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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Adam33 on January 17, 2004, at 3:18:24
Hello,
I suffer from performance anxiety/SA, and after getting some guidance in an earlier post, have gotten on Klonopin. I know this will probably work for me since Xanax was pretty effective in treating my performance anxiety (which I took as needed). I want to use Klonopin because it seems like it’s a better drug to take consistently than Xanax (taking the Xanax only as needed didn’t help with my “worrying” about my upcoming performances).I predict that the Klonopin will help keep my SA down generally, but expect I will still need to “load up” prior to big performances (and hope I don’t get too dumbed down). So here’s my question: If I were to combine the Klonopin with a SSRI, do you think that it would keep me from getting that giant surge of anxiety before a performance better than just taking the Klonopin alone? If so, is there a recommended SSRI for SA (particularly performance anxiety)? I did try Paxil CR for a few weeks, but wasn’t on it long enough to feel the difference due to the anorgasmic effect it gave me. My doctor thought maybe Lexapro, and I’ve heard people from this forum praise Effexor’s anti-anxiety effects? Wellbutrin comes up a lot in the context of an SSRI with low risk of sexual side effects, I don’t hear it praised for its effect on SA.
Thanks in advance for any guidance!
Posted by sb2 on January 17, 2004, at 10:59:44
In reply to What's the best SSRI for SA/Performance Anxiety?, posted by Adam33 on January 17, 2004, at 3:18:24
> Hello,
> I suffer from performance anxiety/SA, and after getting some guidance in an earlier post, have gotten on Klonopin. I know this will probably work for me since Xanax was pretty effective in treating my performance anxiety (which I took as needed). I want to use Klonopin because it seems like it’s a better drug to take consistently than Xanax (taking the Xanax only as needed didn’t help with my “worrying” about my upcoming performances).
>
> I predict that the Klonopin will help keep my SA down generally, but expect I will still need to “load up” prior to big performances (and hope I don’t get too dumbed down). So here’s my question: If I were to combine the Klonopin with a SSRI, do you think that it would keep me from getting that giant surge of anxiety before a performance better than just taking the Klonopin alone? If so, is there a recommended SSRI for SA (particularly performance anxiety)? I did try Paxil CR for a few weeks, but wasn’t on it long enough to feel the difference due to the anorgasmic effect it gave me. My doctor thought maybe Lexapro, and I’ve heard people from this forum praise Effexor’s anti-anxiety effects? Wellbutrin comes up a lot in the context of an SSRI with low risk of sexual side effects, I don’t hear it praised for its effect on SA.
>
> Thanks in advance for any guidance!
>sure a ssri will work. just depends on how you react to them. welbutrin will probably make you a little to nervous. personaly i think something like celexa will work however sexual side effects come with the good benefits. personally i tried effexor and got off of it in 1 week. if you just need a little help st johns wort seems to work well with klonopin with no sexual side effects.
Posted by geralyn on January 18, 2004, at 18:59:15
In reply to What's the best SSRI for SA/Performance Anxiety?, posted by Adam33 on January 17, 2004, at 3:18:24
I have the same problem. I tried Effexor and it definitely reduced anxiety generally, but still needed xanax or similar before a performance. Side effects of Effexor are tough to take, so I switched to Lexapro. I'm only on 10 mg and I feel some benefit, not quite as good as on Effexor, but might be when I get up to 20 mg. I would give an SSRI a try; avoid Wellbutrin, which is not in the SSRI class - no anti-anxiety effect. If fact, it will make you jittery.
Posted by Adam33 on January 18, 2004, at 21:21:06
In reply to Re: What's the best SSRI for SA/Performance Anxiety?, posted by geralyn on January 18, 2004, at 18:59:15
Do you prefer xanax or Klonopin prior to a performance?
> I have the same problem. I tried Effexor and it definitely reduced anxiety generally, but still needed xanax or similar before a performance. Side effects of Effexor are tough to take, so I switched to Lexapro. I'm only on 10 mg and I feel some benefit, not quite as good as on Effexor, but might be when I get up to 20 mg. I would give an SSRI a try; avoid Wellbutrin, which is not in the SSRI class - no anti-anxiety effect. If fact, it will make you jittery.
Posted by Kon on January 18, 2004, at 21:54:16
In reply to What's the best SSRI for SA/Performance Anxiety?, posted by Adam33 on January 17, 2004, at 3:18:24
If klonopin works, why even bother adding on an SSRI and risk the side-effects? If you need an extra boost during performing situations, why not up the klonopin dosage or even add Xanax?
Posted by Alex2 on January 19, 2004, at 0:22:42
In reply to Re: What's the best SSRI for SA/Performance Anxiety?, posted by Kon on January 18, 2004, at 21:54:16
I am with Kon; if you don't need an SSRI and your doc is willing to prescribe Klonopin on an ongoing base, I'd just go with that.
While SSRIs, especially Paxil, are great for SA, they have side effects of their own, that might outweigh their benefit. In my case, Paxil has helped tremendously for PD as well as depression; however, it is causing extreme sleepiness, disinterest in sex, flattening of emotions, a-motivation, weight gain. I have tried Prozac and Zoloft - way to agitating; Celexa - didn't work; Wellbutrin, while not an SSRI - even more agitating. I have also tried Xanax and Klonopin in combination with an AD and on its own.
Xanax and Klonopin are great meds to reduce extreme anxiety. I also think that there side effect profile is much better. On a low dose I experienced some tiredness, but my body eventually adjusted. A word of caution - both of these meds are addictive, which means when taken on a regular basis, you can't stop them abruptly.
BTW, SSRIs are supposedly non-addictive drugs, yet a weaning-off process is recommended to avoid extreme withdrawal effects.
Posted by Viridis on January 19, 2004, at 2:47:53
In reply to Re: What's the best SSRI for SA/Performance Anxiety?, posted by Alex2 on January 19, 2004, at 0:22:42
Benzodiazepines like Klonopin and Xanax are great for anxiety, and they're rarely addictive -- people do become dependent on them and have to taper off slowly, but some of the most commonly-prescribed antidepressants (especially Paxil) are even worse in this respect. For some reason (probably because most ADs are, or were until recently, still under patent), the term "discontinuation syndrome" is used instead. But it's really no different than benzos or many other drugs.
True addiction is the situation in which you crave a substance, escalate doses, use it in a way that causes harm, and so on. Benzos rarely fit this profile for those who need them, and have a much longer track record of safety than SSRIs and other newer antidepressants.
Posted by Alex2 on January 19, 2004, at 2:59:24
In reply to Re: What's the best SSRI for SA/Performance Anxiet » Alex2, posted by Viridis on January 19, 2004, at 2:47:53
Viridis,
I agree with you. I thought that's what my post expressed as well. Maybe wrong choice of words - I should have used "dependend" instead of "addicted."
Posted by Adam33 on January 19, 2004, at 15:37:55
In reply to Re: What's the best SSRI for SA/Performance Anxiety?, posted by geralyn on January 18, 2004, at 18:59:15
You all seem like you have good insight into SA drugs, so I was hoping (or anyone else who reads this) will take a look at a follow up question I just posted (on Jan, 19 1:40pm PT)
THANKS!!
Posted by Geralyn on January 19, 2004, at 22:13:56
In reply to Question for Geralyn, posted by Adam33 on January 18, 2004, at 21:21:06
never tried Klonopin (but I will now). I usually take Ativan (lorazepam), which works great to relieve anxiety, but a day later I can't remember what I did or said during the performance.
Posted by Adam33 on January 19, 2004, at 23:55:36
In reply to Re: Question for Geralyn, posted by Geralyn on January 19, 2004, at 22:13:56
I think you will like Klonopin. I haven't used Ativan, but I have taken Xanax plenty, and I seem to feel much less fuzzy on Klonopin (during the short period I have been on it). I am hoping to start Lexapro (in combonation with Klonopin) next week, so I hope that goes well.
Good luck
> never tried Klonopin (but I will now). I usually take Ativan (lorazepam), which works great to relieve anxiety, but a day later I can't remember what I did or said during the performance.
Posted by theo on January 20, 2004, at 19:07:09
In reply to Re: What's the best SSRI for SA/Performance Anxiety?, posted by geralyn on January 18, 2004, at 18:59:15
This is the end of the thread.
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