![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by Douglas Thomas on August 16, 1999, at 18:40:15
I have been suffering from mild social phobia for the last 20 years. It usually manifests itself by sweating in certain social situations when I am the center of attention. I had learned to live with it(mostly through avoidance), but finally after a particularly bad/embarrassing episode, I decided to seek professional help. I was prescribed Paxil and took 10 mgs a day for a week then 20 mgs daily for a week. The sexual side effect of extrememly delayed ejaculation or even no orgasm was unacceptable, and my doctor said this type of side effect usually doesn't subside. I was then prescribed Celexa in hopes of alleviating the sexual side effect. This is my third day of 10 mgs of Celexa. I amm supposed to gradually increase the dosage. I was wondering if anyone out there has any experience with Celexa or any other ssri as part of a treatment plan for social phobia. Also, is anyone taking Celexa without experiencing similar side effects ?
Posted by Adam on August 16, 1999, at 18:46:46
In reply to Social phobia - side effects of Celexa, posted by Douglas Thomas on August 16, 1999, at 18:40:15
I took Celexa for about a week and had total anorgasmia, more so
than on any other drug I have ever been on. I guess it's different
for different people, but for me Celexa was the worst.
> I have been suffering from mild social phobia for the last 20 years. It usually manifests itself by sweating in certain social situations when I am the center of attention. I had learned to live with it(mostly through avoidance), but finally after a particularly bad/embarrassing episode, I decided to seek professional help. I was prescribed Paxil and took 10 mgs a day for a week then 20 mgs daily for a week. The sexual side effect of extrememly delayed ejaculation or even no orgasm was unacceptable, and my doctor said this type of side effect usually doesn't subside. I was then prescribed Celexa in hopes of alleviating the sexual side effect. This is my third day of 10 mgs of Celexa. I amm supposed to gradually increase the dosage. I was wondering if anyone out there has any experience with Celexa or any other ssri as part of a treatment plan for social phobia. Also, is anyone taking Celexa without experiencing similar side effects ?
Posted by Douglas Thomas on August 17, 1999, at 12:11:04
In reply to Re: Social phobia - side effects of Celexa, posted by Adam on August 16, 1999, at 18:46:46
> I took Celexa for about a week and had total anorgasmia, more so
> than on any other drug I have ever been on. I guess it's different
> for different people, but for me Celexa was the worst.
>
>
> > I have been suffering from mild social phobia for the last 20 years. It usually manifests itself by sweating in certain social situations when I am the center of attention. I had learned to live with it(mostly through avoidance), but finally after a particularly bad/embarrassing episode, I decided to seek professional help. I was prescribed Paxil and took 10 mgs a day for a week then 20 mgs daily for a week. The sexual side effect of extrememly delayed ejaculation or even no orgasm was unacceptable, and my doctor said this type of side effect usually doesn't subside. I was then prescribed Celexa in hopes of alleviating the sexual side effect. This is my third day of 10 mgs of Celexa. I amm supposed to gradually increase the dosage. I was wondering if anyone out there has any experience with Celexa or any other ssri as part of a treatment plan for social phobia. Also, is anyone taking Celexa without experiencing similar side effects ?Thanks for the response. Have you taken any other ssri that didn't have sexual side effects ?
Posted by bones on August 17, 1999, at 12:26:23
In reply to Social phobia - side effects of Celexa, posted by Douglas Thomas on August 16, 1999, at 18:40:15
Hi Douglas: I too suffer from Social Anxiety (OCD too). I was recently on a drug called Manerix which I found was quite effective with my Social Anxiety. I felt very "sharp" mentally, (something I dislike about the SSRI's which make me apathetic and mentally foggy). It stopped my tremors. (However I did feel a little "edgy".) I was on quite a small dose, but had to come off of it as it exacerbated my OCD. I would recommend that if the Celexa doesn't work that you give it a try. (It's part of the MAOI family - a newer drug - no (or little) dietary restrictions.) Good luck. I've been struggling with my Social Anxiety for 20 years; I hate having to take medication, but find if I want to be out in the workplace I have to take it. (Also no sexual side effect with the Manerix.)
> I have been suffering from mild social phobia for the last 20 years. It usually manifests itself by sweating in certain social situations when I am the center of attention. I had learned to live with it(mostly through avoidance), but finally after a particularly bad/embarrassing episode, I decided to seek professional help. I was prescribed Paxil and took 10 mgs a day for a week then 20 mgs daily for a week. The sexual side effect of extrememly delayed ejaculation or even no orgasm was unacceptable, and my doctor said this type of side effect usually doesn't subside. I was then prescribed Celexa in hopes of alleviating the sexual side effect. This is my third day of 10 mgs of Celexa. I amm supposed to gradually increase the dosage. I was wondering if anyone out there has any experience with Celexa or any other ssri as part of a treatment plan for social phobia. Also, is anyone taking Celexa without experiencing similar side effects ?
Posted by dj on August 17, 1999, at 13:13:19
In reply to Re: Social phobia - side effects of Celexa, posted by bones on August 17, 1999, at 12:26:23
Anyone out there had experience with Manerix & if so how was it for you???? Did it help with depression???
I've only briefly tried Celexa for a few days before backing off because of hot flushes, perspiration and racing heart in a.m. as well as dull sense of anomie, alienation, fatigue, yawning, etc. Still uncertain which is worse the symptoms of depression & social anxiety or the symptoms from the meds. -- hard to seperate at times effect and cause and whether the ADs exaserbate the situation. Sucks eithe way!!!
> Hi Douglas: I too suffer from Social Anxiety (OCD too). I was recently on a drug called Manerix which I found was quite effective with my Social Anxiety. I felt very "sharp" mentally, (something I dislike about the SSRI's which make me apathetic and mentally foggy). It stopped my tremors. (However I did feel a little "edgy".) I was on quite a small dose, but had to come off of it as it exacerbated my OCD... (It's part of the MAOI family - a newer drug - no (or little) dietary restrictions.) ...(Also no sexual side effect with the Manerix.)
>
> > I have been suffering from mild social phobia for the last 20 years...This is my third day of 10 mgs of Celexa. I amm supposed to gradually increase the dosage. I was wondering if anyone out there has any experience with Celexa or any other ssri as part of a treatment plan for social phobia. Also, is anyone taking Celexa without experiencing similar side effects ?
Posted by Douglas Thomas on August 17, 1999, at 18:24:03
In reply to Re: Social phobia - side effects of Celexa, posted by bones on August 17, 1999, at 12:26:23
> Hi Douglas: I too suffer from Social Anxiety (OCD too). I was recently on a drug called Manerix which I found was quite effective with my Social Anxiety. I felt very "sharp" mentally, (something I dislike about the SSRI's which make me apathetic and mentally foggy). It stopped my tremors. (However I did feel a little "edgy".) I was on quite a small dose, but had to come off of it as it exacerbated my OCD. I would recommend that if the Celexa doesn't work that you give it a try. (It's part of the MAOI family - a newer drug - no (or little) dietary restrictions.) Good luck. I've been struggling with my Social Anxiety for 20 years; I hate having to take medication, but find if I want to be out in the workplace I have to take it. (Also no sexual side effect with the Manerix.)
>
> > I have been suffering from mild social phobia for the last 20 years. It usually manifests itself by sweating in certain social situations when I am the center of attention. I had learned to live with it(mostly through avoidance), but finally after a particularly bad/embarrassing episode, I decided to seek professional help. I was prescribed Paxil and took 10 mgs a day for a week then 20 mgs daily for a week. The sexual side effect of extrememly delayed ejaculation or even no orgasm was unacceptable, and my doctor said this type of side effect usually doesn't subside. I was then prescribed Celexa in hopes of alleviating the sexual side effect. This is my third day of 10 mgs of Celexa. I amm supposed to gradually increase the dosage. I was wondering if anyone out there has any experience with Celexa or any other ssri as part of a treatment plan for social phobia. Also, is anyone taking Celexa without experiencing similar side effects ?
Hi Bones,
What dietary restrictions did you have with Manerix ? Is alcohol strictly prohibited while taking Manerix ?
Posted by bones on August 17, 1999, at 18:36:08
In reply to Re: Social phobia - Celexa & Manerix???, posted by dj on August 17, 1999, at 13:13:19
>Hi DJ: Just me (Bones) again. I didn't mention that Manerix improved my mood greatly. I wasn't on it for too long, and was only on a very small dose, so I don't know if I'm the best "guinea pig". I never think that depression is one of my symptoms. Particularly after reading how afflicted some are. My heart goes out to them. I have to say that Manerix improved my mood better than the SSRI's. I remember sitting on my front porch - feeling the wind in my face, watching it blow through the trees and thinking - yes, this is what it's like to feel truly happy. The down side of the medication for me was that it made me edgy - my brain worked overtime - thinking, thinking - not good for someone with OCD. I've always had trouble with motivation - the Manerix seemed to help with my initiative. Didn't sleep well with it either - although this seems to be prevalent with a lot of the SSRI's too. Depending on the person. Manerix I believe is only approved for use in Canada, not the U.S. that's perhaps why not too much is written in psychobabble. Best of luck. Have you any other med tips you can give me? Anything else that worked on your social anxiety but you had to give up because of side effects?? (Celexa is the next drug of choice suggested to me by my Dr.) Just tried Paxil - I found it had little effect on my Social Anxiety. Prozac was good for Social Anxiety - made me very lethargic - unmotivated - I had trouble getting out of bed in the morning - would sleep at any opportunity. Enough said!! I'm writing a book!!
Anyone out there had experience with Manerix & if so how was it for you???? Did it help with depression???
>
> I've only briefly tried Celexa for a few days before backing off because of hot flushes, perspiration and racing heart in a.m. as well as dull sense of anomie, alienation, fatigue, yawning, etc. Still uncertain which is worse the symptoms of depression & social anxiety or the symptoms from the meds. -- hard to seperate at times effect and cause and whether the ADs exaserbate the situation. Sucks eithe way!!!
>
> > Hi Douglas: I too suffer from Social Anxiety (OCD too). I was recently on a drug called Manerix which I found was quite effective with my Social Anxiety. I felt very "sharp" mentally, (something I dislike about the SSRI's which make me apathetic and mentally foggy). It stopped my tremors. (However I did feel a little "edgy".) I was on quite a small dose, but had to come off of it as it exacerbated my OCD... (It's part of the MAOI family - a newer drug - no (or little) dietary restrictions.) ...(Also no sexual side effect with the Manerix.)
> >
> > > I have been suffering from mild social phobia for the last 20 years...This is my third day of 10 mgs of Celexa. I amm supposed to gradually increase the dosage. I was wondering if anyone out there has any experience with Celexa or any other ssri as part of a treatment plan for social phobia. Also, is anyone taking Celexa without experiencing similar side effects ?
Posted by Rick on August 17, 1999, at 20:23:44
In reply to Social phobia - side effects of Celexa, posted by Douglas Thomas on August 16, 1999, at 18:40:15
Apparently side effects (including sexual) sometimes go away after awhile, but sometimes they don't. And while SSRI's often casue sexual dysfunction, you just can't generalize across patients as to which SSRI is going to cause the most (and least) problems. It's all all trial and error, and waiting long enough to see if effects go away. "Supposedly" Celexa is less *likely* to lead to lack of orgasm, but I've heard lots of complaints. (And if they don't, there are always augmentation strategies that may help).
I have had horrible generalized social anxiety "forever". After MAOI Nardil did some great, but very inconsistent, things for me, it then pooped out entirely in four weeks (AND left me completley incapable of orgasm; converted me from hypertensive to hypotensive(!!), etc.).
Snipping out some interim details to cut to the chase, I convinced my pdoc to let me try Klonopin (I had used Xanax on an as-needed basis, but it was very sedating and only moderately helpful). The idea was that, after a ten-day washout from Nardil, I would try another AD. I was going to try for Celexa or Serzone (virtually NEVER causes sexual dysfunction, and has been shown as useful for Social Phobia in Medline abstracts).
But I was doing so well on low-dose Klonopin that we decided to forego an AD completely. I also take 5mg of Selegeline (selective MAOI requiring NO food restrictions at that dose), and about a week ago added 5mg Visken ( aka Pindolol, a dopamine-enhancing beta-blocker hypertensive) since my heart rate and BP were kind of high.
As a non-selective beta blocker, Pindolol is also good for providing a "calming" effect in performance sitautions like presentations or big meetings, not that I need it very much with the incredible Klonopin.Now, compared to the AD days, I am 90% free of social anxiety. No desire to be a social animal, but people don't make me nervous and I am not avoidant. I talk a lot more, and rarely suffer the shaky, halting voice or pounding heart that was so familiar before. I've had a few MINOR relapses (especially when extremely hungry and/or tired), but adjusting the timing of my 2mg daily Klonopin has helped smooth those out.
Ahhh, and the sweet release from AD side effects (Nardil had many more than I mentioned above)! By gradually dosing up the Klonopin, starting with .5mg at bedtime (in case it made me sleepy), it caused virtually no sedation problems as my body adjusted. Unlike with some AD's, I enjoyed the full effects of the Klonopin in less than a week.
Physically, I just feel, well, normal! Mentally (with regard to social anxiety), I'm an 85-90% new man, at least for now. And, my God, the cognition enhancement! The ideas just FLOW at work! I don't know if that's due to Selegeline's reputed cognition enhancement, or Klonopin's releasing my mind from its focus on anxiety. Whichever, I like it!
And look at this history with regard to sexual function:
Before meds: Fine (normal)
After 3 weeks of Nardil: Orgasm impossible
Today: Fireworks and skyrockets! It's
amazing! I've read that Klonopin can
have increased libido as a possible
side effect, but this goes way beyond
that. My profuse apologies for being
too explicit, but the sexual sensations
are physically overwhelming. It must be
the Selegeline (possibly potentiated by the K and/or V), which I read -- and my
pdoc confirmed -- can act as an
aphrodisiac.Regardless of everything I've discussed above, it's the Klonopin that is -- at least thus far -- my "near"-wonder drug. I can't believe I had to talk him into letting me try it (BTW, he is NOT anti-Benzo; he's just not a Klonopin fan!)
Rick
----
> I have been suffering from mild social phobia for the last 20 years. It usually manifests itself by sweating in certain social situations when I am the center of attention. I had learned to live with it(mostly through avoidance), but finally after a particularly bad/embarrassing episode, I decided to seek professional help. I was prescribed Paxil and took 10 mgs a day for a week then 20 mgs daily for a week. The sexual side effect of extrememly delayed ejaculation or even no orgasm was unacceptable, and my doctor said this type of side effect usually doesn't subside. I was then prescribed Celexa in hopes of alleviating the sexual side effect. This is my third day of 10 mgs of Celexa. I amm supposed to gradually increase the dosage. I was wondering if anyone out there has any experience with Celexa or any other ssri as part of a treatment plan for social phobia. Also, is anyone taking Celexa without experiencing similar side effects ?
Posted by Rick on August 17, 1999, at 20:38:38
In reply to Re: Social phobia - side effects of Celexa, posted by Rick on August 17, 1999, at 20:23:44
OOPS! Didn't proofread my post before sending. SUBSTANTIVE corrections: (1) Last sentence in first paragraph (the one in parentheses) should be second-to-last instead. (2) Visken/Pindolol is a SERATONIN-protecting ANTI-hypertensive. BTW, it's often used to add some "oomph" to AD's, especially SSRI's.
------
> Apparently side effects (including sexual) sometimes go away after awhile, but sometimes they don't. And while SSRI's often casue sexual dysfunction, you just can't generalize across patients as to which SSRI is going to cause the most (and least) problems. It's all all trial and error, and waiting long enough to see if effects go away. "Supposedly" Celexa is less *likely* to lead to lack of orgasm, but I've heard lots of complaints. (And if they don't, there are always augmentation strategies that may help).
>
> I have had horrible generalized social anxiety "forever". After MAOI Nardil did some great, but very inconsistent, things for me, it then pooped out entirely in four weeks (AND left me completley incapable of orgasm; converted me from hypertensive to hypotensive(!!), etc.).
>
> Snipping out some interim details to cut to the chase, I convinced my pdoc to let me try Klonopin (I had used Xanax on an as-needed basis, but it was very sedating and only moderately helpful). The idea was that, after a ten-day washout from Nardil, I would try another AD. I was going to try for Celexa or Serzone (virtually NEVER causes sexual dysfunction, and has been shown as useful for Social Phobia in Medline abstracts).
>
> But I was doing so well on low-dose Klonopin that we decided to forego an AD completely. I also take 5mg of Selegeline (selective MAOI requiring NO food restrictions at that dose), and about a week ago added 5mg Visken ( aka Pindolol, a dopamine-enhancing beta-blocker hypertensive) since my heart rate and BP were kind of high.
> As a non-selective beta blocker, Pindolol is also good for providing a "calming" effect in performance sitautions like presentations or big meetings, not that I need it very much with the incredible Klonopin.
>
> Now, compared to the AD days, I am 90% free of social anxiety. No desire to be a social animal, but people don't make me nervous and I am not avoidant. I talk a lot more, and rarely suffer the shaky, halting voice or pounding heart that was so familiar before. I've had a few MINOR relapses (especially when extremely hungry and/or tired), but adjusting the timing of my 2mg daily Klonopin has helped smooth those out.
>
> Ahhh, and the sweet release from AD side effects (Nardil had many more than I mentioned above)! By gradually dosing up the Klonopin, starting with .5mg at bedtime (in case it made me sleepy), it caused virtually no sedation problems as my body adjusted. Unlike with some AD's, I enjoyed the full effects of the Klonopin in less than a week.
>
> Physically, I just feel, well, normal! Mentally (with regard to social anxiety), I'm an 85-90% new man, at least for now. And, my God, the cognition enhancement! The ideas just FLOW at work! I don't know if that's due to Selegeline's reputed cognition enhancement, or Klonopin's releasing my mind from its focus on anxiety. Whichever, I like it!
>
> And look at this history with regard to sexual function:
> Before meds: Fine (normal)
> After 3 weeks of Nardil: Orgasm impossible
> Today: Fireworks and skyrockets! It's
> amazing! I've read that Klonopin can
> have increased libido as a possible
> side effect, but this goes way beyond
> that. My profuse apologies for being
> too explicit, but the sexual sensations
> are physically overwhelming. It must be
> the Selegeline (possibly potentiated by the K and/or V), which I read -- and my
> pdoc confirmed -- can act as an
> aphrodisiac.
>
> Regardless of everything I've discussed above, it's the Klonopin that is -- at least thus far -- my "near"-wonder drug. I can't believe I had to talk him into letting me try it (BTW, he is NOT anti-Benzo; he's just not a Klonopin fan!)
>
> Rick
> ----
> > I have been suffering from mild social phobia for the last 20 years. It usually manifests itself by sweating in certain social situations when I am the center of attention. I had learned to live with it(mostly through avoidance), but finally after a particularly bad/embarrassing episode, I decided to seek professional help. I was prescribed Paxil and took 10 mgs a day for a week then 20 mgs daily for a week. The sexual side effect of extrememly delayed ejaculation or even no orgasm was unacceptable, and my doctor said this type of side effect usually doesn't subside. I was then prescribed Celexa in hopes of alleviating the sexual side effect. This is my third day of 10 mgs of Celexa. I amm supposed to gradually increase the dosage. I was wondering if anyone out there has any experience with Celexa or any other ssri as part of a treatment plan for social phobia. Also, is anyone taking Celexa without experiencing similar side effects ?
Posted by Douglas on August 17, 1999, at 20:50:09
In reply to Re: Social phobia - side effects of Celexa, posted by Rick on August 17, 1999, at 20:23:44
> Apparently side effects (including sexual) sometimes go away after awhile, but sometimes they don't. And while SSRI's often casue sexual dysfunction, you just can't generalize across patients as to which SSRI is going to cause the most (and least) problems. It's all all trial and error, and waiting long enough to see if effects go away. "Supposedly" Celexa is less *likely* to lead to lack of orgasm, but I've heard lots of complaints. (And if they don't, there are always augmentation strategies that may help).
>
> I have had horrible generalized social anxiety "forever". After MAOI Nardil did some great, but very inconsistent, things for me, it then pooped out entirely in four weeks (AND left me completley incapable of orgasm; converted me from hypertensive to hypotensive(!!), etc.).
>
> Snipping out some interim details to cut to the chase, I convinced my pdoc to let me try Klonopin (I had used Xanax on an as-needed basis, but it was very sedating and only moderately helpful). The idea was that, after a ten-day washout from Nardil, I would try another AD. I was going to try for Celexa or Serzone (virtually NEVER causes sexual dysfunction, and has been shown as useful for Social Phobia in Medline abstracts).
>
> But I was doing so well on low-dose Klonopin that we decided to forego an AD completely. I also take 5mg of Selegeline (selective MAOI requiring NO food restrictions at that dose), and about a week ago added 5mg Visken ( aka Pindolol, a dopamine-enhancing beta-blocker hypertensive) since my heart rate and BP were kind of high.
> As a non-selective beta blocker, Pindolol is also good for providing a "calming" effect in performance sitautions like presentations or big meetings, not that I need it very much with the incredible Klonopin.
>
> Now, compared to the AD days, I am 90% free of social anxiety. No desire to be a social animal, but people don't make me nervous and I am not avoidant. I talk a lot more, and rarely suffer the shaky, halting voice or pounding heart that was so familiar before. I've had a few MINOR relapses (especially when extremely hungry and/or tired), but adjusting the timing of my 2mg daily Klonopin has helped smooth those out.
>
> Ahhh, and the sweet release from AD side effects (Nardil had many more than I mentioned above)! By gradually dosing up the Klonopin, starting with .5mg at bedtime (in case it made me sleepy), it caused virtually no sedation problems as my body adjusted. Unlike with some AD's, I enjoyed the full effects of the Klonopin in less than a week.
>
> Physically, I just feel, well, normal! Mentally (with regard to social anxiety), I'm an 85-90% new man, at least for now. And, my God, the cognition enhancement! The ideas just FLOW at work! I don't know if that's due to Selegeline's reputed cognition enhancement, or Klonopin's releasing my mind from its focus on anxiety. Whichever, I like it!
>
> And look at this history with regard to sexual function:
> Before meds: Fine (normal)
> After 3 weeks of Nardil: Orgasm impossible
> Today: Fireworks and skyrockets! It's
> amazing! I've read that Klonopin can
> have increased libido as a possible
> side effect, but this goes way beyond
> that. My profuse apologies for being
> too explicit, but the sexual sensations
> are physically overwhelming. It must be
> the Selegeline (possibly potentiated by the K and/or V), which I read -- and my
> pdoc confirmed -- can act as an
> aphrodisiac.
>
> Regardless of everything I've discussed above, it's the Klonopin that is -- at least thus far -- my "near"-wonder drug. I can't believe I had to talk him into letting me try it (BTW, he is NOT anti-Benzo; he's just not a Klonopin fan!)
>
> Rick
> ----
> > I have been suffering from mild social phobia for the last 20 years. It usually manifests itself by sweating in certain social situations when I am the center of attention. I had learned to live with it(mostly through avoidance), but finally after a particularly bad/embarrassing episode, I decided to seek professional help. I was prescribed Paxil and took 10 mgs a day for a week then 20 mgs daily for a week. The sexual side effect of extrememly delayed ejaculation or even no orgasm was unacceptable, and my doctor said this type of side effect usually doesn't subside. I was then prescribed Celexa in hopes of alleviating the sexual side effect. This is my third day of 10 mgs of Celexa. I amm supposed to gradually increase the dosage. I was wondering if anyone out there has any experience with Celexa or any other ssri as part of a treatment plan for social phobia. Also, is anyone taking Celexa without experiencing similar side effects ?
>
Thanks Rick. What do you know about Klonopin as far as being addictive ? Can it be taken long term ?
Posted by Rick on August 17, 1999, at 23:01:26
In reply to Social phobia - side effects of Celexa, posted by Douglas Thomas on August 16, 1999, at 18:40:15
Douglas --
One point I forgot to mention: After quitting the Nardil, it took 3 weeks for orgasms to return. (It was kind of scary!)
As to your query about Benzo dependence and addiction, there's no question that there's some controversy surrounding that issue (as well as doctors who are more concerned about avoiding lawsuits than optimally treating their patients).
I'll make a few points, and then give you a link that has a wealth of great (and cautiously re-assuring) about dependence, addiction, and withdrawal, as well as comparisons of the benefits/risks of various Benzos.
1. Longer-acting Benzos like Klonopin have less addiction potential than short-acting varieties like Xanax.
2. If you have history of drug or alcohol dependence, you are much more prone to addiction and probably should stay away from any Benzo. But if you take it anyways, steer completely clear of alcohol and expect a somewhat more difficult withdrawal process if/when you stop the drug.
3. Alcohol reaction while on a Benzo varies by person, but these drugs are Central Nervous System Depressants and as such DO greatly potentiate alcohol effects. Some say Benzo users must go cold turkey on booze or they could end up in a coma. Most (including my pdoc) say -- and this seems more rational -- that the Benzos multiply the effect of alcohol (i.e., reaction to one beer on a Benzo is like the reaction to three beers without a Benzo; obviously dosage matters). So drink if you must, but in careful moderation!
4. My pdoc (a 20-year board-certified psychiatrist) assures me that as long as I do not exceed 3mg/day of Klonopin; AND dose back down very gradually, there will be minimal withrawal problems if/when I quit the medication. Quitting under a good doctor's supervsion is the best idea.
http://panicdisorder.about.com/library/weekly/aa082797.htm?COB=home&terms=klonopin&PM=112_300_T
Rick-------
> I have been suffering from mild social phobia
for the last 20 years. It usually manifests itself
by sweating in certain social situations when I am
the center of attention. I had learned to live
with it(mostly through avoidance), but finally
after a particularly bad/embarrassing episode, I
decided to seek professional help. I was
prescribed Paxil and took 10 mgs a day for a week
then 20 mgs daily for a week. The sexual side
effect of extrememly delayed ejaculation or even
no orgasm was unacceptable, and my doctor said
this type of side effect usually doesn't subside.
I was then prescribed Celexa in hopes of
alleviating the sexual side effect. This is my
third day of 10 mgs of Celexa. I amm supposed to
gradually increase the dosage. I was wondering if
anyone out there has any experience with Celexa or
any other ssri as part of a treatment plan for
social phobia. Also, is anyone taking Celexa
without experiencing similar side effects ?
Posted by Rick on August 17, 1999, at 23:17:32
In reply to Re: Social phobia - side effects of Celexa, posted by Rick on August 17, 1999, at 23:01:26
A P.S.: I usually don't buy into claims that generics are inferior to the "real thing". But in this case I've seen so many people (including some medical profesionals) profess that the generic clonazepam is inferior that I've insisted on branded Klonopin.
Rick
-------
> Douglas --
>
> One point I forgot to mention: After quitting
the Nardil, it took 3 weeks for orgasms to return.
(It was kind of scary!)
>
> As to your query about Benzo dependence and
addiction, there's no question that there's some
controversy surrounding that issue (as well as
doctors who are more concerned about avoiding
lawsuits than optimally treating their patients).
>
> I'll make a few points, and then give you a
link that has a wealth of great (and cautiously
re-assuring) about dependence, addiction, and
withdrawal, as well as comparisons of the
benefits/risks of various Benzos.
>
> 1. Longer-acting Benzos like Klonopin have less
addiction potential than short-acting varieties
like Xanax.
>
> 2. If you have history of drug or alcohol
dependence, you are much more prone to addiction
and probably should stay away from any Benzo. But
if you take it anyways, steer completely clear of
alcohol and expect a somewhat more difficult
withdrawal process if/when you stop the drug.
>
> 3. Alcohol reaction while on a Benzo varies by
person, but these drugs are Central Nervous System
Depressants and as such DO greatly potentiate
alcohol effects. Some say Benzo users must go
cold turkey on booze or they could end up in a
coma. Most (including my pdoc) say -- and this
seems more rational -- that the Benzos multiply
the effect of alcohol (i.e., reaction to one beer
on a Benzo is like the reaction to three beers
without a Benzo; obviously dosage matters). So
drink if you must, but in careful moderation!
>
> 4. My pdoc (a 20-year board-certified
psychiatrist) assures me that as long as I do not
exceed 3mg/day of Klonopin; AND dose back down
very gradually, there will be minimal withrawal
problems if/when I quit the medication. Quitting
under a good doctor's supervsion is the best idea.
>
>
http://panicdisorder.about.com/library/weekly/aa08
2797.htm?COB=home&terms=klonopin&PM=112_300_T
>
>
> Rick
>
> -------
> > I have been suffering from mild social phobia
> for the last 20 years. It usually manifests
itself
> by sweating in certain social situations when I
am
> the center of attention. I had learned to live
> with it(mostly through avoidance), but finally
> after a particularly bad/embarrassing episode, I
> decided to seek professional help. I was
> prescribed Paxil and took 10 mgs a day for a
week
> then 20 mgs daily for a week. The sexual side
> effect of extrememly delayed ejaculation or even
> no orgasm was unacceptable, and my doctor said
> this type of side effect usually doesn't
subside.
> I was then prescribed Celexa in hopes of
> alleviating the sexual side effect. This is my
> third day of 10 mgs of Celexa. I amm supposed to
> gradually increase the dosage. I was wondering
if
> anyone out there has any experience with Celexa
or
> any other ssri as part of a treatment plan for
> social phobia. Also, is anyone taking Celexa
> without experiencing similar side effects ?
>
Posted by djmd@direct.ca on August 18, 1999, at 8:15:08
In reply to Re: Social phobia - Celexa & Manerix???, posted by bones on August 17, 1999, at 18:36:08
The concept of social anxiety was only recently mentioned to me by a psych. I've been seeing who has also focused on some obsessive thinking patterns which probably effect my core and far ranging anxiety and depression which ranges from dysthamia to major/double.
I've used Impramine, Paxil and Zoloft in the past for several months at a time. All may have helped in combo. with other things but had mental fogging, yawnnnninnGGG and other effects which I didn't appreciate.
I've only tried a few days of 10 mgs. of Celexa which supposedly has minimal effects and then went off it again as I was in an intense workshop using psycho-drama and such and wanted to try without. That was a few weeks ago. On Sunday p.m. I was feeling pretty down and took a 10 mg. dose which I haven't since repeated. Experienced early morning waking and hot flushes & racing heart the following a.m. and since. This a.m woke up flushed and sweaty and feeling somewhat up.
Would the Celexa still have an impact at this point??? I don't know...Hard to seperate AD from non-AD impacts over such a short period as I sometimes have some of those effects without. However the ADs generally did leave me feeling fuzzy and deeply fatigued at times and like I could only access part of my brain. Feel that way when highly stressed too so I don't know what to think about any of this....As I write this the fatigue and weariness is settling back in...go figure....
> > The down side of the medication for me was that it made me edgy - my brain worked overtime - thinking, thinking - not good for someone with OCD. I've always had trouble with motivation - the Manerix seemed to help with my initiative. Didn't sleep well with it either - although this seems to be prevalent with a lot of the SSRI's too. .... Have you any other med tips you can give me? Anything else that worked on your social anxiety but you had to give up because of side effects?? (Celexa is the next drug of choice suggested to me by my Dr.) Just tried Paxil - I found it had little effect on my Social Anxiety. Prozac was good for Social Anxiety - made me very lethargic - unmotivated - I had trouble getting out of bed in the morning - would sleep at any opportunity. Enough said!! I'm writing a book!!
>
> Anyone out there had experience with Manerix & if so how was it for you???? Did it help with depression???
> >
> > I've only briefly tried Celexa for a few days before backing off because of hot flushes, perspiration and racing heart in a.m. as well as dull sense of anomie, alienation, fatigue, yawning, etc. Still uncertain which is worse the symptoms of depression & social anxiety or the symptoms from the meds. -- hard to seperate at times effect and cause and whether the ADs exaserbate the situation. Sucks eithe way!!!
> >
> > > Hi Douglas: I too suffer from Social Anxiety (OCD too). I was recently on a drug called Manerix which I found was quite effective with my Social Anxiety. I felt very "sharp" mentally, (something I dislike about the SSRI's which make me apathetic and mentally foggy). It stopped my tremors. (However I did feel a little "edgy".) I was on quite a small dose, but had to come off of it as it exacerbated my OCD... (It's part of the MAOI family - a newer drug - no (or little) dietary restrictions.) ...(Also no sexual side effect with the Manerix.)
> > >
> > > > I have been suffering from mild social phobia for the last 20 years...This is my third day of 10 mgs of Celexa. I amm supposed to gradually increase the dosage. I was wondering if anyone out there has any experience with Celexa or any other ssri as part of a treatment plan for social phobia. Also, is anyone taking Celexa without experiencing similar side effects ?
Posted by alex on August 26, 1999, at 16:21:07
In reply to Re: Social phobia - Celexa & Manerix???, posted by djmd@direct.ca on August 18, 1999, at 8:15:08
> The concept of social anxiety was only recently mentioned to me by a psych. I've been seeing who has also focused on some obsessive thinking patterns which probably effect my core and far ranging anxiety and depression which ranges from dysthamia to major/double.
>
> I've used Impramine, Paxil and Zoloft in the past for several months at a time. All may have helped in combo. with other things but had mental fogging, yawnnnninnGGG and other effects which I didn't appreciate.
>
> I've only tried a few days of 10 mgs. of Celexa which supposedly has minimal effects and then went off it again as I was in an intense workshop using psycho-drama and such and wanted to try without. That was a few weeks ago. On Sunday p.m. I was feeling pretty down and took a 10 mg. dose which I haven't since repeated. Experienced early morning waking and hot flushes & racing heart the following a.m. and since. This a.m woke up flushed and sweaty and feeling somewhat up.
>
> Would the Celexa still have an impact at this point??? I don't know...Hard to seperate AD from non-AD impacts over such a short period as I sometimes have some of those effects without. However the ADs generally did leave me feeling fuzzy and deeply fatigued at times and like I could only access part of my brain. Feel that way when highly stressed too so I don't know what to think about any of this....As I write this the fatigue and weariness is settling back in...go figure....
>
> > > The down side of the medication for me was that it made me edgy - my brain worked overtime - thinking, thinking - not good for someone with OCD. I've always had trouble with motivation - the Manerix seemed to help with my initiative. Didn't sleep well with it either - although this seems to be prevalent with a lot of the SSRI's too. .... Have you any other med tips you can give me? Anything else that worked on your social anxiety but you had to give up because of side effects?? (Celexa is the next drug of choice suggested to me by my Dr.) Just tried Paxil - I found it had little effect on my Social Anxiety. Prozac was good for Social Anxiety - made me very lethargic - unmotivated - I had trouble getting out of bed in the morning - would sleep at any opportunity. Enough said!! I'm writing a book!!
> >
> > Anyone out there had experience with Manerix & if so how was it for you???? Did it help with depression???
> > >
> > > I've only briefly tried Celexa for a few days before backing off because of hot flushes, perspiration and racing heart in a.m. as well as dull sense of anomie, alienation, fatigue, yawning, etc. Still uncertain which is worse the symptoms of depression & social anxiety or the symptoms from the meds. -- hard to seperate at times effect and cause and whether the ADs exaserbate the situation. Sucks eithe way!!!
> > >
> > > > Hi Douglas: I too suffer from Social Anxiety (OCD too). I was recently on a drug called Manerix which I found was quite effective with my Social Anxiety. I felt very "sharp" mentally, (something I dislike about the SSRI's which make me apathetic and mentally foggy). It stopped my tremors. (However I did feel a little "edgy".) I was on quite a small dose, but had to come off of it as it exacerbated my OCD... (It's part of the MAOI family - a newer drug - no (or little) dietary restrictions.) ...(Also no sexual side effect with the Manerix.)
> > > >
> > > > > I have been suffering from mild social phobia for the last 20 years...This is my third day of 10 mgs of Celexa. I amm supposed to gradually increase the dosage. I was wondering if anyone out there has any experience with Celexa or any other ssri as part of a treatment plan for social phobia. Also, is anyone taking Celexa without experiencing similar side effects ?I haven't dealt with Celexa or Mannerix, but recently was on Parnate (MAOI) for my depression and some social phobia--I didn't find that it helped, and am going back to Wellbutrin for a bit (at least it provided SOME help), but have just heard about something that will be coming out in the States in the fall called Reboxetine. I think it's currently marketed in the U.K. and Europe, possibly Canada as well, under Edronax; it targets norepinephrine, but it also seems to have a favorable effect on social phobia, according to what I've read so far, at least. You might want to ask your doctor about that one...
Posted by JohnB on November 10, 1999, at 21:43:56
In reply to OOPS!! Re: Social phobia - side effects of Celexa, posted by Rick on August 17, 1999, at 20:38:38
Hi,
Celexa and Remeron were to AD's which gave me no noticeable side effects. No sexual effects and no weight gain. However, I also did not notice any efficacy in relieving my social phobia, so I dropped them after about 4 weeks. Perhaps my dosage wasn't high enough. Also, I probably should have looked at an augmentation agent, such as Buspar (45-60mg/day). Buspar is frequently prescribed to reverse the cognitive effects and sexual dysfunction of the SSRI's. I've read some threads indicating zoloft (sertraline) and buspar make for a "magical" combination, with isn't available from Buspar and other SSRI's. I'm writing the doc who posted this response to see exactly what he means by "magical."
Anyway, my experience has been that Celexa, Remeron, and Venlafaxine are devoid of side effects, at least for me.
JohnB :)
Posted by Rick on November 10, 1999, at 23:16:22
In reply to No side-effects while on Celexa, posted by JohnB on November 10, 1999, at 21:43:56
I have a co-worker who started taking Celexa for depression (his first-ever psychotropic med), and saw no results except side effects. He was just about to give up after five weeks, when it suddenly kicked in big-time. He's been taking it about six months now, and says it's turned his life around (despite very infrequent, short-lived, and mild recurrence of symptoms.)
If he were taking it for Social Phobia, I don't know whether those extra two weeks would have made a difference, but, as usual, I've heard of everything from great success to complete lack of response with Celexa.
Buspar is notorious for a long kick-in period (often 5-6 weeks), but taking it as an adjunct to Zoloft may be a different story altogether. After four weeks on Buspar, I just couldn't handle the dizziness, fatigue, and blasted tinnitus that the nighttime dose produced -- and I was only taking 15 mg/day!
Rick
> Hi,
>
> Celexa and Remeron were to AD's which gave me no noticeable side effects. No sexual effects and no weight gain. However, I also did not notice any efficacy in relieving my social phobia, so I dropped them after about 4 weeks. Perhaps my dosage wasn't high enough. Also, I probably should have looked at an augmentation agent, such as Buspar (45-60mg/day). Buspar is frequently prescribed to reverse the cognitive effects and sexual dysfunction of the SSRI's. I've read some threads indicating zoloft (sertraline) and buspar make for a "magical" combination, with isn't available from Buspar and other SSRI's. I'm writing the doc who posted this response to see exactly what he means by "magical."
>
> Anyway, my experience has been that Celexa, Remeron, and Venlafaxine are devoid of side effects, at least for me.
>
> JohnB :)
This is the end of the thread.
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