Posted by Rick on February 22, 2002, at 16:59:28
In reply to Re: Celexa for social anxiety., posted by Frankie on February 22, 2002, at 1:57:26
Thanks for the reply, Frankie.
I think the way my response was worded gave the impression that I was still using Celexa or seeking an effective treatment. Actually, I hit on my "dream combo" over a year and a half ago, after trying various meds solo and in combination: Celexa, Xanax (as-needed basis), BuSpar, pindolol, lithium (as an augmenting agent ... that lasted all of one day!), selegiline, Nardil, Tranxene, Neurontin, and probably one or two others I'm forgetting.
My big breakthrough came when I started Klonopin (clonazepam) on a regular basis. While SSRI's and/or Xanax (alprazolam) are effective for many, many people, nothing except the MAOI Nardil has even approached daily Klonopin in terms of response vs. placebo (about 80% response in the Klonopin group -- see attached Medline abstract.)
While Klonopin (taken during the day not at night) was providing so much relief alone, I hit on my "dream" cocktail when a added a low-side dose of the new, gentle, non-amphetamine psychostimulant Provigil, as well as the AD Serzone (actually the least important part of the cocktail, but helps "round things out" in several different ways).
But thanks for the good advice anyway, I'm sure there are many out there who can benefit from it.
Fyi, while not officially diagnosed as OCD, I definitely have obsessive-compulsive tendencies, and that is one thing my combo does not address. But again, it's non-clinical.Despite its lackluster performance in studies of Social Phobia (Social Anxiety), I know BuSpar can help some folks. One of my most successful combos prior to the combo I've been using the last year and a half was Klonopin + BuSpar + pindolol.
And I know many social phobics swear by Xanax, but for me it wasn't even in the same league as the longer-lasting Klonopin. Moreover, studies using Xanax showed that symptoms recurred after the patient tapered off the drug, while for Klonopin much of the benefit remained after discontinuance. Of course, I was taking Xanax only as-needed. Your Xanax dose is small, so it sounds as if it's a minor part of your regimen, perhaps for sleep? Evening though I now take my full dose (1 mg, down from from the original 2-3) of Klonopin in the morning, it has effectively eliminated any insomnia except on rare occasion.
Rick
J Clin Psychopharmacol 1993 Dec;13(6):423-8
Treatment 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 TrialPMID: 8120156 [PubMed - indexed for MEDLINE]
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> Hello Rick,
>
> I have not come to this site for a few days, so I just now saw your message. Thanks for responding. You are correct. I have a combination that I am taking. I doubt that the Celexa alone would help much. I take 20 mg. daily of Celexa, 30 mg. daily of Buspar, and .25 mg. nightly of Xanax, which is the ultimate medication in combination with an SSRI, for social anxiety. I have primary OCD symptoms, which for the most part, adds to and causes, my social anxiety. The Buspar, even though it is for GAD, can treat social anxiety disorder. It is serotonin and dopamine based. These are two primary neurotransmitters thought to be involved in social anxiety. OCD for that matter too. The other is GABA.
>
> I would suggest that you add a slight stimulant to your Celexa if you are apathetic. I do become very lethargic from this stuff, you are right. As far as the sex drive goes, it is diminished. I have no problems with ejac. or erection, but the drive is low, for me anyway. That is not a complaint though to me because normally Rick, I am a walking hormone! If you are that way, the woman can see right through it! So, I try to make the best of a "not so good" situation. Let me know your thoughts about some possibilities for you to kickstart that Celexa with something else, and I will respond with my suggestions. Talk to you later Rick.
>
> Frankie.
poster:Rick
thread:94271
URL: http://www.dr-bob.org/babble/20020222/msgs/95142.html