![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by Dave001 on September 21, 2002, at 18:46:09
Hi,
Just started tranylcypromine (Parnate) several days ago. It seemed like the logical choice since I have responded best to Dexedrine. Currently I have severe depression, social anxiety disorder, ADD (and probably the rest of the alphabet soup of diagnoses, ad nauseum).
I find it rather frustrating that many people describe various medications as stimulating with an "amphetamine-like effect," when I doubtful whether the majority of these people have actually tried amphetamine. I find that dextroamphetamine in therapeutic doses produces a subjective calming effect, with enhanced mental clarity at the same time. It seems to have a high ratio of CNS/peripheral stimulation. By contrast, many of the so-called "stimulating" antidepressants on the market seem to produce much peripheral stimulation, e.g., agitation and anxiety, but do not enhance mental focus.
I'm going off on tangents here. I have some specific questions.
1.) If you've had success with Parnate for SP, did you feel any initial agitation from the drug? If so, did it dissipate with continued use?
2.) Nardil and weight gain: I know Nardil is infamous for causing weight gain, but what I would like to know, is whether the weight gain is only secondary to excessive eating, or whether it directly influences metabolism or other factors (e.g., insulin sensitivity) which contribute to the weight gain. If anyone has any references to this I would appreciate it if you could post them.
3.) Although I've searched through the archives (both here and Usenet via Google) and have read much concerning this, I would still be interested to hear from people whom have tried both Nardil *and* Parnate (not necessarily at the same time), and which one you found more effective for various symptoms.
4.) Is there any general consensus whether certain dose ranges are more effective for treating one condition over the other? E.g., are lower doses generally more or less effective for SP, while high doses work better for depression? I know these are generalizations and do not apply to everyone, but I'm interested to know if there are any trends concerning this...
5.) Last one: does the initial insomnia go away after awhile?
Thanks, Dave
Posted by chad_3 on September 21, 2002, at 19:39:03
In reply to Questions Re: Parnate Nardil for social anxiety, posted by Dave001 on September 21, 2002, at 18:46:09
Hey Dave -
I tried both Nardil and Parnate at low and high doses. I have (untreated) primary severe generalized Social Anxiety Disorder. I was initially also diagnosied mild sedondary depression, 7 years ago that is.
I think the original dx was almost right on - except I would substitute dysthymia for 2ndary mild depression. I am active and athletic by nature my whole life.
To comment on a few of your queries:
1) On Dexedrine - I agree with you. I wonder only if is neurotoxic in long term. I respond well to ultra low doses ; ie; 1.5mg lasts all day. However I only tried this a couple times and currently anything more complicated than my low Nardil + Klonopin combo is a bit off for me at this time ... (complicated circumstances political and neurological)...
2) I slept ok on both. 6 hours clockwork on high Nardil alone and high energy day and night. Parnate I actually took at varied doses with pretty high Klonopin and still was very activated and also agitated and although rejection sensitivity low - I just was not sociable. Everybody I talked to who tried Parnate for primarily SP had similar experience. Maybe in your circumstances you would respond better than me - actually it does sound like you would do better than me given your descipription.
2) I think for SP , Nardil better at higher dose, and Parnate if it works I don't know because I never met anyone - many I talked to with Nardil get better results at higher dose. For depression I think both can work well at low doses oftentimes.
3) Sleep and weight gain. Nardil weight gain - I hear this is "classic" - but I don't quite know where that comes from. Tricylics, Paxil, Remeron - I think those are more likely to cause weight gain personally.
4) I suggest to try them both. You already started Parnate - cool because is has shorter half life and washout is shorter if you switch off it to try Nardil or something else. Parnate - I will say for me I got a 1-2 day good effect on dose increase fading to axiogenic. I quick buzz. Prozac gives me a lift right on taking too. I think it the amphetamine like effect stated for both of these drugs - which is really temporary IMO on each dosing.
Parnate I kind of liked the middle dose range - saw no advantage to higher - all were tolerable except for not working for me.
But good luck with it - sounds like you have better chance with it that someone like me. Try Nardil too if you can - great MAOI is gaining popularity in recent years (expert comments for years Nardil has been underutilized)
It takes years for new drug hype to fade, sometimes there are good new ones, often not...
Best,
Chad
http://www.socialfear.com/Currently I have severe depression, social anxiety disorder, ADD (and probably the rest of the alphabet soup of diagnoses, ad nauseum).
>
> I find it rather frustrating that many people describe various medications as stimulating with an "amphetamine-like effect," when I doubtful whether the majority of these people have actually tried amphetamine. I find that dextroamphetamine in therapeutic doses produces a subjective calming effect, with enhanced mental clarity at the same time. It seems to have a high ratio of CNS/peripheral stimulation. By contrast, many of the so-called "stimulating" antidepressants on the market seem to produce much peripheral stimulation, e.g., agitation and anxiety, but do not enhance mental focus.
>
> I'm going off on tangents here. I have some specific questions.
>
> 1.) If you've had success with Parnate for SP, did you feel any initial agitation from the drug? If so, did it dissipate with continued use?
>
> 2.) Nardil and weight gain: I know Nardil is infamous for causing weight gain, but what I would like to know, is whether the weight gain is only secondary to excessive eating, or whether it directly influences metabolism or other factors (e.g., insulin sensitivity) which contribute to the weight gain. If anyone has any references to this I would appreciate it if you could post them.
>
> 3.) Although I've searched through the archives (both here and Usenet via Google) and have read much concerning this, I would still be interested to hear from people whom have tried both Nardil *and* Parnate (not necessarily at the same time), and which one you found more effective for various symptoms.
>
> 4.) Is there any general consensus whether certain dose ranges are more effective for treating one condition over the other? E.g., are lower doses generally more or less effective for SP, while high doses work better for depression? I know these are generalizations and do not apply to everyone, but I'm interested to know if there are any trends concerning this...
>
> 5.) Last one: does the initial insomnia go away after awhile?
>
>
> Thanks, Dave
Posted by Dave001 on September 21, 2002, at 23:30:37
In reply to Re: Questions Re: Parnate Nardil for social anxiety, posted by chad_3 on September 21, 2002, at 19:39:03
> Hey Dave -
>
> I tried both Nardil and Parnate at low and high doses. I have (untreated) primary severe generalized Social Anxiety Disorder. I was initially also diagnosied mild sedondary depression, 7 years ago that is.
>
> I think the original dx was almost right on - except I would substitute dysthymia for 2ndary mild depression. I am active and athletic by nature my whole life.
>
> To comment on a few of your queries:
>
> 1) On Dexedrine - I agree with you. I wonder only if is neurotoxic in long term. I respondWell, we've had patients on high doses of amphetamines for over 50 years w/o apparent complications (treatment of narcolepsy). I think most of the studies linking neurotoxicity involved use of substituted amphetamines. And even then, it's the dose that makes the poison...
well to ultra low doses ; ie; 1.5mg lasts all day. However I only tried this a couple times
That is ultra-low. I'm on 30 mg/day which is fairly typical. I have yet to experience any adverse interaction between Dexedrine and the Parnate.
and currently anything more complicated than my low Nardil + Klonopin combo is a bit off for me at this time ... (complicated circumstances political and neurological)...
Benzodiazepines are cognitive inhibitors though; they cause retrograde amnesia in high doses (which is why valium is sometimes given i.v. presurgery) and dose dependly inhibit cognition as a direct effect.
> 2) I slept ok on both. 6 hours clockwork on high Nardil alone and high energy day and night. Parnate I actually took at varied doses with pretty high Klonopin and still was very activated and also agitated and although rejection sensitivity low - I just was not sociable. Everybody I talked to who tried Parnate for primarily SP had similar experience. Maybe in your circumstances you
That's odd; a lot of psychopharmacologists have said the exact opposite: that is, Parnate works better for SP.
would respond better than me - actually it does sound like you would do better than me given your descipription.
>
> 2) I think for SP , Nardil better at higher dose, and Parnate if it works I don't know because I never met anyone - many I talked to with Nardil get better results at higher dose. For depression I think both can work well at low doses oftentimes.
>
> 3) Sleep and weight gain. Nardil weight gain - I hear this is "classic" - but I don't quite know where that comes from. Tricylics, Paxil,Err, the perhaps the literature? Just a guess. ;-)
Remeron - I think those are more likely to cause weight gain personally.
>
> 4) I suggest to try them both. You already started Parnate - cool because is has shorter half life and washout is shorter if you switch off it to try Nardil or something else.The elimination half-life of the drug does not correlate with the pharmacologic effect; the enzyme is irreversibly inhibited so MAO activity only returns to normal as new MAO is synthesized. I'm not quite sure why one would need to wait at all when switching from one MAOI to another; after all, they both do essentially the same thing: inhibit MAO.
Parnate - I will say for me I got a 1-2 day good effect on dose increase fading to axiogenic. I quick buzz. Prozac gives me a lift right on taking too. I think it the amphetamine like effect stated for both of these drugs - which is really temporary IMO on each dosing.
You say, "fading to axiogenic." [sic] What do you mean? You felt an amphetamine-like effect with subsequent anxiety *after* the effect?
> Parnate I kind of liked the middle dose range - saw no advantage to higher - all were tolerable except for not working for me.
Why did you like the middle-range dose if it didn't work for you? :-)
> But good luck with it - sounds like you have better chance with it that someone like me. Try Nardil too if you can - great MAOI is gaining popularity in recent years (expert comments for years Nardil has been underutilized)
>
> It takes years for new drug hype to fade, sometimes there are good new ones, often not...Dave
> Best,
>
> Chad
> http://www.socialfear.com/
>
> Currently I have severe depression, social anxiety disorder, ADD (and probably the rest of the alphabet soup of diagnoses, ad nauseum).
> >
> > I find it rather frustrating that many people describe various medications as stimulating with an "amphetamine-like effect," when I doubtful whether the majority of these people have actually tried amphetamine. I find that dextroamphetamine in therapeutic doses produces a subjective calming effect, with enhanced mental clarity at the same time. It seems to have a high ratio of CNS/peripheral stimulation. By contrast, many of the so-called "stimulating" antidepressants on the market seem to produce much peripheral stimulation, e.g., agitation and anxiety, but do not enhance mental focus.
> >
> > I'm going off on tangents here. I have some specific questions.
> >
> > 1.) If you've had success with Parnate for SP, did you feel any initial agitation from the drug? If so, did it dissipate with continued use?
> >
> > 2.) Nardil and weight gain: I know Nardil is infamous for causing weight gain, but what I would like to know, is whether the weight gain is only secondary to excessive eating, or whether it directly influences metabolism or other factors (e.g., insulin sensitivity) which contribute to the weight gain. If anyone has any references to this I would appreciate it if you could post them.
> >
> > 3.) Although I've searched through the archives (both here and Usenet via Google) and have read much concerning this, I would still be interested to hear from people whom have tried both Nardil *and* Parnate (not necessarily at the same time), and which one you found more effective for various symptoms.
> >
> > 4.) Is there any general consensus whether certain dose ranges are more effective for treating one condition over the other? E.g., are lower doses generally more or less effective for SP, while high doses work better for depression? I know these are generalizations and do not apply to everyone, but I'm interested to know if there are any trends concerning this...
> >
> > 5.) Last one: does the initial insomnia go away after awhile?
> >
> >
> > Thanks, Dave
>
>
Posted by chad_3 on September 22, 2002, at 16:33:50
In reply to Re: Questions Re: Parnate Nardil for social anxiety, posted by Dave001 on September 21, 2002, at 23:30:37
Dave -
> Well, we've had patients on high doses of amphetamines for over 50 years w/o apparent complications (treatment of narcolepsy). I think most of the studies linking neurotoxicity involved use of substituted amphetamines. And even then, it's the dose that makes the poison...
>>>>
The info I see seems to be often negative on Dexedrine for toxicity. Have not looked too much at this though ...
>>>>
> well to ultra low doses ; ie; 1.5mg lasts all day. However I only tried this a couple times
>
> That is ultra-low. I'm on 30 mg/day which is fairly typical. I have yet to experience any adverse interaction between Dexedrine and the Parnate.
>>>>
In my case the ultra low stims all tried with low for me (60) Nardil. Dexedrine toxicity is only thing concerning me here. I found that "rebound depression" the next day could be prevented with low Provigil pretty well.
>>>>
> Benzodiazepines are cognitive inhibitors though; they cause retrograde amnesia in high doses
>>>>>
Klonopin is a pretty atypical benzo and also different types of people are effected differently. I would not compare it to Valium, no more than I would compare Prozac to Paxil in their effects on energy and sedation.
>>>>>>
> That's odd; a lot of psychopharmacologists have said the exact opposite: that is, Parnate works better for SP.
>>>>
Who? I never heard this from any psychiatrist. I would be happy to hear from anyone who takes Parnate in monotherapy for primary generalized SP to robust result. - http://www.socialfear.com/
>>>>
Sleep and weight gain. Nardil weight gain - I hear this is "classic" - but I don't quite know where that comes from. Tricylics, Paxil,
> Err, the perhaps the literature? Just a guess. ;-)
>>>>
I can't go too long here - but Nardil is old and the newer drugs - the ones most used are worse overall IMO. Low and medium dose Nardil is unlikely to be a problem with weight gain or sedation. At high doses some people will get these effects to some degree - true with most psychotropics - most antidepressants currently out will tend to cause weight gain and sedation even at medium or low dose levels ... paxil, zoloft, celexa, luvox, remeron, serzone, ... tricyclics (rarely used due mainly to side effect problems)... etc...
>>>>
> You say, "fading to axiogenic." [sic] What do you mean? You felt an amphetamine-like effect with subsequent anxiety *after* the effect?
>>>>
yes with many of the dopaminergics ... ritalin definitely, parnate, amineptine. What is unique IMO about dexedrine is it's relatively significant serotnergic agonist effect gives can give it a lasting non-axiogenic antidepressant effect in addition to the dopaminergic and stimulant effect.
<<<<
> > Parnate I kind of liked the middle dose range - saw no advantage to higher - all were tolerable except for not working for me.
>
> Why did you like the middle-range dose if it didn't work for you? :-)
>>>>>
I should rephrase - it was effective as a simulating, non-axiolytic antidepressant. I described previossly that the axiogenic effect resulted in poor results in helping my SP - I was agitated and uninterested in socializing with people.Chad
http://www.socialfear.com/
>>>>>>
Posted by Dave001 on September 23, 2002, at 11:41:57
In reply to Re: Questions Re: Parnate Nardil for social anxiety, posted by chad_3 on September 22, 2002, at 16:33:50
> Dave -
>[snip]
> The info I see seems to be often negative on Dexedrine for toxicity. Have not looked too much at this though ...
Again, with all things, it is the dose that makes the poison; rats injected with mega-doses is not necessarily indicitive of what will happen in humans at therapeutic doses. The amphetamines have been used for longer than almost all other drugs we use today.
[snip]
> > Benzodiazepines are cognitive inhibitors though; they cause retrograde amnesia in high doses
> >>>>>
> Klonopin is a pretty atypical benzo and also different types of people are effected differently. I would not compare it to Valium,No, not really. Benzos are consistent across the board WRT to the cognitive inhibiting effects. Searching medline I could find only one report of a paradoxical effect, and this occurred within mice (or rats) receiving an extremely low dose of alprazolam.
> > That's odd; a lot of psychopharmacologists have said the exact opposite: that is, Parnate works better for SP.
> >>>>
> Who? I never heard this from any psychiatrist. I would be happy to hear from anyone who takes Parnate in monotherapy for primary generalized SP to robust result. -
http://www.socialfear.com/It's true that I have heard more people report positive reports from Nardil than Parnate for SP, but I would guess that any psychopharm worth his salt would tell you that "either" works better. ;-) What we describe are really just symptoms, not "diagnoses" per say, e.g., the *cause* is not really known, and it's probably to predict which set of symtpoms are a result of what, etc.. Whatever works...
> >>>>
> Sleep and weight gain. Nardil weight gain - I hear this is "classic" - but I don't quite know where that comes from. Tricylics, Paxil,
> > Err, the perhaps the literature? Just a guess. ;-)
> >>>>
> I can't go too long here - but Nardil is old and the newer drugs - the ones most used are worse overall IMO. Low and medium dose NardilIn terms of weight gain? Not according to the studies..
[snip]
Dave
Posted by chad3 on September 23, 2002, at 16:37:55
In reply to Re: Questions Re: Parnate Nardil for social anxiety, posted by Dave001 on September 23, 2002, at 11:41:57
Hi Dave -
What is your experience with primary general SP and it's treatment. What has worked for you, not worked, side effects, etc...?
>>>
> No, not really. Benzos are consistent across the board WRT to the cognitive inhibiting effects.
>>>
True. No benzo I know of is known to consistently enhance cognition.
>>>
> It's true that I have heard more people report positive reports from Nardil than Parnate for SP, but I would guess that any psychopharm worth his salt would tell you that "either" works better.
>>>
OK - guess away but I'm open to mail from anyone on this with good Parnate results in monotherapy for primary general SP including any "psychopharm"
http://www.socialfear.com/ I'll be waiting.
>>>>
> In terms of weight gain? Not according to the studies..
>>>>
OK if you say so.What is your diag, treatment results, et al et al...??
Best,
Chad
http://www.socialfear.com/
Posted by cybercafe on September 23, 2002, at 19:51:40
In reply to Re: Questions Re: Parnate Nardil for social anxiety, posted by chad3 on September 23, 2002, at 16:37:55
Hey Chad, I kinda don't like the fact that even MAOIs require an additional med (benzo). Are benzos the only drugs that can be used as primary treatment for SP?
Posted by chad_3 on September 24, 2002, at 0:07:03
In reply to Re: Questions Re: Parnate Nardil for social anxiety, posted by cybercafe on September 23, 2002, at 19:51:40
Hi Cybercafe -
I don't follow - however ...
You surely have seen my comments by now - and I don't really have anything to add (however see my website again if you want anytime ...
http://www.socialfear.com/And for novel alternatives - I see many posted here - such as on "dilantin for sp" below.
Chad
http://www.socialfear.com/
Posted by cybercafe on September 25, 2002, at 15:49:54
In reply to Refererals ..., posted by chad_3 on September 24, 2002, at 0:07:03
hmmm... i'm guessing that nardil is better for anxiety than parnate, but isn't it less stimulating?i'm thinking that if i am going to be taking clonazepam (makes you sleep) i would rather be taking it with a stimulating med (parnate) than a sedating one (nardil)
exactly how much does nardil and how much does clonazepam contribute to your anti-anxiety lifestyle chad?
Posted by chad_3 on September 26, 2002, at 1:08:27
In reply to Re: Refererals ... » chad_3, posted by cybercafe on September 25, 2002, at 15:49:54
Cybercafe -
You can search me back for over 8 months on this board - back to jan 2002 - and a bit further i think.
you can search me (extensive posts on many regimen trials including parnate + klonpin, nardil + klonopin, nardil alone, etc. as "jr" on alt.socialphobia about 4 years ago - during 3 months i was trialing "paxil" (did not work well). anyway - someone found this stuff, asked if it was me which i said "yes" it was - and i looked and sure enough all that stuff it was there ...
so that is psychobabble back to jan 2002 as kregpark and ray_3888 and chad and maybe someone else ... reaction to low dose antipsychotic 3.5 week trial of amisulpride in jan 2002 pulled me off treatment - leading to chronic movement disorder tardive drug induced problems - and i went back on regimen nardil + klonopin about 3 weeks ago after about 6 months off virtually no SP treatment.
you can go back about 4 years search altsupport social phobia and "jr" and see stuff on bunch of trials - i recall looking couldl't believe i wrote some long stuff pretty extensive.
as for right now - please check here on p/b going back to jan 2002 - then if you want to ask me again "hey chad hows it going lately with your treatment?" - go ahead - but the answer should be pretty clear this has not been a good year for me - so i probably won't answer if you are going to ask me how great my sp treatment and basically my life has been going this year ...
other than that - you are a smart guy and we all deal differently with our problems we face and i don't have the answers for you so please don't ask me what you should do and why yet again - i would refer you to others for that - i already have provided what info i can... i tried to answer you as best i could but i don't want to argue about it ...
i do not mind if you disagree with me on anything i say - i do not claim to be the answer man - i belive in what i write generally but it's my opinion only .... i am not a dr. and if i was you'd still be getting 1 man's opinion only ...
you have made points that you don't like the idea of benzo's and that klonopin puts us to sleep - and that parnate is superior. perhaps you are right - and maybe you should take parnate. but i really don't have the answers to your problems to tell you the truth - i have my hands full with my own ... ; )
gotta go. good luck and check with me in a few months to see if i am in better form after what i have been through. thanks.
chad
>
> hmmm... i'm guessing that nardil is better for anxiety than parnate, but isn't it less stimulating?
>
> i'm thinking that if i am going to be taking clonazepam (makes you sleep) i would rather be taking it with a stimulating med (parnate) than a sedating one (nardil)
>
> exactly how much does nardil and how much does clonazepam contribute to your anti-anxiety lifestyle chad?
Posted by chad_3 on September 26, 2002, at 1:19:13
In reply to Re: Refererals ... » chad_3, posted by cybercafe on September 25, 2002, at 15:49:54
I guess I should at least add that over last 6 + years - nardil and klonopin have both contributed extensively to my anti-sp lifestyle. my life changed dramatically once I started nardil in 1995.
I don't want to write my life story (I used to do that several years ago). but for 8 years i held steady professional work and began dating and was in relationships. i became independent moving away from my home area.
What i had accomplished back actually to 1993 (nardil starting 1995) - i have been extremely proud of - since prior to 1993 and even 1995 in some ways i had absolutely life crippling sp.
I really don't want to write long stories here though because I am back into treatment and need to focus there. I want to get back to where I was in 2001! A good job - a girlfriend - and a life! Well search p/b and you'll see 2002 has been quite different for me...
thanks for respecting the fact that I have run into a lot of troubles lately ...
chad
>
> hmmm... i'm guessing that nardil is better for anxiety than parnate, but isn't it less stimulating?
>
> i'm thinking that if i am going to be taking clonazepam (makes you sleep) i would rather be taking it with a stimulating med (parnate) than a sedating one (nardil)
>
> exactly how much does nardil and how much does clonazepam contribute to your anti-anxiety lifestyle chad?
Posted by Dave001 on September 26, 2002, at 14:31:25
In reply to Re: Questions Re: Parnate Nardil for social anxiety, posted by cybercafe on September 23, 2002, at 19:51:40
>
> Hey Chad, I kinda don't like the fact that even MAOIs require an additional med (benzo). Are benzos the only drugs that can be used as primary treatment for SP?MAOIs do not require a benzo. Some people may find the combination more effective than either medication alone, but there is certainly no requirement.
In answer to your second question: no. ;-) My general interpretation as well as personal experience with benzos suggests that they do not usually tend to be very effective for generalized SP. Stimulants benefit me more than benzos for SP, but of course, people respond differently, and YMMV; you just have to see what works best for you.
Best of luck,
Dave
Posted by Dave001 on September 26, 2002, at 14:43:54
In reply to Re: Refererals ... » chad_3, posted by cybercafe on September 25, 2002, at 15:49:54
>
> hmmm... i'm guessing that nardil is better for anxiety than parnate, but isn't it lessMost likely that is true for GAD and panic disorder, but SP seems to be a rather unique anxiety disorder.
stimulating?
>Yes, although paradoxical reactions can occur with most meds.
> i'm thinking that if i am going to be taking clonazepam (makes you sleep) i would rather be taking it with a stimulating med (parnate) than a sedating one (nardil)
Again, you don't necessarily need a benzo. Your doc should help you determine the most effective med (or combination) for you. Parnate works better for some people; Nardil works better for others.
Dave
[snip]
Posted by cybercafe on September 26, 2002, at 23:40:45
In reply to Re: Refererals ..., posted by Dave001 on September 26, 2002, at 14:43:54
> Most likely that is true for GAD and panic disorder, but SP seems to be a rather unique anxiety disorder.
i have agoraphobia and social phobia... though the latter came before the former
Posted by chad_3 on September 27, 2002, at 2:39:27
In reply to Re: Refererals ..., posted by cybercafe on September 26, 2002, at 23:40:45
Hi again -
Man am I intolerant to med changes now after amisulpride! I used to tolerate anything safe in terms of change no problem.
Anyway - I feel better again after last night - geez!
So I gotta comment here can't pass up on this ...
For SP and panic both Nardil rules over Parnate in monotherapy and people can say whatever they want here but they are not talking about primary generalized SP. You can look at all research - or you can even scan this p/b board for sp and nardil, sp and parnate - personally i've been sporadic here and seen many people chime in how nardil treats their sp wonderfully - never seen 1 such claim for parnate - not here only - but at my website - from a dr. - nowhere except on tom richards 1 man show in pheonix where fast highs works in cbt ... (parnate fast highs - as well as klonopin - people go away thiking it was his cbt made them feel good that week ... ; ) ).
All you will see here about parnate for sp or anywhere is that somebody switched and their sexual problems lessened - or their sedation.
Again - somebody with major depression - meloncholia - and secondary sp - this is not primary generalized sp and that is not where to look for what works for primary general sp.
talk to any of the top guys - liebowitz, davidson, marshall - they've been around the longest - it is hands down nardil and klonopin.
Dave - "benzo's" for SP is not the issue because only Klonopin has high efficacy for SP. None of the others have proven efficacy. Xanax was barely above placebo in 1 study - probably mostly women responding to monotherapy there.
Cybercafe - sounds like you are agorophobic primary. The SP coming second would suggest it anyway as likely. My opinion you probably need to treat the agoraphobia as primary - that is one anxiety disorder i haven't looked at treatment on - not sure what is good there...
Dave - you are 100% on - benzo's do zip for SP - with one exception which is hugely succesful for primary general SP. Again talk to all the experts here liebowitz, marshall, davidson, gorman, et al.
Or - if you like talk to the "new" SP "guru" - Mr. Murray Stein at UCSD - but he is likely to say Paxil because was in on all the FDA studies promoting this weakly effective SP drug...
Ultimately - I will take the hit - for the longer I keep posting here - the more I miss out getting back to life. I remember how I did that at alt.support.socialphobia - some guy "sylvain" was a poster for years apparently - everyday writing how great paxil was for sp. then he finally explained that he lived in almost complete isolation.
I went from over "very severe" on the SP scale (off the scale) - to "mild" after treatment. And from what looked like possibly never being able to hold any permanent job to stable professional work and good work history for 7 years, overcame fear of dating (basically none) - to having girlfriends - and to being 100% dependent on nuclear family most of each week to completely independent for almost 4 years prior to amisulpride in 2002.
Personally I like to hear diagnoses - treatments - and most important stories specific to success of treatment over hyperbole and general talk with nothing personal and no evidence backing up efficacy of treatment. That is the big problem with info on the internet - including - I'm afraid my post here because how do you even know I'm telling the truth (but I assure you I am!!).
Good night... (I have been generally doing MUCH better last couple weeks - yesterday was rough though - did not handle small amount of provigil well - med sensitivity!) ...
See ya
Chad
http://www.socialfear.com/> > Most likely that is true for GAD and panic disorder, but SP seems to be a rather unique anxiety disorder.
>
> i have agoraphobia and social phobia... though the latter came before the former
Posted by chad_3 on September 27, 2002, at 2:51:33
In reply to Re: Questions Re: Parnate Nardil for social anxiety, posted by Dave001 on September 26, 2002, at 14:31:25
Sounds from below like you have agoraphobia to treat, not SP.
This is the most common error I hear on this board or anywhere really when people start claiming strange drugs are the best for SP - because they either have SP secondary to something else (can be almost any psychiatric disorder) - or because they simply are uninformed and are pulling stuff out of the air.
I don't mean to sound rude but you guys just spread a lot of misinformation to people seeking solutions to serious problems...
Cybercafe - it might be irrelevant in your case to even *discuss* SP treatment since it sounds like you need to treat agoraphobia from what you said recently - but in any case I did not claim that "benzos" and "MAOIs" are the best options for SP. What I said was the "Nardil" and "Klonopin" are by far the best in each of those classes for SP - of the drugs used and/or studied in the USA.
There are additional meds which can be very effective most often in polypharmacy or occasionally perhaps alone. Such as SSRI's, gabapentin, Parnate, and so on. Polypharmacy affords many posssiblities including as Dave pointed out the use of stimulant augmentation which can be very effective in reducing rejection sensitivity, increasing socialbiility, libido, assertivness, energy, mood, enthusiasm, and so on....
Best
Chad
http://www.socialfear.com/
> >
> > Hey Chad, I kinda don't like the fact that even MAOIs require an additional med (benzo). Are benzos the only drugs that can be used as primary treatment for SP?
>
> MAOIs do not require a benzo. Some people may find the combination more effective than either medication alone, but there is certainly no requirement.
>
> In answer to your second question: no. ;-) My general interpretation as well as personal experience with benzos suggests that they do not usually tend to be very effective for generalized SP. Stimulants benefit me more than benzos for SP, but of course, people respond differently, and YMMV; you just have to see what works best for you.
>
> Best of luck,
>
> Dave
Posted by utopizen on September 27, 2002, at 17:12:54
In reply to Re: Questions Re: Parnate Nardil for social anxiety, posted by chad_3 on September 27, 2002, at 2:51:33
"Klonopin" are by far the best in each of those classes for SP
Klonopin's well-known to reduce people's drive to talk... which I get with it. I feel like a cool kid, walk up to girls, and then look weird for not talking to them, then I feel like an idiot.
it's no wonder drug.
Posted by cybercafe on September 27, 2002, at 18:12:02
In reply to Re: Questions Re: Parnate Nardil for social anxiet, posted by utopizen on September 27, 2002, at 17:12:54
> "Klonopin" are by far the best in each of those classes for SP
>
> Klonopin's well-known to reduce people's drive to talk... which I get with it. I feel like a cool kid, walk up to girls, and then look weird for not talking to them, then I feel like an idiot.
>
> it's no wonder drug.yeah i get that problem too.... my friends really give me a hard time (expect me to go med free)... as for the women, you can always just say "talk to me"
Posted by chad_3 on September 28, 2002, at 0:39:03
In reply to Re: Questions Re: Parnate Nardil for social anxiet, posted by utopizen on September 27, 2002, at 17:12:54
Utopizen -
If you don't talk about yourself, your diagnoses (primary, secondary) - and responses to previous trials - there is no way in the world to have a clue how any drug will affect you...
You apparently have some shyness of SP - but what else. Are you a happy guy who functions well in all departments except for social anxiety? Do you work - etc... I mean how can I answer you and try to help when you just say out of the blue that you took drug "x" and walked up to women and were silent.
Note I did not say that Klonopin was a drug that is used to help guys who for whatever reason have trouble talking to women to suddenly be able to do so consisently succesfully, hit on them, date them, etc etc.
So honestly - if you want help you have to really lay out the problem first - which starts out with a little hisotry, psychological issues if relevant and most important clear psychiatric diagnoses primary, secondary, etc. Is a must - no way to really discuss anything without all that first ....
Chad
http://www.socialfear.com/
> "Klonopin" are by far the best in each of those classes for SP
>
> Klonopin's well-known to reduce people's drive to talk... which I get with it. I feel like a cool kid, walk up to girls, and then look weird for not talking to them, then I feel like an idiot.
>
> it's no wonder drug.
Posted by utopizen on September 28, 2002, at 17:12:32
In reply to Utizopian - Spec diagnose(s) before popping pills, posted by chad_3 on September 28, 2002, at 0:39:03
> So honestly - if you want help you have to really lay out the problem first - which starts out with a little hisotry, psychological issues if relevant and most important clear psychiatric diagnoses primary, secondary, etc. Is a must - no way to really discuss anything without all that first ....
>
> ChadRemember that 80's movie where a guy took a bunch of mental patients out to a Met's game (only they never got to it)? There was this one patient who always carried a clipboard and acted like a doctor, giving out medical terms all the time to make people think this (and wearing a lab coat).
Very funny, funny movie.
Anyway.... what was I writing about? Oh yeah, um, Klonopin doesn't make me talk. I'm not sure what you're talking about, but all I meant to say was Klonopin makes me not want to talk. Bad for me. Me like talk.
Posted by McPac on September 28, 2002, at 18:00:05
In reply to Re: Utizopian - Spec diagnose(s) before popping pi, posted by utopizen on September 28, 2002, at 17:12:32
Utizopian, that movie was called "The Dream Team", starring Michael Keaton....
that flick was Hilarious!!!
Posted by chad_3 on September 28, 2002, at 18:26:36
In reply to Re: Utizopian - Spec diagnose(s) before popping pi, posted by utopizen on September 28, 2002, at 17:12:32
Good point - no excellent.
I never spent time on bbs's with good sp treatment - well I'm back on treatment now and if it still works as it did b4 - then I'm ready to depart. So like Cosis and many b4 him who started their SP treatment and stayed away after - let me "re-do" that - and if I'm back here then you'll know after all these years my treatment ain't working so good for me anymore...
Later for now,
Chad
http://www.socialfear.com/>
> > So honestly - if you want help you have to really lay out the problem first - which starts out with a little hisotry, psychological issues if relevant and most important clear psychiatric diagnoses primary, secondary, etc. Is a must - no way to really discuss anything without all that first ....
> >
> > Chad
>
> Remember that 80's movie where a guy took a bunch of mental patients out to a Met's game (only they never got to it)? There was this one patient who always carried a clipboard and acted like a doctor, giving out medical terms all the time to make people think this (and wearing a lab coat).
>
> Very funny, funny movie.
>
> Anyway.... what was I writing about? Oh yeah, um, Klonopin doesn't make me talk. I'm not sure what you're talking about, but all I meant to say was Klonopin makes me not want to talk. Bad for me. Me like talk.
This is the end of the thread.
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