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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Doug on January 20, 2000, at 13:40:17
Just curious, I have had success with taking a dose of 1.125 to 1.25 mgs of Xanax an hr. or so before anticipated social anxiety situations (presentations, staff meetings, etc.) do you think regular lower doses throughout the day would have the same effect ? (takes the fidegting, nervousness, edginess, etc away)
Posted by Rick on January 20, 2000, at 14:40:18
In reply to Benzodiazepenes - Social Anxiety, posted by Doug on January 20, 2000, at 13:40:17
Absolutely, but longer-acting Klonopin (clonazepam) works SOOO much better for me than Xanax. And since it IS longer acting, it doesn't need to be taken as often and, for most people, allows easier withdrawal. Some people will debate me on this, but read the literature, especially this MEDLINE abstract from a major placebo- controlled study (few studies show a medication response rate THIS high; and a similar study for Xanax was inconclusive):
J Clin Psychopharmacol 1993 Dec;13(6):423-8Treatment of social phobia with clonazepam and placebo.
Davidson JR, Potts N, Richichi E, Krishnan R, Ford SM, Smith R, Wilson WH
Department of Psychiatry, Duke University Medical Center, Durham, North Carolina 27710.Clonazepam and placebo were administered in a double-blind pilot study to 75 outpatients with social phobia. The mean maximum dose of clonazepam was 2.4 mg/day at endpoint (range, 0.5 to 3 mg). Treatment was continued for up to 10 weeks. The results of an intent-to-treat analysis indicated superior effects of clonazepam on most measures. Response rates for clonazepam and placebo were 78.3 and 20.0%. Drug effects were apparent on performance and generalized social anxiety, on fear and phobic avoidance, on interpersonal sensitivity, on fears of negative evaluation, and on disability measures. Significant differences were evident by week 1, 2, or 6, depending upon the rating scale used. Clonazepam was well tolerated in general, although unsteadiness and dizziness were more severe and persistent than was the case for placebo subjects.
Publication Types:
Clinical trial
Randomized controlled trial
PMID: 8120156, UI: 94165219----
> Just curious, I have had success with taking a dose of 1.125 to 1.25 mgs of Xanax an hr. or so before anticipated social anxiety situations (presentations, staff meetings, etc.) do you think regular lower doses throughout the day would have the same effect ? (takes the fidegting, nervousness, edginess, etc away)
Posted by Danny on January 20, 2000, at 20:42:36
In reply to Benzodiazepenes - Social Anxiety, posted by Doug on January 20, 2000, at 13:40:17
I take Ativan for insomnia. I have constant GI discomfort from Irritable bowel syndrome. When I tried, at my shrink's request, to take it during the day, it became less effective at night. This proves a general rule with this type of drug (benzodiazepams), which is that you can develop a tolerance and need higher and higher doses, risk complete addiction etc. That said, each case is different. I have known a number of people with this kind of anxiety and most have benefited from a combination of therapy and medication. I have seen great successes in this area. best of luck
> Just curious, I have had success with taking a dose of 1.125 to 1.25 mgs of Xanax an hr. or so before anticipated social anxiety situations (presentations, staff meetings, etc.) do you think regular lower doses throughout the day would have the same effect ? (takes the fidegting, nervousness, edginess, etc away)
Posted by Rick on January 21, 2000, at 0:18:37
In reply to Re: Benzodiazepenes - Social Anxiety, posted by Danny on January 20, 2000, at 20:42:36
Again, Ativan is a short-acting benzo -- even shorter-acting than Xanax. That can make a difference when you're talking about regular dosing.
In the 6 months I've been taking Klonopin, I've tended to LOWER the amount I take. No tolerance whatsoever, which is typical for most (but certainly not "all") people on Klonopin and other longer-acting benzos. I actually do a lot better on 1.5-2.0 mg/day than I did on 3.0.
If a big "challenge" is coming up, I simply shift around the dosing for optimal impact (e.g., take some 45 minutes before a presentation), but that doesn't normally change the total daily amount. BTW, even if I *don't* do the "shift", I'm still much more relaxed in formerly distressing situations than pre-Klonopin.
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> I take Ativan for insomnia. I have constant GI discomfort from Irritable bowel syndrome. When I tried, at my shrink's request, to take it during the day, it became less effective at night. This proves a general rule with this type of drug (benzodiazepams), which is that you can develop a tolerance and need higher and higher doses, risk complete addiction etc. That said, each case is different. I have known a number of people with this kind of anxiety and most have benefited from a combination of therapy and medication. I have seen great successes in this area. best of luck
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> > Just curious, I have had success with taking a dose of 1.125 to 1.25 mgs of Xanax an hr. or so before anticipated social anxiety situations (presentations, staff meetings, etc.) do you think regular lower doses throughout the day would have the same effect ? (takes the fidegting, nervousness, edginess, etc away)
Posted by bigbertha on January 22, 2000, at 2:09:20
In reply to Re: Benzodiazepenes - Social Anxiety, posted by Rick on January 21, 2000, at 0:18:37
> In the 6 months I've been taking Klonopin, I've tended to LOWER the amount I take. No tolerance whatsoever, which is typical for most (but certainly not "all") people on Klonopin and other longer-acting benzo.
Hi Rick
I'm on diazepam (5mg PRN) for SA and have been up/down with
its effectiveness, but no tolerance problems. Have you (anyone else?)
tried diazepam previous to the Klonopin. Does it have
a million-year 1/2life,too? I'm also on Effexor SR.
Thanks in advance!
Posted by Rick on January 22, 2000, at 12:36:22
In reply to Re: Benzodiazepenes - Social Anxiety, posted by bigbertha on January 22, 2000, at 2:09:20
> > In the 6 months I've been taking Klonopin, I've tended to LOWER the amount I take. No tolerance whatsoever, which is typical for most (but certainly not "all") people on Klonopin and other longer-acting benzo.
>
>
> Hi Rick
> I'm on diazepam (5mg PRN) for SA and have been up/down with
> its effectiveness, but no tolerance problems. Have you (anyone else?)
> tried diazepam previous to the Klonopin. Does it have
> a million-year 1/2life,too? I'm also on Effexor SR.
> Thanks in advance!Big Bertha --
I have not used diazepam, but I have used clorazepate, which is even longer-lasting than Klonopin (clonazepam), and, according to what I've heard (haven't confirmed veracity, though) breaks down into metabolites that are very similar to diapzepam. It didn't help my Social Anxiety much, and I didn't like the feel of it. Except for the first week on Klonopin, I can hardly "feel" it at all physically (unless I take over 2 mg. in a day; or over 1 mg in a single dose; or take two doses too close together), but it sure helps big-time with my Social Anxiety. I do not take an AD.
Rick
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