Psycho-Babble Medication Thread 529220

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Re: SSRIs worsening Social Phobia?

Posted by so on July 18, 2005, at 12:32:47

In reply to Re: SSRIs worsening Social Phobia?, posted by SLS on July 18, 2005, at 7:17:53


> Are they messy? Yes. So are just about all psychotropic medications, but they are the best we have to work with at the moment.

But as suggested in the post below
http://www.dr-bob.org/babble/20050718/msgs/529505.html
they are not all we have to work with. What we work with is effected by economic constraints of our culture. Cognitive behavioral therapy is seldom as profitable as is the manufacture of chemicals. Our culture is organized so as to capitalize most profitable economic endeavors.

At the same time, we have seen an erosion of community institions that would offer the sort of wisdom that can be achieved in therapuetic settings. Extended families isolate individuals from more experienced family members. Mobility isolates individuals from more experienced community members.

And as community institutions erode, we have a new set of social stressors. Role expectations are less well defined. Technology exposes us to unfamiliar and powerful stimuli. Evolving cultural expectations can lead to confusion about what is important in life.

If the current pharmacopea is all we have to work with, it is worth considering what we have excluded from our available set of tools.

 

Re: SSRIs worsening Social Phobia? smith562

Posted by so on July 18, 2005, at 12:39:41

In reply to Re: SSRIs worsening Social Phobia? so, posted by smith562 on July 18, 2005, at 4:49:24

> Hey So,
>
> Thank for the advise. I am interested ... what are some of the good reasons people might chose to lead a private life? Thank You.
>
> Smith
>
> >There are plenty of good reasons other than a mental disorder that a person might choose to live a reasonably private life.
>
>


Mental stability might be one reason. Social groups create undue performance pressures on a person, which can be avoided by a carefully chosen and somewhat limited social circle.

I would approach the question from the opposite direction, though. What does a person need from social contact? How much social contact does a person require to fulfill those needs? Beyond those requirements, what are the benefits of social contact? What are the risks? What needs might we be attempting to fulfil with social contact that just might not be satisfied by social contact? At what point does social contact become an addiction, in which we try to satisfy a basic hedonic drive, but in which an increased tolerance leads to an ever increasing need for more social contact?

 

Re: SSRIs worsening Social Phobia?

Posted by linkadge on July 18, 2005, at 17:30:16

In reply to Re: SSRIs worsening Social Phobia?, posted by SLS on July 18, 2005, at 7:17:53

I guess I am just saying that they are not the ideal treatment for social phobia, and that they *may* make it worse.

I would think that ritalin + clonazepam might hit inballences of a social-phobe more accurately.


Linkadge

 

Re: SSRIs worsening Social Phobia?

Posted by linkadge on July 18, 2005, at 17:41:21

In reply to Re: SSRIs worsening Social Phobia? smith562, posted by so on July 18, 2005, at 12:39:41

Social contact is probably the best way to maintain cognitive abilities. Deprived of this basic level of social contact because of a heightened fear is unacceptable.

"Its all we have" is not true. When sertaline went head to head with SJW, and placebo, both failed but SJW came out superior to sertraline.

The study claimed "SJW no better than placebo"!

It is one thing to remove fear from the social setting, and another thing to remove inscentive.

My friend was on paxil for SP. He said that he didn't get anxious around people anymore, but that he totally lost interest in social contact.

Linkadge

 

Re: SSRIs worsening Social Phobia? linkadge

Posted by so on July 18, 2005, at 17:44:12

In reply to Re: SSRIs worsening Social Phobia?, posted by linkadge on July 18, 2005, at 17:30:16


>
> I would think that ritalin + clonazepam might hit inballences of a social-phobe more accurately.
>
>
> Linkadge

yes. Similarly cocaine and ethyl alcohol is often quite effective. For those on a budget, methamphetamine and alcohol is more affordable. Benzos such as clonoazepam, but more often common valium, often find their way into the popular pharmacopea used to treat social anxienty. When benzo's are out of reach, speed-balls, or coca-opiod combinations are often used.

 

Please be civil so

Posted by gardenergirl on July 18, 2005, at 18:51:11

In reply to Re: SSRIs worsening Social Phobia? linkadge, posted by so on July 18, 2005, at 17:44:12

Please refrain from promoting the use of illegal drugs as a way to cope with a mental disorder.

gg

 

Re: Please be civil

Posted by linkadge on July 18, 2005, at 19:01:11

In reply to Please be civil so, posted by gardenergirl on July 18, 2005, at 18:51:11

I don't really know what you're trying to say. Personally, I have been on and off clonazepam so many times, yet I am still withdrawing from SSRI's. So, barring this, I'd rather use clonazepam, as it is more effective for me.


Linkadge

 

Re: Please be linkadge

Posted by gardenergirl on July 18, 2005, at 19:22:43

In reply to Re: Please be civil, posted by linkadge on July 18, 2005, at 19:01:11

> I don't really know what you're trying to say. Personally, I have been on and off clonazepam so many times, yet I am still withdrawing from SSRI's. So, barring this, I'd rather use clonazepam, as it is more effective for me.
>
>
> Linkadge

Hi link,
I was referring to so's post about illegal drugs and alcohol.

gg

 

Re: Please be

Posted by linkadge on July 18, 2005, at 19:59:22

In reply to Re: Please be linkadge, posted by gardenergirl on July 18, 2005, at 19:22:43

Sorry, I was under the impression that he was making fun of my ritalin + clonazepam suggestion for social phobia. I was simply defending it by saying that SSRI's can be addicting too.

Sorry, I'm not making a lot of sence :)


Linkadge

 

Re: Happened again!

Posted by smith562 on July 18, 2005, at 21:30:11

In reply to Re: Please be, posted by linkadge on July 18, 2005, at 19:59:22

I must be ignorant, but I wanted to test my reaction again to zoloft. I increased from 75 to 112.5 mgs this morning .... wow! I felt like molasses ... was very quiet, unsociable and lethargic! Maybe I will try titrating down to 50 mgs to see if my energy improves.

To be fair ... I have a diagnosis of panic disorder and depression with a family h/o of depression, panic disorder and bipolar II. I have found this combo to be best for me ... zoloft 75, klonopin 1, selegiline 10, lithium 450 and lamcital 50. Because of all my meds, I don't know what zoloft is doing exactly.

Smith

 

Re: Please be linkadge

Posted by gardenergirl on July 18, 2005, at 23:26:25

In reply to Re: Please be, posted by linkadge on July 18, 2005, at 19:59:22

Aha, that was my misunderstanding. I thought your post was to me.

:)

gg

 

Re: SSRIs worsening Social Phobia?

Posted by SLS on July 19, 2005, at 10:14:09

In reply to Re: SSRIs worsening Social Phobia? SLS, posted by Kon on July 18, 2005, at 11:12:25

Hi.

Have you ever experienced a robust antidepressant response from a medication?

I have. These drugs work. That's my bias.

I can't review the citations you provided, but I think it is great that you were able to find them. The Internet is a great place to find differences of opinion.

I am not a statistician, but I think biases are probably seen on both sides of a debate over the efficacy of antidepressants.

Approximately 30% of people will "respond" to placebo. Of course, they are not really responding to nothing, they are simply recovering spontaneously, whether it be the natural course of their illness or a psychological effect from belief that they will get well. I don't have the energy to get into a discussion of the selection criteria used for most antidepressant trials, but 30% is too high for these studies to have much meaning. I don't think many of these people belong in these studies to begin with. If you exclude the placebo responders, things look different. Most antidepressant studies report rates of response close to 65-70%. That is an excellent rate of response no matter how you look at it. Many "failed" and "weak" studies report placebo responses significantly higher than 30%. Something is wrong here. Placebo controls don't work when evaluating depression when using the current inclusion criteria.

> Given such weak evidence,

I don't agree that the evidence is weak, as I have indicated above.

why are these drugs so popular with prescribers?

They work.


- Scott

 

Re: SSRIs worsening Social Phobia?

Posted by SLS on July 19, 2005, at 15:56:19

In reply to Re: SSRIs worsening Social Phobia?, posted by SLS on July 19, 2005, at 10:14:09

I wish I could come up with stronger citations than this, but this is a good start to begin to understand the problems with using placebo controls in studies involving depression.

http://www.srmhp.org/0201/media-watch.html

Notice that it takes into consideration the literature and authors that are cited in the link you provided. Unfortunately, there is not as much interest in elucidating the placebo effect in depression studies as might be desired. Know, however, that those people claiming improvement in the placebo arm of a study demonstrate different brain activity than is evidenced by those who respond to either medication or psychotherapy. In addition, this placebo response tends to disappear at approximately week 10 when subjects are studied longitudinally. Many of these people ask to be placed on the active compound once they learn they were given placebo.


- Scott

 

Re: SSRIs worsening Social Phobia?

Posted by linkadge on July 19, 2005, at 17:40:27

In reply to Re: SSRIs worsening Social Phobia?, posted by SLS on July 19, 2005, at 15:56:19

"In addition, this placebo response tends to disappear at approximately week 10"


Wow, that seems to correspond nicely to the timeframe for antidepressant poop out.


Linkadge

 

As An Added Note

Posted by Phillipa on July 19, 2005, at 18:14:45

In reply to Re: SSRIs worsening Social Phobia?, posted by linkadge on July 19, 2005, at 17:40:27

I can remember when an IM injection of a pain med was used. That was for the people who always wanted something for pain. And at times it worked. But pain is considered a serious thing. As it interfers with the healing process. So no longer are placebos allowed in a hospital. Fondly, Phillipa

 

Re: SSRIs worsening Social Phobia? smith562

Posted by Chairman_MAO on July 20, 2005, at 20:44:47

In reply to SSRIs worsening Social Phobia?, posted by smith562 on July 17, 2005, at 18:50:59

No, as a matter of fact, SSRIs do not help social phobia at all. Studies--or rather, only the ones that are published--show that SSRIs differ from placebo in SP by the barest of margins. Phenelzine 1mg/kg gives conservatively a 75% response rate.

 

Re: SSRIs worsening Social Phobia? Chairman_MAO

Posted by linkadge on July 21, 2005, at 15:24:14

In reply to Re: SSRIs worsening Social Phobia? smith562, posted by Chairman_MAO on July 20, 2005, at 20:44:47

I totally agree with you. SSRI's are not good for social phobia. Its not one chemical that is probably out of ballence with them.

If any one chemical was to be implicated, I'd say GABA, or PEA, before serotonin.

Linkadge

 

= Chairman Mao - A question regarding Nardil

Posted by johnb11 on July 24, 2005, at 21:54:03

In reply to Re: SSRIs worsening Social Phobia? smith562, posted by Chairman_MAO on July 20, 2005, at 20:44:47

Think I read a post where you augmented Nardil to help with sexual dysfunction. Could you share with me what worked?

2nd question - Do you have any knowledge about high dosage deprenyl (60 mg/day) being effective for SP. I believe it loses is MAO-B selectivity above 10-20 mg/day.

Oh, one more question. Do you know anything about combining Moclobemide with Deprenyl? My pdoc thinks that could be a strong possibility, without the weight gain and sexual dysfunction of Nardil. Would only mean that my Moclobemide prescription wouldn't be picked up by insurance. I'd have to order from Canada. By the way, there was a study done by Leibowitz et al, combining clorgyline (MAO-B) with Deprenyl. Found it as effective as Nardil. Too bad clorgyline can no longer be had outside of the laboratory.

Thanks, in advance, for your help!

JohnB11

 

Deprenyl + Nardil ?? johnb11

Posted by Declan on July 24, 2005, at 22:47:08

In reply to = Chairman Mao - A question regarding Nardil, posted by johnb11 on July 24, 2005, at 21:54:03

What do you think of the idea of deprenyl (5mg/d ?) and Nardil (30mg/d?)?
Maybe you'd just have desire and no ability. Someone must have tried the two together.

I found moclobemide OK as far as sex went.

Declan

 

Deprenyl + Nardil-- willyee have you tried? Declan

Posted by Questionmark on July 25, 2005, at 18:24:49

In reply to Deprenyl + Nardil ?? johnb11, posted by Declan on July 24, 2005, at 22:47:08

willyee, in a post in an above thread you mentioned that you've "used deprenyl and moclobemide [spelling changed] with maois to fight the fatigue syndrome and give a added kick." This is very interesting. Do you know what dose of MAOI, and which one, you used? And do you remember what dose of deprenyl you used? ...with or without moclobemide? Was this a daily or a once-in-awhile practice? Please also share the effects and your experiences. Thanks very much.

Anyone else with any experiences or thoughts on the matter please chime in as well.

Declan, good question. i've been wondering this myself for quite awhile.


> What do you think of the idea of deprenyl (5mg/d ?) and Nardil (30mg/d?)?
> Maybe you'd just have desire and no ability. Someone must have tried the two together.
>
> I found moclobemide OK as far as sex went.
>
> Declan

 

Re: Deprenyl + Nardil-- willyee have you tried?

Posted by willyee on July 27, 2005, at 17:13:17

In reply to Deprenyl + Nardil-- willyee have you tried? Declan, posted by Questionmark on July 25, 2005, at 18:24:49

Sorry i took so long,dident catch this post until now.

The two aside,moclimide seemed to offer a 2 benifits,one was the *dry* period between parnate doses where it sometimes has u either looking for the next parnate dose,or taking something else which i have a BAD habbit of doing.

I instead took a small dose of molcimide during this period,the result was the parnate seemed to have a added kick working better,providing more relieaf,as well as i took less of it.

The second was i having something to take in those gaps stopped me from being so reliant on my next parnate dose and seeking it.

Deprenyl was the same sceniero,i used it at night after parnate dosing was to be stopped.

Deprenyl alone was a no no,with a benzo it sometimes cancelled each other out,so i stumbled onto something by accident that gave me a week of solid remission but havent since TRIED again yet.

This was to eat,chew on a small amount of mary jane,the effects are much different than smoking as smoking makes me go insane,anyhow chewing a small amount followed by a small droplet or two of deprenyl stablized me for an entire night without any desire to want parnate.

This was much stronger than moclimides relieaf,and in fact i wonder if i could have dropped parnate down to a single morning dose followed by two dosing of the deprenyl combo.The MJ doesent just flow in my state so i have yet to try it again.

Nardil i could not tolerate even a day on it,as the rebound depression from being off parnate was too roboust so ill never know if nardil would have worked for me.

 

Deprenyl + Parnate/Nardil, and etc. willyee

Posted by Questionmark on July 30, 2005, at 17:31:13

In reply to Re: Deprenyl + Nardil-- willyee have you tried?, posted by willyee on July 27, 2005, at 17:13:17

> Sorry i took so long,dident catch this post until now.

~~~~Not a problem. Thanks for responding.


> The two aside,moclimide seemed to offer a 2 benifits,one was the *dry* period between parnate doses where it sometimes has u either looking for the next parnate dose,or taking something else which i have a BAD habbit of doing.
>
> I instead took a small dose of molcimide during this period,the result was the parnate seemed to have a added kick working better,providing more relieaf,as well as i took less of it.
>
> The second was i having something to take in those gaps stopped me from being so reliant on my next parnate dose and seeking it.
>
> Deprenyl was the same sceniero,i used it at night after parnate dosing was to be stopped.


~~~~Interesting stuff. And taking Deprenyl at night didn't give you horrible insomnia? i know when i was on Parnate i had bad insomnia, and it seems like even a small dose of Deprenyl on top of that, esp at night, would make it really hard to sleep.


> Deprenyl alone was a no no,with a benzo it sometimes cancelled each other out,so i stumbled onto something by accident that gave me a week of solid remission but havent since TRIED again yet.


~~~~Oh, i see. Nevermind my previous question. At first i didn't know what you meant by "Deprenyl alone was a no no, with a benzo it sometimes cancelled each other out," but now i assume you're saying this primarily in regard to insomnia.


> This was to eat,chew on a small amount of mary jane,the effects are much different than smoking as smoking makes me go insane,anyhow chewing a small amount followed by a small droplet or two of deprenyl stablized me for an entire night without any desire to want parnate.


~~~~This is really interesting. You're pretty sure it was the mj that made the difference-- or that it actually did something? Did you heat it at all or eat it with anything fatty? THC is fat-soluble and extremely water-insoluble, and it needs a certain amount of heat to be released from the plant material &/or whatever else. So i thought it would basically be impossible to feel anything from the oral ingestion of cannabis unless you cooked it in something fatty enough (or dissolved the THC in alcohol). Help me out here.


> This was much stronger than moclimides relieaf,and in fact i wonder if i could have dropped parnate down to a single morning dose followed by two dosing of the deprenyl combo.The MJ doesent just flow in my state so i have yet to try it again.
>
> Nardil i could not tolerate even a day on it,as the rebound depression from being off parnate was too roboust so ill never know if nardil would have worked for me.


~~~~Oh, that's too bad. i hate that kind of thing. But it sounds like Parnate is a really helpful drug for you, so that's good. But i'd be very interested to know what a small amount of Deprenyl would be like with Nardil. My hunch would be that if a small (or very small?) amount or Deprenyl is okay with Parnate, then it should definitely be okay with Nardil (depending on the respective doses of Parnate & Nardil). i'd like to try it sometime if i ever get the chance-- it seems like Deprenyl would be quite beneficial for some of Nardil's side effects.

 

Re: Deprenyl + Parnate/Nardil, and etc. Questionmark

Posted by Declan on July 30, 2005, at 19:41:23

In reply to Deprenyl + Parnate/Nardil, and etc. willyee, posted by Questionmark on July 30, 2005, at 17:31:13

Deprenyl is OK with Parnate. I take Parnate 10mg/d and deprenyl 1mg/d, the deprenyl for neuroprotection and whyelse I dunno, some sort of aesthetic attraction. Any more than 1mg/d sublingual deprenyl and I notice effects on sleep. The Parnate makes my sleep lighter too. So I'd have thought that deprenyl would be OK with Nardil and interesting to try. That way maybe you can keep the Nardil dose low enough so the side effects are not a problem, and the fact that it's not as effective as it might be is offset by the beneficial effects of the deprenyl which act against the sex problems that Nardil causes.
That's the idea, anyway. Then you'd just have a bit of insomnia, but not as bad as Parnate.
Declan

 

Re: Deprenyl + Parnate/Nardil, and etc.

Posted by willyee on August 2, 2005, at 8:02:32

In reply to Deprenyl + Parnate/Nardil, and etc. willyee, posted by Questionmark on July 30, 2005, at 17:31:13

> > Sorry i took so long,dident catch this post until now.
>
> ~~~~Not a problem. Thanks for responding.
>
>
> > The two aside,moclimide seemed to offer a 2 benifits,one was the *dry* period between parnate doses where it sometimes has u either looking for the next parnate dose,or taking something else which i have a BAD habbit of doing.
> >
> > I instead took a small dose of molcimide during this period,the result was the parnate seemed to have a added kick working better,providing more relieaf,as well as i took less of it.
> >
> > The second was i having something to take in those gaps stopped me from being so reliant on my next parnate dose and seeking it.
> >
> > Deprenyl was the same sceniero,i used it at night after parnate dosing was to be stopped.
>
>
> ~~~~Interesting stuff. And taking Deprenyl at night didn't give you horrible insomnia? i know when i was on Parnate i had bad insomnia, and it seems like even a small dose of Deprenyl on top of that, esp at night, would make it really hard to sleep.
>
>
> > Deprenyl alone was a no no,with a benzo it sometimes cancelled each other out,so i stumbled onto something by accident that gave me a week of solid remission but havent since TRIED again yet.
>
>
> ~~~~Oh, i see. Nevermind my previous question. At first i didn't know what you meant by "Deprenyl alone was a no no, with a benzo it sometimes cancelled each other out," but now i assume you're saying this primarily in regard to insomnia.

____When i say deprenyl alone,i mean period,as in monotherapy,or even in conjunction,simply taking deprenyl by itself at the *time* of dosing catches up with u and becomes to much,this is my exper and usualy most peoples as well,its a very stimulating med.____
>
>
> > This was to eat,chew on a small amount of mary jane,the effects are much different than smoking as smoking makes me go insane,anyhow chewing a small amount followed by a small droplet or two of deprenyl stablized me for an entire night without any desire to want parnate.
>
>
> ~~~~This is really interesting. You're pretty sure it was the mj that made the difference-- or that it actually did something? Did you heat it at all or eat it with anything fatty? THC is fat-soluble and extremely water-insoluble, and it needs a certain amount of heat to be released from the plant material &/or whatever else. So i thought it would basically be impossible to feel anything from the oral ingestion of cannabis unless you cooked it in something fatty enough (or dissolved the THC in alcohol). Help me out here.

____ Ya i heard of that as well,such as melting it into butter for brownies or etc,but no i just chomped it down,the result is nothing like a thc result,more like a benzo affect only less depressing or wierd feeling.I doubt it is a placebo affect cause i feel asleep on chewing it alone a few times,again as with deprenyl,alone its as much fun as a benzo,none,but it did the job,just for whatever reason it seemed to have this synergy with the deprenyl to give that calming factor a benzo would but dident take anything from deprenyl like a benzo sometimes does.____
>
>
> > This was much stronger than moclimides relieaf,and in fact i wonder if i could have dropped parnate down to a single morning dose followed by two dosing of the deprenyl combo.The MJ doesent just flow in my state so i have yet to try it again.
> >
> > Nardil i could not tolerate even a day on it,as the rebound depression from being off parnate was too roboust so ill never know if nardil would have worked for me.
>
>
> ~~~~Oh, that's too bad. i hate that kind of thing. But it sounds like Parnate is a really helpful drug for you, so that's good. But i'd be very interested to know what a small amount of Deprenyl would be like with Nardil. My hunch would be that if a small (or very small?) amount or Deprenyl is okay with Parnate, then it should definitely be okay with Nardil (depending on the respective doses of Parnate & Nardil). i'd like to try it sometime if i ever get the chance-- it seems like Deprenyl would be quite beneficial for some of Nardil's side effects.

---- I have one rule i live by with parnate,and it prob isnt very sensable in reality but it makes me feel safer.When im adding a secondary medication that hold a possable interaction,i make sure i dont take it in direct adjunction with parnate,meaning the same dosing time,i make sure my last parnate has bee ingested and doesent feel extremly strong.Parnate for me is most dangerous the hour of its ingestion,least from any interaction ive had.Ive never had a sitaution where parnate was taken way earlier,and boom i reacted to something taken hrs later.I guess thats bad meaning parnate is dying in my system fast,which i feel it actualy is.------

Just a note,i havent tried the deprenyl/mj thing much,so i cant speak firmly on it,but i do remeber having QUITE a response to parnate/mj once that was incredable,but never was able to repeat it.I might look into the heat method as u said as i had totaly forgotton about thc not releasing without heat,thanks.Wow what a nice ling thead huh!

 

Re: Deprenyl + Parnate/Nardil, and etc. Declan

Posted by Questionmark on August 9, 2005, at 2:36:33

In reply to Re: Deprenyl + Parnate/Nardil, and etc. Questionmark, posted by Declan on July 30, 2005, at 19:41:23

> Deprenyl is OK with Parnate. I take Parnate 10mg/d and deprenyl 1mg/d, the deprenyl for neuroprotection and whyelse I dunno, some sort of aesthetic attraction. Any more than 1mg/d sublingual deprenyl and I notice effects on sleep. The Parnate makes my sleep lighter too. So I'd have thought that deprenyl would be OK with Nardil and interesting to try. That way maybe you can keep the Nardil dose low enough so the side effects are not a problem, and the fact that it's not as effective as it might be is offset by the beneficial effects of the deprenyl which act against the sex problems that Nardil causes.
> That's the idea, anyway. Then you'd just have a bit of insomnia, but not as bad as Parnate.
> Declan


~~~Yes, that's exactly what i was thinking. Cool, i hope we're right. i at least gotta try it.
Now if i can just get some deprenyl....


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