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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 Tepiaca on December 1, 2005, at 17:33:36
Is Prozac the king of SSRIS ?
Has Lexapro taken the place of Prozac?Wich in your experience is better , Celexa , Paxil , Zoloft......
I would like to hear your opinion
Tep
Posted by linkadge on December 1, 2005, at 19:38:04
In reply to Which SSRIS is better for social anxiety ?, posted by Tepiaca on December 1, 2005, at 17:33:36
I have tried all the SSRI's, and the only one that had an effect on sociability was zoloft.
Linakdge
Posted by Tepiaca on December 1, 2005, at 20:30:59
In reply to Re: Which SSRIS is better for social anxiety ?, posted by linkadge on December 1, 2005, at 19:38:04
> I have tried all the SSRI's, and the only one that had an effect on sociability was zoloft.
>
> Linakdge
Link have you ever tried Nardil ?Tep
Posted by med_empowered on December 1, 2005, at 23:46:05
In reply to Re: Which SSRIS is better for social anxiety ? » linkadge, posted by Tepiaca on December 1, 2005, at 20:30:59
Paxil worked first time around, but my depression got worse (picture it: finally able to socialize, then going home and feeling suicidal, but strangely calm. Odd, very, very odd). Withdrawal was hell. Zoloft helped at the higher end (150mgs) but then stopped. Effexor wasn't very impressive. Celexa was OK, but nothing all that exciting, really. Tofranil was OK for depression, but made anxiety worse...also caused weight gain. Cymbalta didn't do much of anything, and withdrawal gave me insomnia for about a month.
Good luck!
Posted by Cairo on December 2, 2005, at 8:19:39
In reply to Which SSRIS is better for social anxiety ?, posted by Tepiaca on December 1, 2005, at 17:33:36
My teen daughter tried Celexa and Lexapro for SA. Lexapro improved socialbility, but she had problems with energy, apathy, cognition and memory on it. Switching to Zoloft improved all the above and it had a greater effect on socialbility. I believe it was the increased effect on dopamine of Zoloft that helped. Improved socialbility maxed out at 75mg.
Adding Seroquel, an atypical antipsychotic, improved socialbility and sleep even further. No problems with daytime drowsiness at 12.5mg when it's taken at night.
I'd still like to add something for confidence, but we're not doing too badly. She is continuing individual CBT with exposure therapy and a teen group.
Our experience with her is that CBT by itself did nothing. We needed the correct meds to give her a leg up to start with. And exposure to situations in the community and with people has been critical for our success so far.
Awhile back we tried Librium, also chosen for it's increased dopamine effect; we needed it as immediate help for school refusal issues, but she didn't like the idea of a prn med. With her, the once a day dosing took away the feeling of "I can't socialize unless I take a med".
Haven't tried adding propranolol as an adjunct to an SSRI, as we're still playing with the Seroquel dose.
No one will discuss using MAOIs with a teen.
As to which SSRI is best for SA, I'd say it depends on your individual neurological makeup. What works for one may not work for another. I always suspected that dopamine might be a critical factor due to family history of other diseases.
Cairo
>
> Is Prozac the king of SSRIS ?
> Has Lexapro taken the place of Prozac?
>
> Wich in your experience is better , Celexa , Paxil , Zoloft......
>
> I would like to hear your opinion
>
> Tep
Posted by linkadge on December 2, 2005, at 10:50:23
In reply to Re: Which SSRIS is better for social anxiety ? » linkadge, posted by Tepiaca on December 1, 2005, at 20:30:59
No, I tried parnate, but not nardil.
I have not been diagnosed with social phobia. When I am depressed I don't talk to people. Zoloft was the only one that made a difference in my desire to connect to people. The others actually had a negative impact in this area. Ie celexa made me terrably antisocial.
Linkadge
Posted by theo on December 3, 2005, at 10:25:40
In reply to Which SSRIS is better for social anxiety ?, posted by Tepiaca on December 1, 2005, at 17:33:36
Paxil, hands down in the SSRI class, although, Paxil hits norepinephrine pretty good and think that's why. All others in this class raised my social anxiety and made me jumpy.
Posted by blueberry on December 3, 2005, at 17:11:56
In reply to Which SSRIS is better for social anxiety ?, posted by Tepiaca on December 1, 2005, at 17:33:36
In literature I believe zoloft and paxil would come up the winners for social anxiety, with lexapro close behind. We all respond differently though. Any of them could work. All of them have decreased social anxiety for me except lexapro, which made me relaxed but just not wanting to be around anyone. If someone's chemistry needs just a little norepinephrine tweeking, then paxil. If it needs just a little dopamine tweeking, then zoloft. If it is pure serotonin, then lexapro. On the other hand, there are plenty of clinical studies that show pure norepinephrine meds like reboxetine work best. Go figure. Trial and error.
Posted by med_empowered on December 3, 2005, at 18:32:18
In reply to Re: Which SSRIS is better for social anxiety ?, posted by blueberry on December 3, 2005, at 17:11:56
yeah...social anxiety is a kind of odd disorder, and there are so many varying degrees of it..you have mild social avoidance to total reclusiveness and selective mutism. My personal advice would that if you're going with an SSRI, start with Paxil--its the standard treatment it seems, and it works OK. If you take the normal (not CR) version, you might want to split the tab and take it 2X daily, since the half-life is so short (same goes for celexa). Benzos are a good choice if you're unable to leave your house or otherwise pretty severely handicapped by this, at least in the short-term. Ideally, you could do 4 weeks or less of benzos while an AD starts to work. Some people need extended treatment...if that happens, Klonopin would probably be the tranquilizer of choice.
BuSpar isnt great for social anxiety, but it does help reduce SSRI side effects, boost the AD response, and reduce overall tension...for *some* people, this improves the overall picture (mood and anxiety symptoms and side effects). Be warned..about 10% of people who take BuSpar end up discontinuing it b/c of side effects.
Personally, I hate antipsychotics, but some people with social phobia like them, so that could be an option. Benzos and AD should probably be used before antipsychotics, though.
Finally, self-help and/or therapy/couneslling can be tremendously helpful. Please pursue something along these lines.
Posted by Iansf on December 4, 2005, at 17:43:36
In reply to Which SSRIS is better for social anxiety ?, posted by Tepiaca on December 1, 2005, at 17:33:36
> Is Prozac the king of SSRIS ?
> Has Lexapro taken the place of Prozac?
>
> Wich in your experience is better , Celexa , Paxil , Zoloft......
>
> I would like to hear your opinion
>
> TepBoth Prozac and Luvox worked very well for me for social anxiety, as well as depression, but their side effects were not welcome. Celexa, Lexapro and Citalopram were no help at all for either social anxiety or depression.
This is the end of the thread.
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