nardil kicks in for you in the next couple of weeks.
It you list your specific symptoms and the meds you have already tried it would help people give you ideas on what meds to try next.
DO NOT USE GHB. It causes rebound anxiety and is addictive.
As far as I know Gamalate B6 and Picamilone won't be useful despite what some internet sites may claim.
Adrafinil and Deprenyl are not first choices for social anxiety, but if you have tried 'everything else' you may want to try these because they help some I think. Personally, deprenyl has helped improve my confidence.
I don’t think Pagoclone and Pregabalin are approved yet in the US or anywhere else.
Amisulpride is available in the UK. I remember a posting from a British man who was prescribed (low dose) amisulpride for his social anxiety. It also can help with concentration. I have an information piece on it I can send you; andrewb@seanet.com.
Best wishes,
AndrewB
Posted by ChrisB on September 2, 2000, at 13:43:19
In reply to social phobia - nardil, pagoclone, pregabalin, posted by Matty on September 1, 2000, at 12:00:49
I have exactly the same problem when not on a med thats working - when people are showing me how to
do something in a new job for example, or even
just talking in a social situation,
info. just goes in one ear and out the other! I
hear the words but dont get the true meaning.
I agree with AndrewB in that you should avoid GHB, Ive heard some nasty things about it.
Pagoclone or Pagodone is still in clinical trials as far as I know: look up the "New Medicines In Development Database".
If I were you Id give Nardil the flick - eight
weeks is definitely long enough to give a med.
to work. Dont they have Parnate over there? This
med. took away my social phobia COMPLETELY, but it
does have a fair few side fx. I tried Nardil and
found it a much weaker version of Parnate. I know
what its like to suffer this condition and you
dont need to waste any more time on a med thats
not working. Its much better to try Parnate first
rather than go to all the trouble of ordering from o/s for a med that may or may not work (Ive
tried this avenue as well).
Parnate works incredibly for social phobia in me
- it may for you too - I dont know why Nardil gets
more press.
Posted by Matty on September 3, 2000, at 9:38:28
In reply to Re: social phobia - nardil, pagoclone, pregabalin » Matty, posted by ChrisB on September 2, 2000, at 13:43:19
Thanks everyone for the response,
In reply to your points and questions - I asked my psychiatrist about clonazepam, he said that he was not prepared to use a benzo unless it was a last resort (and to him that is not yet). Pagoclone is a new allegedly safer altenative to the benzo's, pregabalin is a newer version of neurontin (my docs laughed when I asked about neurontin saying that it is an anticonvulsant and they see of no reason why it should benefit anxiety), most stuff on the net about it is American and it is little used over here. Pregabalin however shows promise for anxiety and is probably set to be approved for anxiety disorders (when though, I have no idea). Gamalate and picamilone are benzo alternatives I have only read about in on-line pharmacy stores. I have had a hell of a lot of weight gain with nardil, but apart from that no other side effects. I even eat cheese and drink beer, I see my doc on wedsnesday he will probably suggest giving nardil a bit longer. We do have parnate over here and that may be my next choice should he agree. I would also like to try deprenyl but am worried about combining two differant MAOI's, has anyone done this? I think I may try adrafinil. Other meds I have tried (all pretty much with no success) are prozac, celexa, effexor, clomipramine, moclobemide, paxil, anetenol and buspar ( I am currently taking 60mg nardil and 10mg pindolol) As for my symptoms I tend to get very anxious about the thought of going out and meeting people, sometimes to the point of full panic attack. I also get panic attacks when I have being thinking about an 'embarassing' situation without realising it has even been on my mind. In social situations I hate being in crowds, I find it difficult to talk in crowds for fear of people 'listening in'. When placed in a social situation it is the fear of being mocked that weighs most heavily on my mind. I also get very panicy when spoken to and I find it difficult to concentrate on what people are saying to me thus am unable to reply. I often sweat, blush and stutter when I am finding a conversation particularaly stressful. Because of this nervousness and inability to concentrate I often come accross as aloof, clumsy and a bit of an idiot, but I know this not to be true. I too tend to be more avoidant and just want to join in more and come across more confident rather than actually being highly 'jittery' and anxious, perhaps dopaminergics are for me, or perhaps I do need a drug that boosts GABA activity. Again sorry about the essay but any further correspondance would be much appreciated. If anyone wishes they can also send info to me at supaleeds@hotmail.com> I have exactly the same problem when not on a med thats working - when people are showing me how to
> do something in a new job for example, or even
> just talking in a social situation,
> info. just goes in one ear and out the other! I
> hear the words but dont get the true meaning.
> I agree with AndrewB in that you should avoid GHB, Ive heard some nasty things about it.
> Pagoclone or Pagodone is still in clinical trials as far as I know: look up the "New Medicines In Development Database".
> If I were you Id give Nardil the flick - eight
> weeks is definitely long enough to give a med.
> to work. Dont they have Parnate over there? This
> med. took away my social phobia COMPLETELY, but it
> does have a fair few side fx. I tried Nardil and
> found it a much weaker version of Parnate. I know
> what its like to suffer this condition and you
> dont need to waste any more time on a med thats
> not working. Its much better to try Parnate first
> rather than go to all the trouble of ordering from o/s for a med that may or may not work (Ive
> tried this avenue as well).
> Parnate works incredibly for social phobia in me
> - it may for you too - I dont know why Nardil gets
> more press.
>
Posted by Bigdave on June 1, 2001, at 9:34:45
In reply to social phobia - nardil, pagoclone, pregabalin, posted by Matty on September 1, 2000, at 12:00:49
> Hi, I live in the UK and suffer from social phobia. I have found difficulty obtaining answers to my questions and if anybody out there can help I would be very grateful.
> > How long does nardil take to work for social phobia? I have been on it eight weeks now and have still found no relief from my symptoms.
> > Does anybody know when pregabalin or pagoclone will become available in the UK? (My psychiatrist, GP and mental health nurse have never even heard of them). Has anyone got any info on their efficacy with social anxiety?
> > Has any body got any info on the efficacy of other meds/drugs? Of particular interest to me are adrafinil, deprenyl, GHB, Gamalate B6 and Picamilone - a UK Psychiatrist would never prescribe these meds, or any that is not widely used for depression or anxiety but all traditional antidepressants have not helped me. These drugs however, can be purchased on the net. The first two interest me as my problems seem to stem from my inability to think properly or concentrate when I am spoken to and thus have no reasonable response for people, maybe a bit of cognitive stimulation is what I need. The latter three I see as possible alternatives to benzo's ( my docs won't prescribe benzo's either)
> Sorry about the essay but please, please, please, any response would be much appreciated.
Hi Matty, I live in the UK too, and I've orderd both Adrafinil and GHB over the net for social anxiety.. The Adrafinil didnt seem to have any anti-anxiety benefits, but did lift mood/depression and improve concentration and remove negative thinking patterns. GHB is rather like alcohol in terms of affects, I felt much less disinhibited and did help a lot with anxiety, and made me more socialable. The only problem was the cost of it, and also the risk of overdosing.Dave
Posted by PaulB on June 1, 2001, at 16:14:11
In reply to Re: social phobia - nardil, pagoclone, pregabalin, posted by Bigdave on June 1, 2001, at 9:34:45
> > Hi, I live in the UK and suffer from social phobia. I have found difficulty obtaining answers to my questions and if anybody out there can help I would be very grateful.
> > > How long does nardil take to work for social phobia? I have been on it eight weeks now and have still found no relief from my symptoms.
> > > Does anybody know when pregabalin or pagoclone will become available in the UK? (My psychiatrist, GP and mental health nurse have never even heard of them). Has anyone got any info on their efficacy with social anxiety?
> > > Has any body got any info on the efficacy of other meds/drugs? Of particular interest to me are adrafinil, deprenyl, GHB, Gamalate B6 and Picamilone - a UK Psychiatrist would never prescribe these meds, or any that is not widely used for depression or anxiety but all traditional antidepressants have not helped me. These drugs however, can be purchased on the net. The first two interest me as my problems seem to stem from my inability to think properly or concentrate when I am spoken to and thus have no reasonable response for people, maybe a bit of cognitive stimulation is what I need. The latter three I see as possible alternatives to benzo's ( my docs won't prescribe benzo's either)
> > Sorry about the essay but please, please, please, any response would be much appreciated.
>
>
> Hi Matty, I live in the UK too, and I've orderd both Adrafinil and GHB over the net for social anxiety.. The Adrafinil didnt seem to have any anti-anxiety benefits, but did lift mood/depression and improve concentration and remove negative thinking patterns. GHB is rather like alcohol in terms of affects, I felt much less disinhibited and did help a lot with anxiety, and made me more socialable. The only problem was the cost of it, and also the risk of overdosing.
>
> DaveSOCIAL ANXIETY DISORDER
Pregabalin and Pagaclone are two drugs in the latter stages of development that are indicated for use in Social Anxiety. I think Pagaclone sounds the better of the two because its selective for GABA and does not cause sedation, memory loss etc. This drug is currently in phase 3 trials for panic disorder and phase 2 trials for generalised anxiety disorder. Licence is possible in 2003 because of the fact that it is in its last stages of development but I have read the drug may not be licnesed until the trials and its effaciousness for GAD are proven.
Pregabalin is the GABA analogue I think? The more potent version of Gabapentin which is already available. The drug company that manufactures Gabapentin gave up its trials and investigations into Gabapentin and Social Anxiety Disorder and Panic disorder after Pregabalin was discovered and is now showing more promise. Yet some people are doing v-well on Gabapentin for anxiety disorders. The best thing to do if your doctor is unfamiliar with its use for anxiety disorders take along some evidence. If nothing else at least Gabapentin is not addictive. It passes through the body unchanged and the drug itself appears to mimic GABA in the brain providing a sense of peace and calm.
I cant think of other drugs commonly used other than the benzodiazepines, SSRIS, MAO's and Gabapentin that are of use for Social Anxiety Disorder. Nardil is supposed to be v-good although 8 weeks is a long-time for this drug to not to of had an effect. Of course other than these drugs if you did not respond to Nardil or other antidepressant augmentation with a drug that may turn you into a 'responder' is quite common. Options:
-Smaller than therapeutic doses of serotonin agonists such as Trazadone, Clonazepam or Buspirone
-Lithium(Tryptophan re-uptaker)
-Tryptophan-In the UK its called Optimax.
-Pindol-blocks serotonin auto-receptors thus fooling your brain into thinking theres no serotonin about there so fires more.You mentioned adrafinil, deprenyl, GHB, Gamalate B6. These are all smart drugs and theres less evidence that the first two will work for social anxiety disorder. The latter two may, but its a novel approach. Both may stimulate GABA. I thinks youve been too smart-drugs.net???? Anyway thats what I think. Paul B
Posted by lawrence s. on June 5, 2001, at 0:28:30
In reply to Re: social phobia - nardil, pagoclone, pregabalin, posted by Bigdave on June 1, 2001, at 9:34:45
> > Hi, I live in the UK and suffer from social phobia. I have found difficulty obtaining answers to my questions and if anybody out there can help I would be very grateful.
> > > How long does nardil take to work for social phobia? I have been on it eight weeks now and have still found no relief from my symptoms.
> > > Does anybody know when pregabalin or pagoclone will become available in the UK? (My psychiatrist, GP and mental health nurse have never even heard of them). Has anyone got any info on their efficacy with social anxiety?
> > > Has any body got any info on the efficacy of other meds/drugs? Of particular interest to me are adrafinil, deprenyl, GHB, Gamalate B6 and Picamilone - a UK Psychiatrist would never prescribe these meds, or any that is not widely used for depression or anxiety but all traditional antidepressants have not helped me. These drugs however, can be purchased on the net. The first two interest me as my problems seem to stem from my inability to think properly or concentrate when I am spoken to and thus have no reasonable response for people, maybe a bit of cognitive stimulation is what I need. The latter three I see as possible alternatives to benzo's ( my docs won't prescribe benzo's either)
> > Sorry about the essay but please, please, please, any response would be much appreciated.> Hi, I live in the U.S. I have been on Nardil quite a bit. To answer your qestion on how long it takes to respond to Nardil. It took about 3-5 months. Then WOW!!! It worked like a miricale! My SP was so bad that I couldn't even be around a child without feeling extremely uncomfortable. I come from a family which is reserved, quiet, submissive, and I changed into a "social butterfly" I did also take some Klonopin with it which helped a lot too. Nardil is such a profound social lubricant. Without the drugged feeling that you get from Klonopin SSRIs and TCAs. I often wondered if I was hypomanic while on it. My doc didn't seem to think so. The only drawback is not being able to remember dreams, and change in sexual performance. usually for the worst. But it can greatly prolong ejaculation. Which my girlfriend seemed to like.
A doctor once told me that Nardil is a curative med. in that it affects gabba reuptake that seems to have a lasting effect on anxiety. Any comments on that? LARRY.
> >
> Hi Matty, I live in the UK too, and I've orderd both Adrafinil and GHB over the net for social anxiety.. The Adrafinil didnt seem to have any anti-anxiety benefits, but did lift mood/depression and improve concentration and remove negative thinking patterns. GHB is rather like alcohol in terms of affects, I felt much less disinhibited and did help a lot with anxiety, and made me more socialable. The only problem was the cost of it, and also the risk of overdosing.
>
> Dave
Posted by Carlos on April 22, 2003, at 17:35:59
In reply to Re: social phobia - nardil, pagoclone, pregabalin, posted by AndrewB on September 2, 2000, at 12:15:35
> DO NOT USE GHB. It causes rebound anxiety and is addictive.
>
You're kidding right?? Are you trying to say that SSRI's, Benzos, and MAOIs don't cause rebound anxiety and addiction after discontinuation.Frequency and moderation is the key. I also don't think you have much right to knock something that you probably know little about and have particualary not personally tried.
This is the end of the thread.
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