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Dr. Bob is Robert Hsiung, MD,
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Posted by angels78 on July 31, 2010, at 15:44:30
In reply to Re: Saying Bye Bye to Nardil Forever, posted by SLS on July 31, 2010, at 4:48:09
Can you give a recommendation on what medication SSRI or combination would you recommend for SP? Non-MAOI.
Posted by ed_uk2010 on July 31, 2010, at 15:45:19
In reply to Saying Bye Bye to Nardil Forever, posted by angels78 on July 31, 2010, at 2:31:26
>Now I was thinking going back to the SSRI route and trying Paxil and a high dose and see how it effects me. If anyone has any input I'd love to hear from you. Thanks
Hi Angel,
Although Paxil can be effective for both depression and social anxiety, it does tend to cause more side effects (including weight gain) than most SSRIs. In addition, it causes more frequent and severe withdrawal symptoms when stopped.
Sertraline (Zoloft) is approved both for depression and social phobia. Have you tried it? The 'standard' dose is 50mg per day but you can go right up to 200mg if necessary.
You cannot start any SSRI until at least 14 days after stopping Nardil. Personally, I think it might be safer to give it three weeks. When starting the SSRI, a low test dose can be given initially eg. 25mg of sertraline.
Posted by angels78 on July 31, 2010, at 15:49:23
In reply to Re: Saying Bye Bye to Nardil Forever » angels78, posted by ed_uk2010 on July 31, 2010, at 15:45:19
Yes, my Pdoc and I are going to wait awhile before switching meds. I am coming off 15 mg every 2 weeks. Started down from 75mg.
I've taken Zoloft before Nardil at max dosage 200mg, and felt nothing..
Posted by ed_uk2010 on July 31, 2010, at 15:53:50
In reply to Re: Saying Bye Bye to Nardil Forever » ed_uk2010, posted by angels78 on July 31, 2010, at 15:49:23
>I've taken Zoloft before Nardil at max dosage 200mg, and felt nothing.
Ah OK. Did you take it for a prolonged period? Just asking because SSRIs can sometimes take quite a long time to help anxiety.
Posted by SLS on July 31, 2010, at 17:11:49
In reply to Re: Saying Bye Bye to Nardil Forever » SLS, posted by angels78 on July 31, 2010, at 15:44:30
> Can you give a recommendation on what medication SSRI or combination would you recommend for SP? Non-MAOI.
I would consider Effexor and perhaps add Klonopin.
- Scott
Posted by sigismund on July 31, 2010, at 23:17:50
In reply to Saying Bye Bye to Nardil Forever, posted by angels78 on July 31, 2010, at 2:31:26
>All I can is Nardil made me really talkative, it made me have energy, made me feel good, let me go into social settings and not be afriad.
If anyone can find anything (legal) other than Nardil that can do this I'd be really interested.
Posted by SLS on August 1, 2010, at 8:06:16
In reply to Re: Saying Bye Bye to Nardil Forever, posted by sigismund on July 31, 2010, at 23:17:50
> >All I can is Nardil made me really talkative, it made me have energy, made me feel good, let me go into social settings and not be afriad.
>
> If anyone can find anything (legal) other than Nardil that can do this I'd be really interested.
You can research pregabalin (Lyrica). It has been approved in Europe for social anxiety. I don't know how effective it is.
- Scott
Posted by bleauberry on August 1, 2010, at 13:06:02
In reply to Saying Bye Bye to Nardil Forever, posted by angels78 on July 31, 2010, at 2:31:26
Do you realize how many thousands of people struggle with all their being to get where you were on Nardil? You reached a place many do not. Consider yourself majorly blessed.
There is a price for that blessing. It doesn't come free. The weight gain can be managed. The excess can be lost. Exercise is not enough. Whatever your diet is, it needs to be yet new and improved even more than what it is now. If you are visiting any departments in the store than produce and lean meats, weight loss will be extremely frustrating.
I don't know. I would much rather fight the weight monster than the depression monster. At least one I can control, the other I can't. I don't care what anyone says, weight can be managed. If present efforts are not working, they are either the wrong efforts or they are not aggressive enough.
I say stay on Nardil and buckle down for a total menu makeover. That way, you stay real happy and the only ones who suffer are the taste buds....temporarily...until they change to prefer your new improved grocery list, which they will.
Worst case scenario...you gain even more weight and have a big belly forever. So what? You have a life! A happy life! Not a bad trade.
Or is a more depressed less sociable you with a skinny belly a better deal?
I wouldn't risk walking away from Nardil because many times we have seen people return to previously good meds only to find they don't work a second time around. Take all that risk because of a belly you think is too big? Not.
You got the depression managed. That's a major win. You may never win again if you let it go now. The weight monster is a preferable foe to battle against.
Ok, so you go ahead and stop nardil and want a new drug. If I had $1000 in my pocket to bet you would not find anything close to nardil, I would put it all on the table right now for a very low risk win.
Posted by ed_uk2010 on August 1, 2010, at 14:45:29
In reply to Re: Saying Bye Bye to Nardil Forever, posted by bleauberry on August 1, 2010, at 13:06:02
>I wouldn't risk walking away from Nardil because many times we have seen people return to previously good meds only to find they don't work a second time around.
Yep, and Angel has already said that his depression/anxiety does not respond to Zoloft at high doses. If Zoloft doesn't help, it's not likely that Paxil will help either. Paxil is the med which he is wanting to try.
Posted by sigismund on August 1, 2010, at 17:01:18
In reply to Re: Saying Bye Bye to Nardil Forever » sigismund, posted by SLS on August 1, 2010, at 8:06:16
I was thinking of PEA and deprenyl in the mornings and gabapentin at nights with Xanax in between.
Lyrica has a lot of side effects.
Posted by ed_uk2010 on August 1, 2010, at 17:06:37
In reply to Re: Saying Bye Bye to Nardil Forever » SLS, posted by sigismund on August 1, 2010, at 17:01:18
>Lyrica has a lot of side effects.
....but gabapentin is much weaker.
Posted by sigismund on August 1, 2010, at 17:25:40
In reply to Re: Saying Bye Bye to Nardil Forever » sigismund, posted by ed_uk2010 on August 1, 2010, at 17:06:37
It's strong enough for me. It's good for sleep. Not *too* addictive.
Very good for airports which (these days) are not as much fun as they used to be.
Posted by angels78 on August 2, 2010, at 1:16:47
In reply to Re: Saying Bye Bye to Nardil Forever, posted by bleauberry on August 1, 2010, at 13:06:02
> Do you realize how many thousands of people struggle with all their being to get where you were on Nardil? You reached a place many do not. Consider yourself majorly blessed.
>
> There is a price for that blessing. It doesn't come free. The weight gain can be managed. The excess can be lost. Exercise is not enough. Whatever your diet is, it needs to be yet new and improved even more than what it is now. If you are visiting any departments in the store than produce and lean meats, weight loss will be extremely frustrating.
>
> I don't know. I would much rather fight the weight monster than the depression monster. At least one I can control, the other I can't. I don't care what anyone says, weight can be managed. If present efforts are not working, they are either the wrong efforts or they are not aggressive enough.
>
> I say stay on Nardil and buckle down for a total menu makeover. That way, you stay real happy and the only ones who suffer are the taste buds....temporarily...until they change to prefer your new improved grocery list, which they will.
>
> Worst case scenario...you gain even more weight and have a big belly forever. So what? You have a life! A happy life! Not a bad trade.
>
> Or is a more depressed less sociable you with a skinny belly a better deal?
>
> I wouldn't risk walking away from Nardil because many times we have seen people return to previously good meds only to find they don't work a second time around. Take all that risk because of a belly you think is too big? Not.
>
> You got the depression managed. That's a major win. You may never win again if you let it go now. The weight monster is a preferable foe to battle against.
>
> Ok, so you go ahead and stop nardil and want a new drug. If I had $1000 in my pocket to bet you would not find anything close to nardil, I would put it all on the table right now for a very low risk win.Very thought out post. I was on Nardil for severe Social Phobia/agoraphobia/panic attacks, with no depression symptoms.
Posted by ed_uk2010 on August 2, 2010, at 15:21:36
In reply to Re: Saying Bye Bye to Nardil Forever » bleauberry, posted by angels78 on August 2, 2010, at 1:16:47
>Very thought out post. I was on Nardil for severe Social Phobia/agoraphobia/panic attacks, with no depression symptoms.
To be honest Angel, I think you'll find Nardil very difficult to replace. I would be concerned about the risk of relapse. SSRIs such as Paxil are pretty reliable for pure panic disorder but their efficacy in social phobia leaves a lot to be desired. There are other alternatives such as Lyrica, but Lyrica can also cause weight gain.
Posted by Phillipa on August 2, 2010, at 19:45:24
In reply to Re: Saying Bye Bye to Nardil Forever, posted by ed_uk2010 on August 2, 2010, at 15:21:36
So angel what are you going to do about the med? Phillipa
Posted by angels78 on August 3, 2010, at 5:12:25
In reply to Re: Saying Bye Bye to Nardil Forever, posted by Phillipa on August 2, 2010, at 19:45:24
I have a pdoc appt. this coming week. He's going to do the usual med run around. Try Paxil, Try zoloft, Try Effexor(I heard this might be the best SSRI for treating Social Phobia), there's also Celexa. But I want to stay away from weight gain. If anyone has any good recommendations in mind, please let me know. Thanks :)
Posted by angels78 on August 3, 2010, at 5:14:55
In reply to Re: Saying Bye Bye to Nardil Forever, posted by Phillipa on August 2, 2010, at 19:45:24
My main diagnosis is Social phobia, panic attacks, OCD, body dysmorphic disorder, with no depression symptoms.
Posted by ed_uk2010 on August 3, 2010, at 15:03:30
In reply to Re: Saying Bye Bye to Nardil Forever » Phillipa, posted by angels78 on August 3, 2010, at 5:12:25
> I have a pdoc appt. this coming week. He's going to do the usual med run around. Try Paxil, Try zoloft, Try Effexor(I heard this might be the best SSRI for treating Social Phobia), there's also Celexa. But I want to stay away from weight gain. If anyone has any good recommendations in mind, please let me know. Thanks :)
I thought you had already tried SSRIs at high doses?
Posted by Phillipa on August 3, 2010, at 20:41:34
In reply to Re: Saying Bye Bye to Nardil Forever » Phillipa, posted by angels78 on August 3, 2010, at 5:14:55
Angel I do wish your babblemail was on but it's not. Contrary to what a lot of folks may or may not feel I feel strongly that benzodiazapines help the most with any type of anxiety disorder. 40 years later maybe some tolerance but no poop out or higher doses. Phillipa
Posted by angels78 on August 4, 2010, at 2:28:51
In reply to Re: Saying Bye Bye to Nardil Forever » angels78, posted by Phillipa on August 3, 2010, at 20:41:34
Phillipa the only thing I worry about with Benzo's is the tolerance problem. I doubt anyone could go a couple years taking the same amount beit 1-2mg of Klonopin or any other benzo and have it work and not build a tolerance. I know when i tried Xanax I built a tolerance within a months time..
Posted by angels78 on August 4, 2010, at 2:31:40
In reply to Re: Saying Bye Bye to Nardil Forever, posted by ed_uk2010 on August 3, 2010, at 15:03:30
Yes Ed I've taken a few SSRI's at max doses and they didnt do anything to me, I keep hearing from pdoc's and my doctor that "Nardil is not good, and is too old and has 2 many side effects" and they keep telling me to switch medications. And I havent taken every SSRI yet, I know there's still Effexor, Celexa, Wellbutrin I havent tried, but its so frustrating to wein off Nardil completely to just try and SSRI..I just hope I don't tell myself " I told you so "
Posted by manic666 on August 4, 2010, at 3:52:19
In reply to Re: Saying Bye Bye to Nardil Forever » ed_uk2010, posted by angels78 on August 4, 2010, at 2:31:40
You keep says all the ssri,s half your listing are snri,s. totally differnt meds.Benzo addiction is an illness in its self ,so you are wise to be wary. Quick acting benzo,s are easy to get addicted to, like xanax an ativan at anything like 4 mg a day over 1 month or so. I have levelled at 4mg,but that took 20 years to achieve,20 years of unbelievable amouts ,you get to a point where you say to yourself if i take 6 mg of ativan in 1 dose i will be cool for 3 days, but in realaity its about 6 hours ,then where are you at????????? Valium is so weak you need 20mg at the start of treatment to feel the slightest effect.the thing i would only recomment it for is to detox from the real benzo,s like i mentioned.The rundown houswife med. prince valium as ladies call it,is use in combos at unbelievable high doses 100mg plus for it long life so it remain,s working to a mild affect all day an night.But at low doses to someone with cronic anxierty forget it.When addicted to ativan at high does i tried 40 mg dose,s of valium 3 times a day as an experiment ,it didnt take the slightest edge of ativan addicton.But thats just me, my brain is nuked so it didnt have much to work on.
Posted by Justherself54 on August 4, 2010, at 11:30:29
In reply to Re: Saying Bye Bye to Nardil Forever » Phillipa, posted by angels78 on August 4, 2010, at 2:28:51
I've been on .05 clonazapam at bedtime for years. There have been times when I've had to take extra (usually during a short term crisis of some sort). I've never had the desire to increase it on my own.
Posted by manic666 on August 4, 2010, at 12:40:13
In reply to Re: Saying Bye Bye to Nardil Forever, posted by Justherself54 on August 4, 2010, at 11:30:29
Dont forget i had no other meds when first addicted,i now have a back up med in sertraline. You are taking he same as 1mg of ativan a night with your o.5 of clonazapam, do you need that or has that become a habit. Would you sleep without it.I have slept forgeting my 2mg of ativan ,but woke in a panick next day, an found it hard to stablize haveing broken the cicle
Posted by ed_uk2010 on August 4, 2010, at 15:27:50
In reply to Re: Saying Bye Bye to Nardil Forever » ed_uk2010, posted by angels78 on August 4, 2010, at 2:31:40
>Yes Ed I've taken a few SSRI's at max doses and they didnt do anything to me, I keep hearing from pdoc's and my doctor that "Nardil is not good, and is too old and has 2 many side effects"
The fact that Nardil is 'old' is not relevant. As far as side effects are concerned, only the ones which you experience are relevant. Of course, your doctor will prefer to have you on an SSRI rather than Nardil, in order to reduce the risk of medico-legal problems if anything goes wrong.
>And I havent taken every SSRI yet, I know there's still Effexor, Celexa, Wellbutrin
Effexor and Wellbutrin are not SSRIs. Celexa is an SSRI.
Which SSRIs have you tried, for how long, and at what doses? The SSRIs are Prozac, Luvox, Paxil, Celexa, Lexapro and Zoloft. Have you tried any other psych meds for your anxiety?
If you have tried two or three SSRIs at adequate dosages (for several months each) and experienced no benefit, it is very unlikely that another SSRI will work well for you.
Wellbutrin is used to treat depression, but not social phobia.
Effexor can sometimes be (slighty) more effective than the SSRIs for severe depression. It does not appear to be superior for anxiety disorders, but does cause more adverse effects and withdrawal symptoms.
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