Psycho-Babble Medication Thread 14476

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Re: Any SSRI/other? good as Nardil for Social Phobia?

Posted by Adam on November 3, 1999, at 19:05:12

In reply to Any SSRI/other? good as Nardil for Social Phobia?, posted by JohnB on November 3, 1999, at 9:49:22

Mirtazapine (Remeron) might be an option. It blocks certain alpha-adrenergic receptors which can lead to enhanced release of norepinepherine
and serotonin (in that order). It also blocks certain serotonin receptors (5-HT2 and 3), which, according to some, are associated with the
sexual side-effects of serotonergics, while leaveing 5-HT1 alone (that one, I guess, must be stimulated to achieve a good antidepressant effect
via enhanced serotonin levels). It also binds histamine receptors, and it is thought that this combined antihistamine and serotonergic effect
might make mirtazepine a bit of an anxiolytic. Unfortunately, this histamine receptor blockage also leads to weight gain, which I know you
don't want. I think weight gain might be easier to prevent than sexual side effects.

I'm not aware of any studies of mirtazepine as a treatment for social phobia, but perhaps it might work, given its serotonergic/anxiolytic
properties. I personally found it too sedating, but some tolerate it well, I guess. I never slept better, that's for sure.

As for reboxetine, I've read it seems to enhance social _functioning_ (motivation, ability to feel reward and so on), but I've not heard it was
used for social phobia. Perhaps indirect effects on serotonin release might be a factor, if this is true...


> hi, i suffer from pretty severe social phobia. argh! i've found the most effective drug has been nardil, but weight gain and sexual dysfunction drove me crazy. currently taking marplan (50 mg/day), but it doesn't work nearly as well. parnate didn't work for me either. WOULD LIKE TO KNOW IF ANY OF THE SSRI'S OR OTHER DRUGS (VENLAFAXINE, SERZONE, ETC) WORK AS WELL FOR SOCIAL PHOBIA, AND WITHOUT THE WEIGHT/SEXUAL SIDE EFFECTS. i also take klonopin, which is effective, but pretty sedating and just destroys my short-term memory. in fact, the other day, i couldn't remember an assignment my boss had given me in a meeting which occured one hour earlier!!!!!!!!!
>
> ALTERNATIVES (?)
> i guess an alternative could be to supplement nardil with burpropion or something else to reverse the sexual dysfunction and weight gain. anyone with experience, here?
>
> maybe a second alternative is taking zoloft/buspar combination - maybe this is worth a try (?) saw where someone mentioned it being activating, and without the sexual/weight problems. just don't know if it's effective for severe social phobia.
>
> please help. feel i've run out of options.
>
> thanks. johnb

 

To Elizabeth RE: Nardil/Marplan

Posted by JohnB on November 3, 1999, at 22:10:21

In reply to Re: Any SSRI/other? good as Nardil for Social Phobia?, posted by Elizabeth on November 3, 1999, at 12:54:47

> Hi John. I don't think that any SSRI has been compared directly with Nardil, but all the SSRIs are probably effective. SSRIs don't cause weight gain as a rule, certainly not as often as Nardil does. SSRIs do cause sexual dysfunction. Serzone is a possible alternative, though there isn't much evidence to suggest that it would work. It doesn't generally cause the sexual dysfunction.
>
> How much Marplan are you taking? 50mg is probably a good standard dose to try, but you might need more. (How much Nardil were you taking when it was at its most effective?)
>
> Buspar probably doesn't help with social phobia, at least not in the doses typically used (you could try higher doses, up to 90mg or so), but it can be added to an SSRI to counter the sexual side effects. Most docs probably won't want to add it to an MAOI, though I know that this has been done.
>
> Maybe a different benzodiazepine, such as Xanax or Ativan, would have less effect on your alertness and memory?


Thanks alot, Elizabeth! Really appreciate your comments!! My Nardil was 50-60 mg/day to achieve effectiveness. I undersand "maintenance" doses as low as 30 mg/day have been used with some success, but it didn't work for me. My Klonopin is 2mg/day. My psychdoc says he thinks this has the least negative effect on memory and cognition as it has the longest half-live of the benzos, and therefore maintains relatively contast plasma levels. I didn't follow his thinking completely, but i like the twice a day dosing, on a maintenance basis. Just wish I could eliminate the benzodiazepine completely.

 

To: Torchgrl

Posted by JohnB on November 3, 1999, at 22:13:27

In reply to Re: Any SSRI/other? good as Nardil for Social Phobia?, posted by torchgrl on November 3, 1999, at 18:08:29

> Running the risk of sounding like I work for Pharmacia-Upjohn: Reboxetine is supposed to work well for people with social phobia. It should be available in the U.S. early next year (I hope!). That's the only one I've heard about that doesn't seem to cause weight gain, so I'm really hoping everything I've heard is at least somewhat true...

Hi, and thanks for your thoughts! I really appreciate your time to share your information! I've been looking forward to Reboxetine . . .until today, that is. I read one of the postings, above, from someone who is taking it on what seems like some FDA trial. He mentioned he immediately experienced sexual dysfunction. Argh! Mabye there's an easier cure for this when taking Reboxetine, than when on an MAOI or SSRI. Thanks, again. John

 

To: Adam

Posted by JohnB on November 3, 1999, at 22:17:20

In reply to Re: Any SSRI/other? good as Nardil for Social Phobia?, posted by Adam on November 3, 1999, at 19:05:12

> Mirtazapine (Remeron) might be an option. It blocks certain alpha-adrenergic receptors which can lead to enhanced release of norepinepherine
> and serotonin (in that order). It also blocks certain serotonin receptors (5-HT2 and 3), which, according to some, are associated with the
> sexual side-effects of serotonergics, while leaveing 5-HT1 alone (that one, I guess, must be stimulated to achieve a good antidepressant effect
> via enhanced serotonin levels). It also binds histamine receptors, and it is thought that this combined antihistamine and serotonergic effect
> might make mirtazepine a bit of an anxiolytic. Unfortunately, this histamine receptor blockage also leads to weight gain, which I know you
> don't want. I think weight gain might be easier to prevent than sexual side effects.
>
> I'm not aware of any studies of mirtazepine as a treatment for social phobia, but perhaps it might work, given its serotonergic/anxiolytic
> properties. I personally found it too sedating, but some tolerate it well, I guess. I never slept better, that's for sure.
>
> As for reboxetine, I've read it seems to enhance social _functioning_ (motivation, ability to feel reward and so on), but I've not heard it was
> used for social phobia. Perhaps indirect effects on serotonin release might be a factor, if this is true...
>
Thanks, Adam. I have tried Remeron. It might not have been long enough or the right dosage, though. I didn't experience weight gain or sexual dysfunction, but I didn't seem to get any relief from my social phobia. Perhaps it's worth another try at a different dosage (???)

Thanks very much for taking the time and energy to respond. JohnB

 

Re: To: Adam

Posted by Adam on November 4, 1999, at 11:40:28

In reply to To: Adam, posted by JohnB on November 3, 1999, at 22:17:20

Well, as I said, I've never heard of Remeron being used for social phobia, so maybe it's not effective for that indication. It's a pretty new drug
on the scene, though, so it's not always possible to know just based on the literature if it might work or not.

I don't suffer from social phobia, but I have had issues with OCD, and, hence, anxiety. My pdoc recommended Remeron to me b/c it was "dual-acting"
(effects on both 5-HT and NE) and so, he reasoned, it might be good for both depression and OCD. It seems venlafaxene might be a good choice for treating
comorbid anxiety disorders (dual acting), but, again, you run into weight gain and sexual problems. I'm not sure about selegiline. I'm having quite a lot
of success using it; it's been a great antidepressant, I've lost weight (and keep losing it!), I'm experiencing no sexual side effects at all, and I'm
not being bothered too much by OCD. But, like tranylcypromine, it might be a dubious choice for social phobia (or any anxiety disorder-can't figure
out why I'm doing so well) since what little historical information exists on its use for depression seems to indicate people with anxiety problems don't
respond as well to it, as either a treatment for depression or comorbid anxiety, as, say, phenelzine.

It's too bad Remeron didn't work for you. As for dosing, I got up to 45mg/day without a lot of response, and, as I said, it put me in a stupor. If
it's well tolerated, though, I bet you could go up to 60mg/day.

Also, I have read in places (and this seems mechanistically sound, if what they theorize about mirtazepine is true), taking Remeron initially, maybe
up to 30mg/day, and then adding an SSRI might protect against the sexual side effects of the SSRI, due to 5-HT2 and 3 blockage. Perhaps a fairly
activating and "anorexic" (so they say) SSRI like fluoxetine, in combo with mirtazapine, might not be a bad thing to try. I might have tried it too
except my issues with depression have been so severe I decided an MAOI was the way to go.


> Thanks, Adam. I have tried Remeron. It might not have been long enough or the right dosage, though. I didn't experience weight gain or sexual dysfunction, but I didn't seem to get any relief from my social phobia. Perhaps it's worth another try at a different dosage (???)
>
> Thanks very much for taking the time and energy to respond. JohnB

 

Re: To: Torchgrl

Posted by torchgrl on November 4, 1999, at 13:26:53

In reply to To: Torchgrl, posted by JohnB on November 3, 1999, at 22:13:27

I'll have to look through the paperwork that I have, but I'm pretty sure the sexual dysfunction side-effect is not one of the most frequently occuring ones (of course, that's little encouragement when it's happening to you!). One of the attractive things about reboxetine is that there is a much lower occurance of side-effects than with the SSRIs. I'll try to check out the "official" statistics tonight...

 

Re: Any SSRI/other? good as Nardil for Social Phobia?

Posted by Rick on November 4, 1999, at 15:07:14

In reply to Any SSRI/other? good as Nardil for Social Phobia?, posted by JohnB on November 3, 1999, at 9:49:22

Why would you discontinue the Klonopin? I have pretty severe SP myself, and have tried Nardil, Xanax, Selegiline, BuSpar, and Klonopin. And, by far, the most relief (a huge amount after two months) has come from the Klonopin. And with NO side effects except a few NICE ones.

You didnít say if you also suffer depression; in that case you may NEED an anti-depressant, and might as well ignore the rest of my post. But if SP is your overwhelming concern (as it was for me), read on.

There is a good possibility that what you perceive as negative Klonopin side effects are actually coming from the combination and (documented) interaction of this med and Nardil. Your sedation on 2.0 mg. Klonopin would probably be far less taking it solo than in combo with the Nardil. (But donít expect a quick change, since the MAOI can stay with you quite awhile after quitting. For instance it took me almost four weeks after discontinuing Nardil before I was able to have an orgasm...and a pepperoni pizza.)

Also keep in mind Ė as documented in the ďTipsĒ section of this site - that MANY psychotropics can cause short-term memory loss, including the SSRIís. I would imagine the same is true for MAOIís, and again the Nardil/Klonopin combo could be potentiating this effect. So, reiterating, donít be so quick to blame the Klonopin, but do expect the memory effects to continue for a few weeks even if you DO follow my suggestion and try dumping the Nardil half of your regimen.

Xanax made me feel drugged and sedated. It was much less ďsmoothĒ feeling than Klonopin, and had to be taken more frequently. (I take Klonopin upon waking, three hours later, and four hours after that Ė currently about 1.5 to 2.0 mg total per day. I also take a tiny amount of the beta blocker Pindolol (2.5 mg. twice a day) which seems to smooth out any remaining tidbits of social anxiety and helps keep down my heart rate/BP.)

With Klonopin and NO antidepressant, I simply feel normal, alert, and have plenty of energy; the only difference is Ė for example -- that I can stand in front of a room of staring faces and feel almost totally relaxed instead of falling apart. To me, itís amazing, a godsend. And Iíve had no adverse side effects (other than a little sedation the first few weeks and when I took too much in a single dose or for the whole day). Conversely, Iíve had a few truly pleasant side effects like INCREASED libido/sexual sensations (donít know how common this reaction is) and good sleep. (A dosage-related aside: an article on SP elsewhere in Dr. Bob's site recommends a WAY too high dose of 3-6 mg/day. Taking more than needed DECREASES the effectiveness and increases the possibility of sedation and cognitive problems. I hate to see that article on this site and elsewhere, because this dosage recommendation is probably leading to bad results and turning people off to Klonopin's amazing benefits for SP.)

Good Luck. And if neither this nor other folks' suggestions do it for you, take heart in the fact that LOTS of potential meds are currently being tested for SP and showing initial promise. And thereís always CBT.

Rick


> hi, i suffer from pretty severe social phobia. argh! i've found the most effective drug has been nardil, but weight gain and sexual dysfunction drove me crazy. currently taking marplan (50 mg/day), but it doesn't work nearly as well. parnate didn't work for me either. WOULD LIKE TO KNOW IF ANY OF THE SSRI'S OR OTHER DRUGS (VENLAFAXINE, SERZONE, ETC) WORK AS WELL FOR SOCIAL PHOBIA, AND WITHOUT THE WEIGHT/SEXUAL SIDE EFFECTS. i also take klonopin, which is effective, but pretty sedating and just destroys my short-term memory. in fact, the other day, i couldn't remember an assignment my boss had given me in a meeting which occured one hour earlier!!!!!!!!!
>
> ALTERNATIVES (?)
> i guess an alternative could be to supplement nardil with burpropion or something else to reverse the sexual dysfunction and weight gain. anyone with experience, here?
>
> maybe a second alternative is taking zoloft/buspar combination - maybe this is worth a try (?) saw where someone mentioned it being activating, and without the sexual/weight problems. just don't know if it's effective for severe social phobia.
>
> please help. feel i've run out of options.
>
> thanks. johnb

 

Re: Any SSRI/other? good as Nardil for Social Phobia?

Posted by Doug on November 4, 1999, at 20:34:54

In reply to Re: Any SSRI/other? good as Nardil for Social Phobia?, posted by Rick on November 4, 1999, at 15:07:14


Hi JohnB,
I too suffer from social phobia. I tried Buspar and it did nothing for the social phobia. I also tried the ssri's - paxil, celexa, and luvox but the sexual side effects were almost immediate. I am currently on my fifth week with with serzone, and have had no sexual side effects. My social phobia usually manifests itself with severe sweating and rapid heartbeat etc. in certain social situations. So far this hasn't happened. But then again I haven't really had the right social situation present itself... I will keep you posted on whether or not it has a positive effect on the social phobia.

 

Thanks, Rick!!

Posted by johnb on November 4, 1999, at 23:29:36

In reply to Re: Any SSRI/other? good as Nardil for Social Phobia?, posted by Rick on November 4, 1999, at 15:07:14

hi, rick. you make a good point about the klonopin. perhaps the MAOI's/SSRI's potentiated the negative effects. never thought of it that way. i know my psychdoc thought he could minimize the klonopin dosage by supplementing with an MAOI/SSRI or other. your idea of pindolol sounds interesting. i've heard of it being used to augment various other meds. maybe it's time to go off the anti-depressants, as i don't suffer from depression.

thanks again for your time and effort to help me. it was very kind of you!!!!. johnb

 

thanks doug!!

Posted by johnb on November 4, 1999, at 23:32:53

In reply to Re: Any SSRI/other? good as Nardil for Social Phobia?, posted by Doug on November 4, 1999, at 20:34:54

thanks for the info on serzone, doug. i was thinking about trying either that or zoloft. i read a post about someone trying a zoloft/buspar combination and achieved a wonderful sense of energy. think he or she used the word "magical." i'm so tired of trying new meds and then switching back to old and then trying new. looking for the ideal combination and haven't found it, yet.

thanks again for your thoughts and the time and effort to write your post. really appreciate it!!! johnb

 

Re: Any SSRI/other? good as Nardil for Social Phobia?

Posted by johnb on November 4, 1999, at 23:38:17

In reply to Re: Any SSRI/other? good as Nardil for Social Phobia?, posted by saint james on November 4, 1999, at 21:46:12

hi, saint james. i just came across an article in pubmed which suggested a high dose of buspirone (45mg/day +) resulted in much improved + for about 70& of the social phobics. I tried buspar some time ago, but i'm sure my psychdoc wasn't nearly as agressive on the dosage. also, i read a post up above where someone talked of a zoloft/buspar combination which was "magical." seemed to be energizing and everything else. wonder if it works for social phobia?

oh, i'm also going to e-mail franklin shneirer at the new york state psychiatric institute. he's the guy who authored the article on high dose buspar working for social phobia. i've e-mailed him before about other meds, and he was very quick to reply. if i hear something, i'll pass it along. Thank you very much. johnb

 

Re: Any SSRI/other? good as Nardil for Social Phobia?

Posted by saint james on November 4, 1999, at 23:58:48

In reply to Re: Any SSRI/other? good as Nardil for Social Phobia?, posted by johnb on November 4, 1999, at 23:38:17

> hi, saint james. i just came across an article in pubmed which suggested a high dose of buspirone (45mg/day

James here....

What i was trying to sugest was beta blockers for the physical problems (sweating, heart beat) I use them to calm my figgity add movements and shakey hand in some situations and esp when I sing on stage. they work well, but just on body manifestations of anxeity and have no effect on the brain side. You would not want to take them all the time and they can make you depressed, but only when used 24/7. They produce a great physical sence of calm in the body, thinking is still clear. Ask you doc about them, perhaps.
Hope this gets there I am having ISP problems.

j

 

Thanks, James

Posted by JohnB on November 5, 1999, at 8:24:15

In reply to Re: Any SSRI/other? good as Nardil for Social Phobia?, posted by saint james on November 4, 1999, at 23:58:48

hi, james. thanks for the beta blocker suggestion. i should look into as supplementary treatment. i know when i feel myself start to shake or think about my face blushing, my sp gets worse. maybe this is means, along with other meds, of attacking this problem.

really appreciate your thoughts and the time and energy you put into responding. johnb

 

Neurontin

Posted by DL on November 5, 1999, at 11:16:34

In reply to Thanks, James, posted by JohnB on November 5, 1999, at 8:24:15

Neurontin, (one of the anticonvulsants used now as mood stabilizers)is very helpful for social phobia.

 

Re: Neurontin

Posted by Rick on November 5, 1999, at 11:47:10

In reply to Neurontin, posted by DL on November 5, 1999, at 11:16:34

From what I've heard, Neurontin does great things for Social Phobia for 1/3-1/2 of people who try it for a reasonable length of time, and is a complete bust for others. Also, for some it causes a lot of sedation, dizziness and/or cognition problems, while for others it's virtually side-effect free after the first week or two.

If, for some reason, the Klonopin ever stops working wonders for my Social Phobia (and there's sure no evidence of that after months of use!), Neurontin is high on my list of alternatives to try.

Serzone is another. That's one AD that seems incredibly variable in terms of reactions -- a low side-effect wonder for some, and a totally non-theraputic source of major side-effects for other (excepting sexual dysfunction). But the reported de-personalization tendency of all mood stabilizers/AD's would concern me.

Rick


> Neurontin, (one of the anticonvulsants used now as mood stabilizers)is very helpful for social phobia.

 

TO: DL Re: Neurontin For SP, Doage?

Posted by JohnB on November 5, 1999, at 15:57:10

In reply to Neurontin, posted by DL on November 5, 1999, at 11:16:34

> Neurontin, (one of the anticonvulsants used now as mood stabilizers)is very helpful for social phobia.

Hi, DL. I've heard of Neurontin (Gabapentin) being helpful for SP. I tried it for a limited time at 1800mg/day. I now understand from a search of PubMed that it has been tried in doses up to 3600mg/day and that is where it has been found to be effective. CAN YOU TELL ME AT WHAT DOSE YOU FOUND MARKED RELIEF? HOW LONG DID IT TAKE TO "KICK-IN?"

 

Re: TO: DL Re: Neurontin For SP, Doage?

Posted by DL on November 5, 1999, at 23:21:43

In reply to TO: DL Re: Neurontin For SP, Doage?, posted by JohnB on November 5, 1999, at 15:57:10

CAN YOU TELL ME AT WHAT DOSE YOU FOUND MARKED RELIEF? HOW LONG DID IT TAKE TO "KICK-IN?"

I have finally found a psychiatrist who is very knowledgeable and willing to work with me to find the right med (s) for me. He tried neurontin since he feels my "major depression" dx is really more like "mixed state bipolar". Neurontin is one of the mood stabilizers that seems to have less side effects and less interactions with other meds. After the first week I had no side effects. The dose was titrated up quickly and now I am on 2400mg a day. At this level I noticed that I was much more comfortable with other people and relaxed at social events. However, since we are working on lifting the long standing depression and that was not happening, the doc has added Zyprexa. This surprise me since I am not in the least psychotic and never have been that I know of. He showed me a printout of some recent studies where it was shown to be an effective antidepressant and mood stabilizer. AND, in my case it seems to be helping.

 

Re: Nardil/Marplan

Posted by Elizabeth on November 5, 1999, at 23:35:44

In reply to To Elizabeth RE: Nardil/Marplan, posted by JohnB on November 3, 1999, at 22:10:21

> Thanks alot, Elizabeth! Really appreciate your comments!! My Nardil was 50-60 mg/day to achieve effectiveness. I undersand "maintenance" doses as low as 30 mg/day have been used with some success, but it didn't work for me.

That's an old recommendation (as are many things one hears about Nardil these days )...I think that current practice (maintenance dose = initial dose) is much likelier to prevent relapse.

> My Klonopin is 2mg/day. My psychdoc says he thinks this has the least negative effect on memory and cognition as it has the longest half-live of the benzos, and therefore maintains relatively contast plasma levels. I didn't follow his thinking completely, but i like the twice a day dosing, on a maintenance basis. Just wish I could eliminate the benzodiazepine completely.

That's true...Ativan and Xanax need to be dosed at least t.i.d. (3x/day), and I've heard of people needing to take Xanax every 4 hours. (How do they sleep, one wonders.) (I'm not sure I follow your doctor's thinking either in saying that Klonopin would cause the least impairment, for whatever that's worth! As far as I can tell, benzodiazepine side effects are pretty individualized.)

 

Re: Neurontin

Posted by SJ on November 5, 1999, at 23:42:20

In reply to Re: Neurontin, posted by Rick on November 5, 1999, at 11:47:10

I'm not sure what a diagnosis of social phobia involves. I started with Neurontin last spring for a bipolar II disorder, and have had very good results with it. I discontinued it briefly a few months ago, in favor of Topamax (because it can cause weight loss, but decided to stick with the Neurontin.

For me, the side effects are more troublesome when I increase the dose too quickly, or take a dose in the morning. Sleepiness is the main problem for me, although it's very manageable if I avoid a morning dose.

I wish the manufacturer would come up with a timed-release version, because it's such a hassle to have to remember to take a mid-day dose.

I've not experienced too much general anxiety while taking Neurontin, something which was a problem before. When I first started with it, I remember thinking that it felt like my brain felt "soothed". Must be why it is more commonly used by GP's for pain.

SJ

> From what I've heard, Neurontin does great things for Social Phobia for 1/3-1/2 of people who try it for a reasonable length of time, and is a complete bust for others. Also, for some it causes a lot of sedation, dizziness and/or cognition problems, while for others it's virtually side-effect free after the first week or two.
>
> If, for some reason, the Klonopin ever stops working wonders for my Social Phobia (and there's sure no evidence of that after months of use!), Neurontin is high on my list of alternatives to try.
>
> Serzone is another. That's one AD that seems incredibly variable in terms of reactions -- a low side-effect wonder for some, and a totally non-theraputic source of major side-effects for other (excepting sexual dysfunction). But the reported de-personalization tendency of all mood stabilizers/AD's would concern me.
>
> Rick
>
>
> > Neurontin, (one of the anticonvulsants used now as mood stabilizers)is very helpful for social phobia.

 

Re: Any SSRI/other? good as Nardil for Social Phobia?

Posted by Craig on November 6, 1999, at 11:59:51

In reply to Re: Any SSRI/other? good as Nardil for Social Phobia?, posted by Adam on November 3, 1999, at 19:05:12

Adam suggested Remeron, stating the weight gain may be easier to control...I don't know. I 've always been a very disciplined person in my diet, but Remeron wiped that out. I could not stop eating...and I had problems staying awake.

As mentioned above, the SSRIs should all be helpful with social phobias. But there is the sexual dys. and I noticed the effects taper over time.

I'm taking Serzone and notice a difference in social settings after three weeks. I think quite a few people try it for social phobia, judging from earlier threads. No weight problems (actually easier to lose weight) and no sexual probs. I'd give it a whirl maybe while waiting for Reboxetine? Although I don't think Reb. would work on general anxiety/worry (I say that b.c. it sounds similar to welbutrin.

Never tried Nardil, but wouldn't considering my reaction to Remeron...

I'll be interested to know what you try.

 

TO DL: RE NEURONTIN

Posted by JOHNB on November 6, 1999, at 13:46:34

In reply to Re: TO: DL Re: Neurontin For SP, Doage?, posted by DL on November 5, 1999, at 23:21:43

JUST A THOUGHT - RECENT RESEARCH (FOUND ON PUBMED) PERFORMED BY PARKE-DAVIS PHARMACEUTICALS SUGGESTS 3600 MG/DAY OF NEURONTIN FOR SOCIAL PHOBIA/.

THANKS. JOHNB :)

 

Re: Neurontin

Posted by JOHNB on November 6, 1999, at 13:50:24

In reply to Re: Neurontin, posted by SJ on November 5, 1999, at 23:42:20

HI, SJ. THIS IS FOR WHAT IT'S WORTH - I READ A STUDY IN PUBMED SUGGESTING THAT NEURONTIN CAN BE TAKEN TWICE A DAY, AND BE JUST AS EFFECTIVE AS TID DOSING. SO,MAYBE A MID-DAY AND EVENING DOSE WOULD SOLVE THE PROBLEM OF MORNING DROWSINESS DUE TO THE MORNING DOSE.

SEE YOU. JOHNB :)

 

Re: Any SSRI/other? good as Nardil for Social Phobia?

Posted by JOHNB on November 6, 1999, at 13:56:44

In reply to Re: Any SSRI/other? good as Nardil for Social Phobia?, posted by Craig on November 6, 1999, at 11:59:51

THANKS, CRAIG. I'LL BE SEEING MY PSYCHDOC IN ABOUT A WEEK TO DISCUSS A CHANGE IN MEDS. HE'S A GOOD PSYCHOPHARMACOLOGIST, AND IS WILLING TO GIVE MOST THINGS A TRY, INCLUDING BUPROPION + MAOI'S, EVEN THOUGH THIS IS CONTRAINDICATED IN THE CONSERVATIVE DRUG HANDOUT LITERATURE. THE 4 ALTERNATIVES:
(1) HIGH DOSE BUSPAR (60MG/DAY). PUB MED ARTICLE. (2) HIGH DOSE NEURONTIN (3600 MG/DAY). FOUND A PUBMED ARTICLE BY PARKE-DAVIS SUGGESTING THIS HIGH DOSE WAS EFFECTIVE FOR SP.
(3) ZOLOFT OR SERZONE IN COMBINATION WITH BUSPAR (40MG/DAY). AGAIN, RAN ACROSS PUBMED CONTROLLED STUDY IN WHICH BUSPAR ENHANCES THE ANTI-PHOBIC EFFECT OF SSRI'S AND OTHER AD'S
(4) NARDIL, PLUS SOMETHING TO COUNTERACT ITS EFFECT UPON APETITE AND SEXUAL DYSFUNCTION - MAYBE DOPAMINE AGONISTS, SUCH AS BUPROPION OR SELEGILINE.

WILL POST BACK ABOUT WHAT I TRY AND IT'S EFFECT.

THANKS, CRAIG. JOHNB :)


 

**** CAUTION: NARDIL+SELEGILINE!!!

Posted by Rick on November 7, 1999, at 21:13:22

In reply to Re: Any SSRI/other? good as Nardil for Social Phobia?, posted by JOHNB on November 6, 1999, at 13:56:44

JohnB, be v-e-r-y careful if you try idea #4 with Nardil+Selegiline. It turns out the warnings about mixing MAOI's can be true! While I was still on Nardil for Social Phobia, my pdoc added a small dose (5 mg) of Selegiline.

Not only did this NOT help sexual function return, but I also found that about a half hour after taking the two meds together, my blood pressure would rise to DANGEROUSLY high levels (e.g. I'd jump from 110/75 to 200/110). I was totally asymptomatic (perhaps because I've had high BP in the past), but for others this kind of jump could result in a hypertensive crisis with serious consequences. The BP would go back down to normal levels within another 30-60 mins., but this is NOT something to fool around with!!! I was stupid to keep taking the combo, even for just a week.

After this we dumped the Nardil completely and went a little higher on the Selegiline. Eventually, we moved (thank God) to Klonopin.

BTW, for Social Phobia NO MED has EVER shown as great an effect vs. placebo (double-blind, controlled, large sample) as Klonopin did in Dr. Davidson's landmark 12/93 study at Duke. The results were 78% significant improvement for Klonopin (clonazepam) vs. 20% for placebo. The Medline (Pub Med) abstract is at the url below. I urge you to order the complete article.

Regardless, BE WARY OF A NARDIL+SELEGILINE COMBO!!!!

Rick

http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=8120156&form=6&db=m&Dopt=b


> THANKS, CRAIG. I'LL BE SEEING MY PSYCHDOC IN ABOUT A WEEK TO DISCUSS A CHANGE IN MEDS. HE'S A GOOD PSYCHOPHARMACOLOGIST, AND IS WILLING TO GIVE MOST THINGS A TRY, INCLUDING BUPROPION + MAOI'S, EVEN THOUGH THIS IS CONTRAINDICATED IN THE CONSERVATIVE DRUG HANDOUT LITERATURE. THE 4 ALTERNATIVES:
> (1) HIGH DOSE BUSPAR (60MG/DAY). PUB MED ARTICLE. (2) HIGH DOSE NEURONTIN (3600 MG/DAY). FOUND A PUBMED ARTICLE BY PARKE-DAVIS SUGGESTING THIS HIGH DOSE WAS EFFECTIVE FOR SP.
> (3) ZOLOFT OR SERZONE IN COMBINATION WITH BUSPAR (40MG/DAY). AGAIN, RAN ACROSS PUBMED CONTROLLED STUDY IN WHICH BUSPAR ENHANCES THE ANTI-PHOBIC EFFECT OF SSRI'S AND OTHER AD'S
> (4) NARDIL, PLUS SOMETHING TO COUNTERACT ITS EFFECT UPON APETITE AND SEXUAL DYSFUNCTION - MAYBE DOPAMINE AGONISTS, SUCH AS BUPROPION OR SELEGILINE.
>
> WILL POST BACK ABOUT WHAT I TRY AND IT'S EFFECT.
>
> THANKS, CRAIG. JOHNB :)

 

How would you compare CELEXA to SERZONE... ????

Posted by Milena on January 5, 2002, at 11:18:09

In reply to Re: Any SSRI/other? good as Nardil for Social Phobia?, posted by JOHNB on November 6, 1999, at 13:56:44

Has anyone ever been on Celexa at one time and Serzone another? I'm on 60mg of celexa now and I'm gaining weight, and have sexual side effects as well. I heard that with Serzone there is no weight gain and no sexual side effects, but how is it compared to celexa for social phobia? Is it better/worse??

Thanx,

Milena


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