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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by Adam33 on January 14, 2004, at 7:57:34
Hello, I recently was diagnosed with SA Disorder (with a mild form of OCD as well)
I am not really worried about treating the OCD, but would like to do all I can to find a SA med that works for my needs. I am a law student who needs to be able to put on effective presentations very frequently so I am looking for a calming med, but preferrably one that will not dumb me up.I have had and used xanax and propranolol with good success for quite awhile, but am looking for more of a constant med rather than the "take as needed" approach. Plus, combo of those two drugs really tires me out an does tend to dull my acumen (but I guess that's better than not being able to get up their at all, as otherwise would be the case).
Recently I have tried Paxil & Neurontin
The Paxil had some sexual side effects, and it seems like people with SA are only having moderate success with SSRI's anyway.
As for the Neurontin, I don't seem to be getting much of a response at all from that.From reading these posts, I am thinging that Klonopin or Parnate/Nardil might be good things for me to try!
I would really appreciate any thoughts. And if there are other meds I didn't mention you think might be helpful as well, please mention themThank You!
Posted by SandyWeb on January 14, 2004, at 8:34:19
In reply to Please help me choose a Social Anxiety Med..., posted by Adam33 on January 14, 2004, at 7:57:34
I've found the following to help my severe social anxiety, but it doesn't completely take it away:
Neurontin 800mg BID (1600mg total)
Celexa 20mg BID (40mg total)
Remeron 45mg HS
Inderal LA 80mg BID (160mg total)I do not find these meds to be dulling. However, the anxiety is still there, albiet at a much lower degree.
Good luck!
Sandy
Posted by Bill LL on January 14, 2004, at 9:54:58
In reply to Please help me choose a Social Anxiety Med..., posted by Adam33 on January 14, 2004, at 7:57:34
All antidepressants help social anxiety. I am not aware of a social anxiety drug that is not an antidepressant.
The antidepressants that do not have sexual side effects are Wellbutrin, Remeron, and Serzone.
Posted by Mimi on January 14, 2004, at 11:38:17
In reply to Please help me choose a Social Anxiety Med..., posted by Adam33 on January 14, 2004, at 7:57:34
Posted by Ame Sans Vie on January 14, 2004, at 13:05:46
In reply to Please help me choose a Social Anxiety Med..., posted by Adam33 on January 14, 2004, at 7:57:34
Go with the Klonopin -- it is *the* gold standard for treatment of social phobia. Parnate and Nardil work for many, but are not as consistent and offer up a bit of inconvenience, what with the dietary/medication restrictions and all. I've been taking large doses of Klonopin (currently 8mg) every day for years; I feel it's literally saved my life. I don't find it to have a dulling effect, but the fact that I take 60mg of Adderall daily as well certainly helps keep me mentally capable. Then again, I never had cognitive problems from Klonopin during the years I took it before starting Adderall (and Adderall is a great social phobia med as well, combined with Klonopin -- the Klonopin eliminates anxiety and the Adderall provokes sociability).
Posted by Mimi on January 14, 2004, at 14:15:28
In reply to Re: Please help me choose a Social Anxiety Med..., posted by Ame Sans Vie on January 14, 2004, at 13:05:46
> Go with the Klonopin -- it is *the* gold standard for treatment of social phobia. Parnate and Nardil work for many, but are not as consistent and offer up a bit of inconvenience, what with the dietary/medication restrictions and all. I've been taking large doses of Klonopin (currently 8mg) every day for years; I feel it's literally saved my life. I don't find it to have a dulling effect, but the fact that I take 60mg of Adderall daily as well certainly helps keep me mentally capable. Then again, I never had cognitive problems from Klonopin during the years I took it before starting Adderall (and Adderall is a great social phobia med as well, combined with Klonopin -- the Klonopin eliminates anxiety and the Adderall provokes sociability).
Klonopin was WAY too strong for me. I only took .5mg a day and was heavily sedated the all day after day.Mimi
Posted by Ame Sans Vie on January 14, 2004, at 15:32:15
In reply to Re: Please help me choose a Social Anxiety Med... » Ame Sans Vie, posted by Mimi on January 14, 2004, at 14:15:28
Yes, some people are quite sensitive to the effects of Klonopin. After all, it (along with Halcion, prescribed as a sleep aid) is the most potent benzodiazepine available in the U.S. My stepfather dozes off after taking any more than 1/16 mg of Klonopin, lol. But with continued use, tolerance develops to the sedative effects of all benzodiazepines, leaving behind only the therapeutic effects (in most cases -- some people still experience memory impairment). Plus, the stimulant/tranquilizer combination which is so great for many social phobics prevents this side effect.
Posted by Franz on January 14, 2004, at 15:51:29
In reply to Buspar rocks! (nm) » Adam33, posted by Mimi on January 14, 2004, at 11:38:17
Posted by Metalblade on January 14, 2004, at 16:37:57
In reply to Please help me choose a Social Anxiety Med..., posted by Adam33 on January 14, 2004, at 7:57:34
I've come to the conclusion that my depression which I believe to be Bipolar II is the main problem behind my Social Phobia. I always do well when I first take an antidepressant but then it stops working. Some times it works too well, for instance, Effexor will make me manic. When I'm on that stuff I can talk to anyone but I do crazy reckless stuff on it too. Paxil Kind of makes me Hypomanic but then I quickly get depressed again. I have been Cycling Paxil for 2 years now constantly changing the dose up and down to keep it working. I tried lithium the other day. I bummed like 10 300mg pills off of someone I know that takes it.The lithium keep the Paxil working. I told my doctor this but anything I suggest he totally disagrees on. Its like he has some kind of doctor ego where he can only come up with Ideas and what I think doesn't matter. He just put me on an anti-psychotic called risperdal. Its making me even more depressed and slowing my thinking. I'm changing doctors and finding one that will listen to me. I read a post on here where someone said the key to beating Social Phobia is a controled Hypomania and I belive this to be true.
Posted by Mimi on January 14, 2004, at 17:49:31
In reply to Why? Re: Buspar rocks! (nm), posted by Franz on January 14, 2004, at 15:51:29
I have found Buspar to very effectively counteract social anxiety.
Also, Buspar alleviates the sexual side effects of other psych meds.
Two really good pluses.
Mimi
Posted by zeugma on January 14, 2004, at 19:26:43
In reply to Re: Why? Re: Buspar rocks! » Franz, posted by Mimi on January 14, 2004, at 17:49:31
> I have found Buspar to very effectively counteract social anxiety.
>
> Also, Buspar alleviates the sexual side effects of other psych meds.
>
> Two really good pluses.
>
> Mimi
Buspar at 30mg did nothing for my social anxiety.I twice tried to raise dosage above this to get an anti-SA effect but each time lowered the dosage because of questionable efficacy and unacceptable side effects.
Klonopin .25 mg does more for my anxiety than anything else I have tried. I still am socially anxious but to much less degree than before. And I am a true social phobic: unable to eat in front of others, hyper-sensitive to how I am perceived (I turn red very easily), dreading getting my hair cut because I hate the proximity of another person to me. Klonopin's mitigated all this, although I probably take too low a dosage to induce full remission.
From all the studies I've looked at, plus evidence from this board, Klonopin and Nardil are in a class by themselves for the treatment of severe social anxiety.
Posted by Mimi on January 14, 2004, at 19:42:45
In reply to Re: Why? Re: Buspar rocks!, posted by zeugma on January 14, 2004, at 19:26:43
> > I have found Buspar to very effectively counteract social anxiety.
> >
> > Also, Buspar alleviates the sexual side effects of other psych meds.
> >
> > Two really good pluses.
> >
> > Mimi
>
>
> Buspar at 30mg did nothing for my social anxiety.
>
> I twice tried to raise dosage above this to get an anti-SA effect but each time lowered the dosage because of questionable efficacy and unacceptable side effects.
>
> Klonopin .25 mg does more for my anxiety than anything else I have tried. I still am socially anxious but to much less degree than before. And I am a true social phobic: unable to eat in front of others, hyper-sensitive to how I am perceived (I turn red very easily), dreading getting my hair cut because I hate the proximity of another person to me. Klonopin's mitigated all this, although I probably take too low a dosage to induce full remission.
>
> From all the studies I've looked at, plus evidence from this board, Klonopin and Nardil are in a class by themselves for the treatment of severe social anxiety.
>
I'm hypersensitive to meds of all sorts, so the less strong meds works better for me. I can't argue with the fact that Klonopin works very well for many folks with SA and other disorders. My social anxiety was also severe.Mimi
Posted by zeugma on January 14, 2004, at 20:01:12
In reply to Re: Why? Re: Buspar rocks! » zeugma, posted by Mimi on January 14, 2004, at 19:42:45
> > > I have found Buspar to very effectively counteract social anxiety.
> > >
> > > Also, Buspar alleviates the sexual side effects of other psych meds.
> > >
> > > Two really good pluses.
> > >
> > > Mimi
> >
> >
> > Buspar at 30mg did nothing for my social anxiety.
> >
> > I twice tried to raise dosage above this to get an anti-SA effect but each time lowered the dosage because of questionable efficacy and unacceptable side effects.
> >
> > Klonopin .25 mg does more for my anxiety than anything else I have tried. I still am socially anxious but to much less degree than before. And I am a true social phobic: unable to eat in front of others, hyper-sensitive to how I am perceived (I turn red very easily), dreading getting my hair cut because I hate the proximity of another person to me. Klonopin's mitigated all this, although I probably take too low a dosage to induce full remission.
> >
> > From all the studies I've looked at, plus evidence from this board, Klonopin and Nardil are in a class by themselves for the treatment of severe social anxiety.
> >
>
>
> I'm hypersensitive to meds of all sorts, so the less strong meds works better for me. I can't argue with the fact that Klonopin works very well for many folks with SA and other disorders. My social anxiety was also severe.
>
> Mimi
>Mimi,
Wasn't trying to invalidate your experience at all, or imply that your SA was less severe than mine. the point I was trying to make is that Buspar is much less reliable as a med for SA than Klonopin or Nardil. I wish Buspar did work for my SA, because it has very few side effects (at 30 mg/day) and does have the pro-sexual effect you mention. i would recommend it much more highly as an adjunct to an AD (particularly a noradrenergic one such as Strattera- I think a lot of complaints of Buspar as 'ineffective' are actually due to its serotonin-modulating properties which may actually reduce the efficacy of an SSRI)than as an anxiolytic agent. But I am very happy that it works for you. SA is a miserable thing.
Posted by Mimi on January 14, 2004, at 21:14:33
In reply to Re: Why? Re: Buspar rocks!, posted by zeugma on January 14, 2004, at 20:01:12
Posted by Pam DaMonium on January 14, 2004, at 23:08:48
In reply to Please help me choose a Social Anxiety Med..., posted by Adam33 on January 14, 2004, at 7:57:34
The psychologist I saw at the Social Anxiety Institute only treats folks w/SAD. His first choice is Klonopin, my MD concurred, so that's what I took. (0.5 2 x day, I think). It worked very well for me - within 3 days, I was answering the 'phone & doorbell and going to public places again.
Of course, the REAL treatment was CBT. Happily, my SA is totally gone. (If you're interested, get more info at the Social Anxiety Institute's website.) Now, if only I could shake my general anxiety & dysthymia...
Posted by Viridis on January 14, 2004, at 23:49:00
In reply to Please help me choose a Social Anxiety Med..., posted by Adam33 on January 14, 2004, at 7:57:34
Klonopin is the "magic bullet" for most anxiety patients, although it may take a week or two to get over the sedating effects. People can say what they want, and everyone reacts differently etc., but in my opinion this has the greatest probability of long-term success with minimal or no side effects.
Posted by Franz on January 15, 2004, at 4:52:07
In reply to Re: Please help me choose a Social Anxiety Med..., posted by Ame Sans Vie on January 14, 2004, at 13:05:46
> Go with the Klonopin -- it is *the* gold standard for treatment of social phobia. Parnate and Nardil work for many, but are not as consistent and offer up a bit of inconvenience, what with the dietary/medication restrictions and all. I've been taking large doses of Klonopin (currently 8mg) every day for years; I feel it's literally saved my life. I don't find it to have a dulling effect, but the fact that I take 60mg of Adderall daily as well certainly helps keep me mentally capable. Then again, I never had cognitive problems from Klonopin during the years I took it before starting Adderall (and Adderall is a great social phobia med as well, combined with Klonopin -- the Klonopin eliminates anxiety and the Adderall provokes sociability).
Excellent point Ame!. it is not only lack of anxiety, but the promotion of sociability that is a problem.Each time I am more convinced that a good level of arousal or stimulation is needed to proper social interaction, desire to interact and not to feel fear.
Posted by Ame Sans Vie on January 15, 2004, at 6:51:27
In reply to sociability Re: Please help me choose a Social » Ame Sans Vie, posted by Franz on January 15, 2004, at 4:52:07
> > Go with the Klonopin -- it is *the* gold standard for treatment of social phobia. Parnate and Nardil work for many, but are not as consistent and offer up a bit of inconvenience, what with the dietary/medication restrictions and all. I've been taking large doses of Klonopin (currently 8mg) every day for years; I feel it's literally saved my life. I don't find it to have a dulling effect, but the fact that I take 60mg of Adderall daily as well certainly helps keep me mentally capable. Then again, I never had cognitive problems from Klonopin during the years I took it before starting Adderall (and Adderall is a great social phobia med as well, combined with Klonopin -- the Klonopin eliminates anxiety and the Adderall provokes sociability).
>
>
> Excellent point Ame!. it is not only lack of anxiety, but the promotion of sociability that is a problem.
>
> Each time I am more convinced that a good level of arousal or stimulation is needed to proper social interaction, desire to interact and not to feel fear.Exactly! I always used to shy away from stimulants because I was always told that they would invariably cause me horrific anxiety. I tried Ritalin when I was younger, and it certainly does not agree with me -- I feel very tense on it. And Wellbutrin caused very similar side effects, with the addition of horrible dry mouth. I'm just so glad that I finally decided to ask my doctor about trying an amphetamine in hopes that it would be gentler than Ritalin, and I was not let down. But of course, I wasn't taking Klonopin during my time on Ritalin years ago, so it could be the benzodiazepine which is preventing anxiety.
FWIW, Dexedrine was my first amphetamine, and I noticed it caused a slight amount of anxiety even with the Klonopin. It worked well though, and I stuck with the Spansules for a while, then switched to DextroStat because the Spansules weren't lasting as long as they should have been. But with DextroStat I was supposed to take 45mg/day, which meant 4.5 pills daily -- Medicaid will only pay for 100 amphetamine pills monthly, and even the extra $30 to get the full 135 pills was a big strain on my budget. So I briefly tried Desoxyn (methamphetamine), and while it was a truly wonderful med, its duration of action was ridiculously short (i.e. 2 hours). The extended-release Desoxyn Gradumets had been discontinued several years ago, but I was unaware that a new extended-release version, Desoxyn-CR was available, so I switched to Adderall XR. And lived happily ever after. :-)
Posted by Peoples on January 15, 2004, at 12:19:03
In reply to Re: sociability Re: Please help me choose a Social » Franz, posted by Ame Sans Vie on January 15, 2004, at 6:51:27
Xyrem, (Sodium Oxybate, or GHB) in the correct dosage is THE MAGIC BULLET for Social Phobia AND depression...think of the reduced anxiety of a benzo (yet even more completely anxiolytic) combined with the actual desire and drive to socialize of...well...I dont know of another med with that property (maybe ecstacy but i am NOT going to promote that one, hehe)
I have tried all others with at most 50% success. I wrote another post about this in the above thread about Social Phobia treaments, please read it with an open mind, as it was written by a fellow sufferer of this horrible, debilitating condition. And if you are ready for a real treament, find a compassionate doc willing to prescribe Xyrem off-label. It is the only thing that made my SP vanish, (along with CBT of course, as its the only true cure to the underlying malignant thought processes).Thank you, and good luck my friends
Peeps
Posted by miss amor on January 16, 2004, at 10:25:59
In reply to Re: sociability Re: Please help me choose a Social » Franz, posted by Ame Sans Vie on January 15, 2004, at 6:51:27
i would have to agree with everyone who has put in a vote for klonopin. i have been taking for several months (actually off and on for 2 years but now take daily) at a constant dosage of .5mg * 2x's daily or as needed. my doctor is open to me taking more during difficult times on my own regulation. I wish i would have had taken my medication regularly when i was in school, but i was uneducated on the effects of the medicine and scared basically to take it everyday. but now i have been taking regularly and have found it to help me in so many ways. it is the only med. i take beyond vitamins, efa's and proper sleep, workout and diet. whats so beautiful is the side effects to me are almost nonexistant and you never actually feel "medicated" or seem "medicated." not my experience with any ssri or the shorter life benzos as xanax. i have had my friends or family say whats wrong with you!!!
i have been very worried about addiction to klonopin, because ppl say it is strongest benzo in how it binds to something in your head very tightly? (i am not very familiar with all these terms, processes, ect.) and that has had me very worried. but my doc said i am causing myself more anxiety trying to understand all about meds and i should just take the medicicne and not worry. and yesterday i told my therapist some of my worries, and she restated what my doc said. so i am going to continue as it has helped me in so many ways. as for the drowsiness some ppl speak of, i am not certain that is entirely true (probably just individual) because i have a very full day, everyday. i work full time in advertising sales, i am writing a business plan, attending weekend real estate classes, work out, i have a puppy, friends, hobbies and could not be tired all the time.
its funny that you said you have ocd as well and are not worried about treating that as much. because that is my other dx. and i have always found it to be very much a big part of my personality. since i was young my friends and family have always teased me about ocd things and i knew of my own strange tendacies and thought patterns but just dealt with it. now that i know i am actually obsessive compulisive i am more aware of the way it affects my behavior. i have performed alot of cbt to myself, i think.
my point really is that when taking klonopin i have found when anxiety is less you actually obsess and compulse less as well. i think ocd is an anxiety disorder or they are related or something. anyway good luck to you and i hope any of my info helps.
miss amor
Posted by coral on January 16, 2004, at 15:29:32
In reply to Re: Why? Re: Buspar rocks!, posted by zeugma on January 14, 2004, at 20:01:12
No med is an absolute for everyone. My sister did very well w/Buspar but my husband suffered severe bradycardia (his heart rate dropped to below 30).
Posted by Adam33 on January 16, 2004, at 22:11:20
In reply to Please help me choose a Social Anxiety Med..., posted by Adam33 on January 14, 2004, at 7:57:34
I read all the posts, and decided to first try takin .5mg of Klonopin 2x a day (with propranolol just when needed). I was tired from it today, but I hope that my body will adjust. If that doesn't work, I'm going to try combining Klonopin with an SSRI, or maybe just try taking Buspar (since several people said it really helped them with SA). Anyway, I would like to thank each and every person who game me some imput. Its nice to get imput from people who realize how devastating these disorders can be!
This is the end of the thread.
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