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Dr. Bob is Robert Hsiung, MD,
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Posted by naughtypuppy on October 27, 2006, at 5:46:14
In reply to Re: Treatment Resistant Social Anxiety! » Tom Twilight, posted by christophrejmc on October 27, 2006, at 4:17:35
> I'm in the same situation--nothing seems to work. If you're doing okay on 75mg, you should consider increasing the dose--many people have needed much higher doses to get results.
>
> I'm also quite interested in D-cycloserine but I know that my doctor wouldn't even consider prescribing it.
>
> The only thing that seems to help for me is Ambien, which seems to cause a complete personality change. But it also leads to a lot of embarrassing behavior.Speaking of embarassing behavior, Nardil gives me such bad gas that I don't even want to be in public sometimes. I smell like I just won the world egg and beer eating contest. How's that for a social anxiety situation. Anybody else have this problem. Plus it's probably the foulest tasting med ever devised.
Posted by naughtypuppy on October 27, 2006, at 5:50:20
In reply to Re: Treatment Resistant Social Anxiety! » naughtypuppy, posted by jedi on October 26, 2006, at 10:52:47
> > I really don't know how you people manage to do it. I tried Nardil at 75mg for about a month and the hypotension was so bad I was blacking out several times a day. It felt like a puppet that had it's strings randomly cut, I fell down so many times. The hypotension is starting to come back a little at 60 mg and the social phobia is starting to increase. May I'm just not cut out for Nardil but everything else is useless.
>
> Hi,
> When I first started Nardil 10+ years ago I had quite a bit of orthostatic hypotension. At the time I was mixing it with trazodone, which can also cause hypotension. I have zero hypotension now, even at high dosages. Watch your drug combinations.
> Take care,
> Jedi
>
>
>I know what you mean with the trazodone. It makes the hypotension much worse for me, plus I get really spaced out until mid afternoon. I am currently taking 1000mg Valproate as well, but I don't think that should be a problem.
Posted by naughtypuppy on October 27, 2006, at 5:54:31
In reply to Re: Treatment Resistant Social Anxiety! » naughtypuppy, posted by Crazy Horse on October 26, 2006, at 11:29:04
> > I really don't know how you people manage to do it. I tried Nardil at 75mg for about a month and the hypotension was so bad I was blacking out several times a day. It felt like a puppet that had it's strings randomly cut, I fell down so many times. The hypotension is starting to come back a little at 60 mg and the social phobia is starting to increase. May I'm just not cut out for Nardil but everything else is useless.
>
> Let's face it ALL MAOI's have mega side effects. I have never heard of or met one person who was on Nardil or Parnate (Two of the most effective MAOI's which are both power house AD's) that didn't have very troubling side effects, i.e. insomnia, fatigue, weight gain, hypotension, dizziness, night jerks, ears ringing, and many more. They are so effective for depression, anxiety, social anxiety, but who can live with the side effects. I tried but couldn't!
>
> -Monte
Usually I will put up with quite a bit when it comes to side efects, but this dosen't seem to be all that effective. Of course life circumstanses are extreamly intense at the moment and no pill will alleviate that.
Posted by tgo on November 1, 2006, at 0:43:43
In reply to Re: Treatment Resistant Social Anxiety! » Crazy Horse, posted by naughtypuppy on October 27, 2006, at 5:54:31
I tried cycloserine. Worked great the first time I took it, then nothin after that. It only lasted for 2-3 hours anyway. Don't waste your money. It doesn't work!
Posted by tgo on November 1, 2006, at 0:45:33
In reply to Treatment Resistant Social Anxiety!, posted by Tom Twilight on October 25, 2006, at 12:34:58
I would really be interested in finding out if anyone has had any luck for SA without weight gain. I'm about to give up hope of ever leading a normal life. Already put on 50 lbs with paxil, which I haven't been able to lose.
Posted by Cairo on November 1, 2006, at 13:35:46
In reply to Treatment Resistant Social Anxiety!, posted by Tom Twilight on October 25, 2006, at 12:34:58
Have you ever tried exposure therapy for your social anxiety? Cognitive behavioral therapy worked only so-so with my teen daughter who has SA, but working with a therapist who made her go out to stores, the mall, answer the phone, call people up, go to a restaurant and speak up when she didn't like something, made a big difference for her. We need to constantly reinforce, but she's improved alot. CGT gave the knowledge of what to do, but she had to go out and DO it for it to work.
I attended a SA conference last year and the keynote speaker emphasized exposure therapy. When he asked the psychologists in the room who did exposure therapy with their SA patients, only two raised their hands.
She's on Zoloft 75mg plus 6.25mg Seroquel. Zoloft works far better for her SA than Lexapro did, and Seroquel is a good adjunct for SA for her.
Good luck.
Cairo
> I've got treatment resistant Social Anxiety :(
>
> Its really frustrating because I've tried so many things, and nothing works long term.
>
> I'm currently on Nardil 75mg, the "Gold Standard"
>
> Its helping GAD, but does nothing for SA.
>
> I worry about becoming deppendent on Benzo's and they don't do much either.
>
> Only opiates seem to help, its strange odd
>
> I don't know were all the social phobics have gone on babble!
> Should I push the Nardil up to 90mg?
> Is D-cycloserine worth trying?
Posted by tgo on November 3, 2006, at 11:25:00
In reply to Re: Treatment Resistant Social Anxiety!, posted by Cairo on November 1, 2006, at 13:35:46
> Have you ever tried exposure therapy for your social anxiety? Cognitive behavioral therapy worked only so-so with my teen daughter who has SA, but working with a therapist who made her go out to stores, the mall, answer the phone, call people up, go to a restaurant and speak up when she didn't like something, made a big difference for her. We need to constantly reinforce, but she's improved alot. CGT gave the knowledge of what to do, but she had to go out and DO it for it to work.
>
> I attended a SA conference last year and the keynote speaker emphasized exposure therapy. When he asked the psychologists in the room who did exposure therapy with their SA patients, only two raised their hands.
>
> She's on Zoloft 75mg plus 6.25mg Seroquel. Zoloft works far better for her SA than Lexapro did, and Seroquel is a good adjunct for SA for her.
>Has she had any weight gain on the zoloft and seroquel?
Posted by kingcolon on November 7, 2006, at 11:49:55
In reply to Treatment Resistant Social Anxiety!, posted by Tom Twilight on October 25, 2006, at 12:34:58
I also have TR SA; Nardil worked for 6 months. I've also got TRD and am augmenting Cymbalta and Lamictal with Requip for its dopamine agonism. I've found the latter makes me more assertive. But here's a wild card--my sleep was poor and I wake with lots of anxiety and I have not responded to Seroquel or trazodone, and have a history of substance abuse many years ago, so my doc and I decided to try low dose baclofen. It's an old drug used for muscle spasms, but is mildly sedating and anxiolytic, and is now being intensely studied in alcohol, cocaine and opiate addiction prevention of relapse. It is not addictive, although you have to taper it slowly to avoid a discontinuation syndrome. It resembles phenibut and GHB in that it stimulates GABA B receptors. I've used GHB in the past and found it helped my social anxiety better than anything (phenibut makes me ill). Since starting baclofen, 20 mg for sleep, I find I am less anxious and get back to sleep better, and that the effect carries over into the day, with less general anxiety and improved social anxiety. I wonder if more research should be done on use of this agent in anxiety disorders, and SA in particular.
Anybody used baclofen?
Posted by ed_uk on November 7, 2006, at 14:06:03
In reply to Re: Treatment Resistant Social Anxiety!, posted by kingcolon on November 7, 2006, at 11:49:55
Interesting idea.
Has anyone else tried this drug for social phobia?
Ed
Posted by kingcolon on November 7, 2006, at 17:21:34
In reply to Baclofen (Lioresal) for social anxiety, posted by ed_uk on November 7, 2006, at 14:06:03
> Interesting idea.
>
> Has anyone else tried this drug for social phobia?
>
> EdAs an addendum to my previous post, I took 10 mg of baclofen today prior to a meeting I had, and felt much less anxious than usual, and even was a touch more assertive. It just seemed to make things feel less tension provoking. I also noticed a better energy level the rest of the day--not really a maniky feeling (which I've experienced before) but a feeling of wanting to get out and do things.
Posted by ed_uk on November 7, 2006, at 17:39:42
In reply to Re: Baclofen (Lioresal) for social anxiety, posted by kingcolon on November 7, 2006, at 17:21:34
That's good news - I hope it continues to help :)
Ed
Posted by sdb on November 8, 2006, at 11:36:28
In reply to Re: Baclofen (Lioresal) for social anxiety, posted by kingcolon on November 7, 2006, at 17:21:34
I once took Baclofen (Lioresal) because of a neurological problem. I had strange dreams during sleep and strange thoughts during the day. It did not help the somatic problem nor I had the impression that it could help for a mental disease.
But if it seems to work for you go further on to test that cautiously.sdb
Posted by ed_uk on November 8, 2006, at 16:34:48
In reply to Baclofen (Lioresal) for social anxiety}} kingcolon, posted by sdb on November 8, 2006, at 11:36:28
Hi S!
>strange thoughts during the day
What sort of thoughts?
Ed
Posted by kingcolon on November 8, 2006, at 17:30:52
In reply to Re: Baclofen (Lioresal) for social anxiety}} kingcolon » sdb, posted by ed_uk on November 8, 2006, at 16:34:48
> Hi S!
>
> >strange thoughts during the day
>
> What sort of thoughts?
>
> EdThe only strange thoughts I've had so far are that I might like to go out and be with people!
Still seems to reduce my fear.From the sparse response to far, seems like there's not a lot of experience with this drug. Doesn't surprise me. Psychiatrists are only now getting interested in it again for addiction disorders, and, from my research, there's nothing on SA; there is one study on PTSD however:
Posted by sdb on November 9, 2006, at 16:09:34
In reply to Re: Baclofen (Lioresal) for social anxiety}} kingcolon » sdb, posted by ed_uk on November 8, 2006, at 16:34:48
Hi ed!
It was quite a long time ago. But I remember that I had some strange dreams maybe even nightmares.
During the day I felt strange but I don't remember exactly what thoughts I had or if there really were thoughts. But after all I am glad that I can't give an exact answer.kind regards
~S
> Hi S!
>
> >strange thoughts during the day
>
> What sort of thoughts?
>
> Ed
Posted by ed_uk on November 9, 2006, at 16:26:05
In reply to Re: Baclofen (Lioresal) for social anxiety}} ed, posted by sdb on November 9, 2006, at 16:09:34
Thank you for the info :) Baclofen has been reported to cause psych side effects for some people.
Regards
Ed
Posted by Quintal on November 11, 2006, at 17:04:31
In reply to Baclofen (Lioresal) for social anxiety, posted by ed_uk on November 7, 2006, at 14:06:03
> Interesting idea.
>
> Has anyone else tried this drug for social phobia?
>
> EdI once took some baclofen that I happened to have lying around to help with social anxiety during clonazepam withdrawal. I think it did relax me slightly, which was good and the most that could reasonably be expected considering I was going cold turkey from 4mg Rivotril.
I have never used it as a monotherapy while stable so cannot comment on its effectiveness for that. I too have used GHB, barbiturates, picamilon etc and found them generally either ineffective or inefficient, or both, compared to benzos.
I am now trying to convince my GP to let me try pregabalin (Lyrica) but she is dragging her heels. I'm thinking it may be more efficient than baclofen et al, but obviously more expensive and perhaps unobtainable for those who have to consider insurance restrictions?
Posted by sdb on November 15, 2006, at 13:36:52
In reply to Re: Baclofen (Lioresal) for social anxiety, posted by Quintal on November 11, 2006, at 17:04:31
Hi ed!
Yes, these types of side effects are mentioned in literature.
As far as I remember I had only the psych side effects written above but nothing else.
To be precise I took the baclofen for a somatic problem not for a psych problem. I can't say if it had any positive effects on mood or whatever.
Hope heartily you're well
~S
p.s. listen still to albinoni
Posted by ed_uk on November 15, 2006, at 15:42:16
In reply to Re: Baclofen (Lioresal) for social anxiety }} Ed, posted by sdb on November 15, 2006, at 13:36:52
>listen still to albinoni
Excellent :) I hope it is bringing you health S :)
Ed
Posted by ed_uk on November 15, 2006, at 15:42:26
In reply to Re: Baclofen (Lioresal) for social anxiety }} Ed, posted by sdb on November 15, 2006, at 13:36:52
>listen still to albinoni
Excellent :) I hope it is bringing you health S :)
Ed
Posted by ed_uk on November 15, 2006, at 15:43:11
In reply to Re: Baclofen (Lioresal) for social anxiety, posted by Quintal on November 11, 2006, at 17:04:31
Hi Q
Which barbiturate did you try? What was your experience?
Ed
Posted by Quintal on November 15, 2006, at 16:32:08
In reply to Re: Baclofen (Lioresal) for social anxiety » Quintal, posted by ed_uk on November 15, 2006, at 15:43:11
> Hi Q
>
> Which barbiturate did you try? What was your experience?
>
> EdHi Ed,
I tried Phenobarbital. I'm not going to state my original intention for buying it, but I tried it later during clonazepam withdrawal in the hope of reducing symptoms and seizures. Phenobarbital strangely had little effect on the withdrawal syndrome but made me feel very leaden and heavily sedated, and in a bad way. Similar to the room-spinning sensation you get when you know you've gone way past your alcohol vomit limit and the 'it's all downhill from here' toilet-hugging feeling of doom.
I don't see why anyone would use it recreationally and it seems to have little therapeutic value for mental illness. I would be interested to try Nembutal (pentobarbital) for insomnia though as there is a good rating of it over at www.remedyfind.com by a guy called Auban. The benzos were a definite improvement IMHO.
Q
Posted by christophrejmc on November 15, 2006, at 16:49:24
In reply to Re: Baclofen (Lioresal) for social anxiety, posted by Quintal on November 15, 2006, at 16:32:08
> Phenobarbital strangely had little effect on the withdrawal syndrome but made me feel very leaden and heavily sedated, and in a bad way. Similar to the room-spinning sensation you get when you know you've gone way past your alcohol vomit limit and the 'it's all downhill from here' toilet-hugging feeling of doom.A lot of people report the same thing. It's one of the long-acting barbs and perhaps the least likely to be abused.
Posted by Quintal on November 15, 2006, at 17:55:57
In reply to Re: Baclofen (Lioresal) for social anxiety, posted by christophrejmc on November 15, 2006, at 16:49:24
> A lot of people report the same thing. It's one of the long-acting barbs and perhaps the least likely to be abused.
That reminds me of the long acting benzo nitrazepam (Mogadon) now you mention it. It made me feel very spaced out and I kept falling out of bed every morning for some reason. That wasn't a problem with diazepam though and that is one of the longest acting benzos according to Ms. Ashton's equivalence chart.
Do you have any experience with barbs yourself christophrejmc? I have heard of a few lone gun pdocs still prescribing them occasionally and there are always pharmacy raids of course. I suppose a short acting barb may be fun to some people, but I've always found benzos to be more pleasurable myself.
Q
Posted by ed_uk on November 16, 2006, at 12:50:26
In reply to Barbs and Benzos, posted by Quintal on November 15, 2006, at 17:55:57
Hi
Phenobarbital is quite different to the barbiturate hynotics. Its subjective effects are different. Pheno is the only barb which is a powerful anticonvulsant at sub-hypnotic doses.
>Phenobarbital strangely had little effect on the withdrawal syndrome but made me feel very leaden and heavily sedated, and in a bad way.
Pheno and the other barbiturates act at different receptors to the benzos. The use of pheno to treat benzo withdrawal symptoms does not appear to be a good idea.
>The benzos were a definite improvement IMHO
In most cases, definitely.
>I suppose a short acting barb may be fun to some people, but I've always found benzos to be more pleasurable myself.
I think most people would find the same thing. Barbs are probably no more likely than benzos to be euphoric.
Regards
Ed
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