Psycho-Babble Medication Thread 15930

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Social Phobia: Caffeine and/or Sugar and/or BP

Posted by Rick on November 29, 1999, at 15:17:33

As I mentioned in another post, I've been on vacation (no place exciting)about five days, and suddenly the daily 1.5 mg of Klonopin isn't doing the usual "wonders" for my Social Phobia. I seem to need more like the 2.0-3.0 I used to take before it became clear that the extra gram was hurting rather than helping.

This doesn't make sense to me. I don't feel like I'm in an uncomfortable situation. Heck, giving a presentation to 100 people back home was a "snap" with less medication than this, but at the moment just a simple phone call to the hotel front desk can have my voice trembling, especially if someone else might be eavesdropping.

The only real difference seems to be that, after relegating my bad eating habits to weekends-only about eight months ago, I'm really "pigging-out and caffeining-out" for a more extended period of time, plus staying up later and getting up later. And, while I have no general anxiety (indeed, I'm enjoying the "debauchery"(!)) it all seems to make me "edgier", and my blood pressure is up a bit.

Do any other Social Phobics (or Panic sufferers, for that matter)find that increased caffeine and/or sugar worsen their condition or cause them to need extra medication to stay calm in the face of traditionally (and irrationally) "threatening" stimuli? Same questions for blood pressure. Indeed, there's a Medline abstract
in which the authors found that subjects with higher blood pressure or heart rate showed poorer outcome from Social Phobia treatment.

One other thought... I've started experimenting with BuSpar again, although by NOOOO means am I giving up my Klonopin (or Pindolol). I almost think BuSpar makes me jittery in normal doses. So I wonder if this is a counter-productive move? (I'm taking 30 mg now; when I used it before without problem, I was only taking 15. Some studies so BuSpar and Pindolol combined have a strong anti-depressant effect, but I'm not depressed).

Sorry for the dis-organized rambler (I'm at a public library and patrons are waiting for this pc), but I'd appreciate any thoughts on possible effects of too much caffeine &/or sugar &/or BuSpar would be welcomed.

Rick

 

Re: Social Phobia: Caffeine and/or Sugar and/or BP

Posted by Rick on November 29, 1999, at 15:19:45

In reply to Social Phobia: Caffeine and/or Sugar and/or BP, posted by Rick on November 29, 1999, at 15:17:33

Last sentence should have included BP, too. Uh oh, the patrons are getting rowdy...
----
> As I mentioned in another post, I've been on vacation (no place exciting)about five days, and suddenly the daily 1.5 mg of Klonopin isn't doing the usual "wonders" for my Social Phobia. I seem to need more like the 2.0-3.0 I used to take before it became clear that the extra gram was hurting rather than helping.
>
> This doesn't make sense to me. I don't feel like I'm in an uncomfortable situation. Heck, giving a presentation to 100 people back home was a "snap" with less medication than this, but at the moment just a simple phone call to the hotel front desk can have my voice trembling, especially if someone else might be eavesdropping.
>
> The only real difference seems to be that, after relegating my bad eating habits to weekends-only about eight months ago, I'm really "pigging-out and caffeining-out" for a more extended period of time, plus staying up later and getting up later. And, while I have no general anxiety (indeed, I'm enjoying the "debauchery"(!)) it all seems to make me "edgier", and my blood pressure is up a bit.
>
> Do any other Social Phobics (or Panic sufferers, for that matter)find that increased caffeine and/or sugar worsen their condition or cause them to need extra medication to stay calm in the face of traditionally (and irrationally) "threatening" stimuli? Same questions for blood pressure. Indeed, there's a Medline abstract
> in which the authors found that subjects with higher blood pressure or heart rate showed poorer outcome from Social Phobia treatment.
>
> One other thought... I've started experimenting with BuSpar again, although by NOOOO means am I giving up my Klonopin (or Pindolol). I almost think BuSpar makes me jittery in normal doses. So I wonder if this is a counter-productive move? (I'm taking 30 mg now; when I used it before without problem, I was only taking 15. Some studies so BuSpar and Pindolol combined have a strong anti-depressant effect, but I'm not depressed).
>
> Sorry for the dis-organized rambler (I'm at a public library and patrons are waiting for this pc), but I'd appreciate any thoughts on possible effects of too much caffeine &/or sugar &/or BuSpar would be welcomed.
>
> Rick

 

Re: Social Phobia: Caffeine and/or Sugar and/or BP

Posted by mb on November 29, 1999, at 16:05:31

In reply to Re: Social Phobia: Caffeine and/or Sugar and/or BP, posted by Rick on November 29, 1999, at 15:19:45

hey, rick. yes, i've found caffeine's anxiogenic effects tend to offset the anti-anxiety effect of klonopin. i've also found that more sleep actually makes my social phobia worse. combining more caffeine with the additional sleep during your vacation may be causing the return of symptoms you previously had pretty well under control. also, my guess is that during your "vacation" you probably weren't under much stress or exposed to situations where your social anxiety rears its head. for that reason, you probably found your 1.5 mg/day klonopin combined with pindolol made you feel extra tired. so, you countered that with extra sleep and caffeine. now, your body is probably feeling like it's without any klonopin/pindolol, just like you wanted it to feel during your vacation. by the way, i've fallen into the same trap. i've copied and pasted for you, below, a pubmed article referring to the "sensitivity" of social phobics to caffeine.

regarding the sugar, i haven't noticed any impact on my social phobia. as far as your starting buspar, that sounds like an interesting augmentation strategy. i've heard that pindolol can both potentiate as well as accelerate the effects of buspar, as well as that of klonopin. i've also heard that closer to 60 mg/day of buspar may be necessary to realize a therapeutic effect from buspar. maybe your pindolol lowers that threshold to 30 mg/day.

i'm sure that once you adjust to your regular regimen of work/stress/lack of sleep/no caffeine/etc, your old formula will return to it's effective state. in the meantime, the add'l klonopin sounds like it's probably necessary for the next few days.

also, please post if find buspar to improve the efficacy of your klonopin/pindolol combination.

good luck. mb

----------
Brain mechanisms of social anxiety disorder.

Nutt DJ, Bell CJ, Malizia AL
Psychopharmacology Unit, University of Bristol, United Kingdom.

The neurobiology of social anxiety disorder is poorly understood, although preliminary research has suggested several possible biological abnormalities. Challenge studies have demonstrated that subjects with social anxiety disorder have a sensitivity to carbon dioxide, cholecystokinin, and caffeine somewhere between that of panic disorder patients and normal controls. Serotonergic pathways may play a role in social anxiety disorder, as shown by the clinical effectiveness of selective serotonin reuptake inhibitors, plus fenfluramine and m-chlorophenylpiperazine challenge studies. Dopaminergic function and striatal dopamine uptake appear to be reduced in social anxiety disorder. There is also evidence for cardiovascular and adrenergic abnormalities. Recently, positron emission tomography has begun to identify brain regions that appear to be uniquely activated in this condition. These results offer the promise of an understanding of the brain mechanisms of social anxiety disorder, but much further research is needed to fully elucidate the neurobiological cause(s) that exist.


 

Re: Social Phobia: Caffeine and/or Sugar and/or BP

Posted by Noa on November 29, 1999, at 16:19:50

In reply to Re: Social Phobia: Caffeine and/or Sugar and/or BP, posted by mb on November 29, 1999, at 16:05:31

For what it is worth, I just bought a book on Nutrition and Healing, and it says definitely stay away from caffeine if you have anxiety disorder.

 

Re: Social Phobia: Caffeine and/or Sugar and/or BP

Posted by Jane on November 29, 1999, at 17:36:05

In reply to Social Phobia: Caffeine and/or Sugar and/or BP, posted by Rick on November 29, 1999, at 15:17:33

hi rick, the maximal daily dose of buspar is 60 mg/day and i'm sure some doctors (especially psychs) would go higher than that although that is not in the product indication (thus theyd be using it "off label" at such a high dosage) so if you up the dose to 30 mgs/day it should be ok, and in fact that is the therapeutic dosage for buspar. lots of docs use buspar and an benzo with their patients although more in the effort of weaning the patient off the benzo. one difference that you're probably aware of in buspar versus the benzos is that it will not make you sedated as the benzos do, so you mention you will not give up the klonopin for sleep. i'm not sure about high levels of caffeine although personally i doubt if that is beneficial for anyone's health let alone someone also on psychotropic meds... (guiltily sipping some decaf as i type).
jane

 

Re: Social Phobia: Caffeine and/or Sugar and/or BP

Posted by Rick on December 2, 1999, at 13:04:12

In reply to Re: Social Phobia: Caffeine and/or Sugar and/or BP, posted by mb on November 29, 1999, at 16:05:31

To mb, Noa, and Jane -

Thanks for the replies. They were definitely helpful and intersesting.

Rick


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