![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Lisa2712 on December 12, 2009, at 18:19:39
I've been on Lexapro 15 mg and Clonazepam 0.5 mg 2 times/day for a while but I still had a lot of social anxiety and trouble leaving my house, and I saw my ARNP (Psychiatric nurse practitioner who prescribes my meds) a few days ago and he put me on generic Depakote, since I told him my mind races and I go very fast. He told me it could help my anxiety but so far it seems to be making me feel a little more anxious and feel floaty and not grounded, they way I do when I'm anxious.
Are there other good meds for severe social anxiety (other than SSRI's or SNRI's or benzodiazepines)? Like I read that Neurontin, Seroquel , and Zyprexa are good for social anxiety and generalized anxiety, and the AP's are grounding.
Thanks,
Lisa
Posted by RocketMan on December 12, 2009, at 19:35:23
In reply to Are there good meds for severe social anxiety?, posted by Lisa2712 on December 12, 2009, at 18:19:39
Like I read that Neurontin, Seroquel , and Zyprexa are good for social anxiety and generalized anxiety, and the AP's are grounding.
>
> Thanks,
> LisaAP's are heavy duty for what you are describing. Paxil is one of the best ssri's for social and general anxiety.
Rocket
Posted by Phillipa on December 12, 2009, at 22:11:39
In reply to Re: Are there good meds for severe social anxiety? » Lisa2712, posted by RocketMan on December 12, 2009, at 19:35:23
Lyrica also can work but can be addicting second hand info. Phillipa
Posted by obsidian on December 12, 2009, at 22:57:43
In reply to Are there good meds for severe social anxiety?, posted by Lisa2712 on December 12, 2009, at 18:19:39
seroquel does help me with social anxiety to some degree, but it is pretty darn sedating
-sid
Posted by SLS on December 13, 2009, at 6:20:48
In reply to Are there good meds for severe social anxiety?, posted by Lisa2712 on December 12, 2009, at 18:19:39
> I've been on Lexapro 15 mg and Clonazepam 0.5 mg 2 times/day for a while but I still had a lot of social anxiety and trouble leaving my house,
I think some people assume that all of the SRIs are alike in their efficacy in treating social anxiety disorder (SAD). However, it seems to me that Lexapro is usually ineffective, while Paxil and Effexor are the most effective of this group. MAOIs, particularly Nardil, have been thought to be the best for treating SAD. Clonazepam makes for a good adjunct to Nardil.
- Scott
Posted by tensor on December 13, 2009, at 8:55:23
In reply to Are there good meds for severe social anxiety?, posted by Lisa2712 on December 12, 2009, at 18:19:39
> I've been on Lexapro 15 mg and Clonazepam 0.5 mg 2 times/day for a while but I still had a lot of social anxiety and trouble leaving my house, and I saw my ARNP (Psychiatric nurse practitioner who prescribes my meds) a few days ago and he put me on generic Depakote, since I told him my mind races and I go very fast. He told me it could help my anxiety but so far it seems to be making me feel a little more anxious and feel floaty and not grounded, they way I do when I'm anxious.
>
> Are there other good meds for severe social anxiety (other than SSRI's or SNRI's or benzodiazepines)? Like I read that Neurontin, Seroquel , and Zyprexa are good for social anxiety and generalized anxiety, and the AP's are grounding.
>
> Thanks,
> LisaHi Lisa,
I think your doses of your current medications should be optimized before even thinking of switching or adding new ones. For instance, clonazepam could alone give you relief at a higher dosage.
I would ditch Depakote and raise clonazepam to 2mg/day to start with and perhaps raise Lexapro to 20mg. If not sufficient response at 4mg/day of clonazepam, try and add Lyrica or Gabitril to your combo. Switch from Lexapro to Paxil, Effexor or Zoloft.Good luck.
/tensor
Posted by Lisa2712 on December 13, 2009, at 10:13:32
In reply to Re: Are there good meds for severe social anxiety? » Lisa2712, posted by tensor on December 13, 2009, at 8:55:23
Hello,
I asked my ARNP a while ago if Paxil would be better for me since I have severe Social anx. disorder, he said it wouldn't make much difference and wanted me to stay on the Lexapro. Next time I see him I'll try to bring it up again. I can't take Effexor, my stomach is allergic to it I think.
I was on 0.75mg 2 times/day of clonazepam for 7 weeks and it made me very angry, irritable, dysphoric, I felt miserable 24/7 and I was a nasty person to be around because of it, and I went down to .5 mg twice daily and I still am more easily irritable and angered but nothing like I was on .75 mg. So I can't go higher on the clonazepam dosage, and I'm now thinking about going lower to .25 mg twice a day because I still have dysphoria from this dosage.
Posted by manic666 on December 13, 2009, at 10:30:24
In reply to Re: Are there good meds for severe social anxiety?, posted by Lisa2712 on December 13, 2009, at 10:13:32
sertraline is what i take generic zoloft. that ok for anxierty at 100 mg .you sometimes have to go up as high as 200 then come down.
Posted by SLS on December 13, 2009, at 11:20:00
In reply to Re: Are there good meds for severe social anxiety?, posted by Lisa2712 on December 13, 2009, at 10:13:32
> I was on 0.75mg 2 times/day of clonazepam for 7 weeks and it made me very angry, irritable, dysphoric, I felt miserable 24/7 and I was a nasty person to be around because of it, and I went down to .5 mg twice daily and I still am more easily irritable and angered but nothing like I was on .75 mg. So I can't go higher on the clonazepam dosage, and I'm now thinking about going lower to .25 mg twice a day because I still have dysphoria from this dosage.
Clonazepam can be a real downer for some people. It is not uncommon that depression and dysphoria develop during its use. Xanax XR might be a useful alternative.
- Scott
Posted by bulldog2 on December 13, 2009, at 13:14:45
In reply to Are there good meds for severe social anxiety?, posted by Lisa2712 on December 12, 2009, at 18:19:39
> I've been on Lexapro 15 mg and Clonazepam 0.5 mg 2 times/day for a while but I still had a lot of social anxiety and trouble leaving my house, and I saw my ARNP (Psychiatric nurse practitioner who prescribes my meds) a few days ago and he put me on generic Depakote, since I told him my mind races and I go very fast. He told me it could help my anxiety but so far it seems to be making me feel a little more anxious and feel floaty and not grounded, they way I do when I'm anxious.
>
> Are there other good meds for severe social anxiety (other than SSRI's or SNRI's or benzodiazepines)? Like I read that Neurontin, Seroquel , and Zyprexa are good for social anxiety and generalized anxiety, and the AP's are grounding.
>
> Thanks,
> LisaI like high dose neurontin for social interaction.
Posted by Phillipa on December 13, 2009, at 19:20:28
In reply to Re: Are there good meds for severe social anxiety?, posted by bulldog2 on December 13, 2009, at 13:14:45
Agree with Scott with the xanax it has a slight antidepressant effect also. Good Luck Phillipa
Posted by hyperfocus on December 16, 2009, at 0:41:01
In reply to Are there good meds for severe social anxiety?, posted by Lisa2712 on December 12, 2009, at 18:19:39
Nardil has probably the best record treating SA. I've read two cases of SA responding to a combination of Lexapro and Risperdal. My pdoc says you need a stong serotonigeric agent to treat SA, so maybe clomipramine alone or combined with something else but I've never read of it used for SA.
Is your SA a primary symptom or is it secondary to something else like MDD or Bipolar II?
Posted by ace on December 20, 2009, at 20:14:29
In reply to Are there good meds for severe social anxiety?, posted by Lisa2712 on December 12, 2009, at 18:19:39
> I've been on Lexapro 15 mg and Clonazepam 0.5 mg 2 times/day for a while but I still had a lot of social anxiety and trouble leaving my house, and I saw my ARNP (Psychiatric nurse practitioner who prescribes my meds) a few days ago and he put me on generic Depakote, since I told him my mind races and I go very fast. He told me it could help my anxiety but so far it seems to be making me feel a little more anxious and feel floaty and not grounded, they way I do when I'm anxious.
>
> Are there other good meds for severe social anxiety (other than SSRI's or SNRI's or benzodiazepines)? Like I read that Neurontin, Seroquel , and Zyprexa are good for social anxiety and generalized anxiety, and the AP's are grounding.
>
> Thanks,
> LisaMAOI's, particularly Nardil, withoubt doubt, are the best.
Benzo's also very helpful.
For pure social anxiety I would stay clear of any antipsychotics.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.