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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 3 Beer Effect on January 23, 2005, at 23:17:36
I have social phobia & I used to take ADD meds to help me study in college. In my experience the only dopaminergics that reduce social phobia are the amphetamines, especially Dextrostat (Adderall causes more anxiety because it contains l-amphetamine salts that release norepinephrine). I have a theory that this may be in part because amphetamines release some serotonin in addition to dopamine. But amphetamines are not a long term solution because eventually they cause depression from depletion of dopamine. Also, Dextrostat is not innocuous - it is a powerful drug that can send you in a socially dysfunctional spiral if you abuse it.
It appears on paper that Selegeline at 5-10 mg per day might be the answer to social phobia. There is a dopaminergic theory of Social Phobia & since Selegeline increases dopamine you would think it would work. But I assure you this is NOT the case. It causes terrible anxiety (partially from the fact that it is metabolized to the bad l-amphetamines that release norepinephrine). It also causes the worst dry mouth ever, which makes your breath smell bad which does not help social phobia! It also causes sweating in social situations or if you are stressed at work or it is simply warm in the room. It is not good to shake people´s hands when they are all sweaty & if you are sweaty all the time, people think you are a weirdo.
Ritalin & also Wellbutrin make social phobia worse & studies of Ritalin in rats support this idea. In fact Ritalin seems to make you, to put it crudely "socially retarded/nerdy". In fact I think all dopamine reuputake inhibitors share this trait, (I noticed that cocaine, also a dopamine reuptake inhibitor increases anxiety in a manner similar to Ritalin, although it may increase confidence, but cocaine users are usually also drunk while using to reduce the negative/anxiety producing effects.) On the other hand Dopamine releasers like dextroamphetamine/methamphetamine or serotonin releasers such as Ecstacy decrease social phobia. Meth in lower non-paranoia producing doses seems to cause a talkativeness that almost is on par with drunkeness as a cure for social phobia. But of course you will soon become a scarecrow, & a paranoid socially dysfunctional (with dyskinesias & nervous ticks) person soon if you use that stuff. Also, it causes rapid dialation & constriction of the pupils which causes hallucinations & the appearence that things such as people on the posters on your wall are talking & moving. Very scary stuff (although it is safer than Cocaine because it doesn´t raise your blood pressure as much, while 1.2 grams of pure cocaine will kill you- instead of dying of meth overdoses people usually go crazy first & become violent and/or do crazy things like climb up telephone polls (watch the TV show COPS for examples - Meth is a serious problem in this country, especially in the midwest & in California.)
The only real long term cure for social phobia are the SSRIs (i´ve had success with Zoloft 100 mg or Prozac 20 mg). Also the MAOIs Nardil & Parnate are said to work even better than the SSRIs (although i´ve never tried them & most doctors are afraid of prescribing them). Either that or you could drink in social situations, which to tell the truth, alcohol is still the best social phobia medication out there. But that will eventually cause depression, among other problems, too.
Perhaps one day they will find a medicine that duplicates alcohol´s many positive effects on the problem of shyness without its inherent problems on memory, depression, & "dumb drugness". Alcohols effects are wide ranging though, releasing Serotonin, Dopamine, increasing glutamine, potentiating GABA, & evening affecting opoid receptors. To duplicate those effects you would have to be on a cocktail of an SSRI + Dextrostat + Klonopin or barbituate or GABA increasing anticonvulsant (Gabitril?), + long acting opoid agonist like methadone. If you took such a combo you probably couldn´t even remember your name, let alone drive or go to work! It would sure make you feel good though!
I think there may be an overlooked connection between histamine release & social phobia. Social Phobics tend to blush easily which is said to be a histamine reaction. So there may be some connection to either excessive histamine release or a hypersensitivity to its effects. Also, Benadryl tends to slightly alleviate social anxiety (although it is a "dumb drug").
Cheers,
3 Beer Effect
Posted by medhed on January 24, 2005, at 2:18:41
In reply to Dopamine may be overated in Social Phobia!, posted by 3 Beer Effect on January 23, 2005, at 23:17:36
GHB. but the government was afraid we might feel good. but really, not abused and taken occasionally, this is the drug you are talking about. i'm just afraid to make my own... and it's now a schedule I controlled substance in the U.S. i always thought alcohol was the no.1 date drug. oh yeah, did you hear mmda can kill you...NOT.
Posted by TheOutsider on January 24, 2005, at 4:56:31
In reply to Re: Dopamine may be overated in Social Phobia!, posted by medhed on January 24, 2005, at 2:18:41
> GHB. but the government was afraid we might feel good. but really, not abused and taken occasionally, this is the drug you are talking about.
Yes GHB is the best drug (in my experience) for Social Anxiety, it ehances GABA function and is also elevates seratonin and dopamine receptor expression (D2 and 3 I think).
It is not completely benighn, but its a lot safer than alchohol, even a little alchohol makes me depressed!
Posted by banga on January 24, 2005, at 7:27:39
In reply to Re: Dopamine may be overated in Social Phobia!, posted by TheOutsider on January 24, 2005, at 4:56:31
In terms of dopamine depletion--could you not take amino acids to lessen this effect, replete the stores? I know it is not as simple as that--take them and POP you have more dopamine, but still, it must affect levels a little is taken frequently.....
Posted by Optimist on January 24, 2005, at 11:15:05
In reply to Dopamine may be overated in Social Phobia!, posted by 3 Beer Effect on January 23, 2005, at 23:17:36
To prevent dopamine depletion could you not supplement with tyrosine or phenylalanine? I use tryosine with my Adderall and haven't experienced tolerance what so ever. I've been on Adderall for 5 months and use it for atypical/dysthymia depression.
Taking amphetamines in low non-abusable doses will not cause paranoia or any other movement disorders I was under the impression of. Would not low non-abusable doses of methamphetamine be a useful treatment of social phobia then if it doesn't have as much of the unwanted norepinephrine anxiety effects?
What about the dopamine reuptake inhibitor Amineptine, or dopamine agonists Cabergoline and Bromocriptine among others? I'm sure they don't have the peripheral side effects from heightened norephinephrine as you describe. So it's not really the problem with dopamine not being effective with social phobia, it's the adverse effects of norepinephrine am I not correct?
I find alcohol exacerbates my social anxiety. The primary reason is probably that it lowers my blood sugar and I get the accompaning irritability, withdrawn, shyness, and depression that follows.
My best results with social phobia have been the herbal dopamine agonist Vitex(Agnes Cactus). It was extrememly robust and 100% elimated any social anxiety but sadly pooped out which I've heard dopamine agonists are famous for. So I'm venturing on to Parnate in hope of a more sustained prodopamine effect without the residual anxiety of Wellbutrin or Adderall that I'm currently taking.
3 Beer Effect, have you ever takin a dopamine agonist before? I'd be curious with your results.
Brian
Posted by sfy on January 24, 2005, at 11:25:24
In reply to Dopamine may be overated in Social Phobia!, posted by 3 Beer Effect on January 23, 2005, at 23:17:36
> I have social phobia & I used to take ADD meds to help me study in college. In my experience the only dopaminergics that reduce social phobia are the amphetamines, especially Dextrostat (Adderall causes more anxiety because it contains l-amphetamine salts that release norepinephrine). I have a theory that this may be in part because amphetamines release some serotonin in addition to dopamine. But amphetamines are not a long term solution because eventually they cause depression from depletion of dopamine. Also, Dextrostat is not innocuous - it is a powerful drug that can send you in a socially dysfunctional spiral if you abuse it.
As always, YMMV. Dextrostat (dextroamphetamine) had absolutely no effect on my Social Phobia.
>
> It appears on paper that Selegeline at 5-10 mg per day might be the answer to social phobia. There is a dopaminergic theory of Social Phobia & since Selegeline increases dopamine you would think it would work. But I assure you this is NOT the case. It causes terrible anxiety (partially from the fact that it is metabolized to the bad l-amphetamines that release norepinephrine). It also causes the worst dry mouth ever, which makes your breath smell bad which does not help social phobia! It also causes sweating in social situations or if you are stressed at work or it is simply warm in the room. It is not good to shake people´s hands when they are all sweaty & if you are sweaty all the time, people think you are a weirdo.Again, my experience with low dose Selegiline differs. While it didn't have any noticeable positive effects, I also didn't suffer from any side effects at all while on it. (I don't know if taking it with DL-phenylalanie made any difference.)
> The only real long term cure for social phobia are the SSRIs (i´ve had success with Zoloft 100 mg or Prozac 20 mg). Also the MAOIs Nardil & Parnate are said to work even better than the SSRIs (although i´ve never tried them & most doctors are afraid of prescribing them). Either that or you could drink in social situations, which to tell the truth, alcohol is still the best social phobia medication out there. But that will eventually cause depression, among other problems, too.
>The SSRI's have done little to nothing for my social phobia. Nardi, in conjunction with Klonopin, did have a noticeable positive effect (with little reason to fear).
Posted by JayDee on January 24, 2005, at 17:01:19
In reply to Re: Dopamine may be overated in Social Phobia!, posted by sfy on January 24, 2005, at 11:25:24
Adderall helps with SP, alot.
So does Hydrocodone.
I don't know if the prozac helped or not. (been on it a few months)
Posted by Rick on January 25, 2005, at 2:36:06
In reply to Re: My personal experience says otherwise..., posted by Optimist on January 24, 2005, at 11:15:05
> I find alcohol exacerbates my social anxiety. The primary reason is probably that it lowers my blood sugar and I get the accompaning irritability, withdrawn, shyness, and depression that follows.
Interesting. I was beginning to think I was unique in terms of an *increased* susceptibility to breakthrough social anxiety symptoms after drinking -- although my own post-imbibing reactions are milder than you describe...mainly things like a bit of voice quavering if I feel I'm being scrutinized. Your hypoglycemic-reaction theory sounds plausible.
Posted by Optimist on January 25, 2005, at 11:14:59
In reply to Re: My personal experience says otherwise... » Optimist, posted by Rick on January 25, 2005, at 2:36:06
The intolerance to alcohol is probably a good thing since my father, sister, and aunt are alcoholics.
I've wrote before about how Prozac eliminated all my hypoglycemic symptoms. I could drink alcohol and feel like what everyone else must feel. More uninhibited, social, fun. I didn't get carried away with it, but drinking was much more enjoyable then.
Brian
This is the end of the thread.
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