![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Donna Lynn on September 8, 2000, at 21:36:23
I'm suffering from very bad depression and social phobia.The doc had me on Trazodone and Celexa, the Traz is helping with the depression but my social problem has not improved one bit. So instead of Celexa he put me on Serzone. Did anyone have any luck with Serzone and this sort of problem? Has anyone taken both Traz and Serzone? I need to stop being afraid of people watching me as I play with my kids, or pay at a grocery checkout. Does anyone relate? Why do I care what people think of me? What's the best med for this?
Posted by T~ on September 9, 2000, at 10:14:45
In reply to Squirrely with social anxiety/Serzone gd?, posted by Donna Lynn on September 8, 2000, at 21:36:23
< < I'm suffering from very bad depression and social phobia. > >
hi donna,
social phobia are tuff, been there done that, AM THERE! cant answer your questions about the meds.
but i am here to support and be supported. i also suffer from depression and anxiety.
T~
Posted by KarenB on September 9, 2000, at 11:33:53
In reply to Re: Squirrely with social anxiety/Serzone gd? » Donna Lynn, posted by T~ on September 9, 2000, at 10:14:45
Donna Lynn,
Are these your only symptoms(social anxiety and feeling you are being watched) or do you experience fatigue and excessive daytime sleepiness or general anxiety, irritability, insomnia or something else? Tell more and you'll likely get more help here.
Karen
Posted by Donna Lynn on September 9, 2000, at 14:14:09
In reply to Re: Squirrely? Donna Lynn, posted by KarenB on September 9, 2000, at 11:33:53
> Donna Lynn,
>
> Are these your only symptoms(social anxiety and feeling you are being watched) or do you experience fatigue and excessive daytime sleepiness or general anxiety, irritability, insomnia or something else? Tell more and you'll likely get more help here.
>
> KarenHello to you all, I've been lurking for awhile, finally left my message. Thanks for your interest in helping me. I'm a huge mess. Well, actually, the Trazodone helps my depression with little or no side effects, so I'm happy with it.I'm mellow yet anxious. Sleep good if I'm not awakened by my baby, which is most of the time. But I can wake up easily and get back to sleep easily. I need to know what someone takes for social phobia, meaning, suppose they have no depression? Serzone is touted as an anti-depressant, so that must mean it treats social phobia on a minimal scale, right? What I'm trying to ask, is, what med is well known for treating exclusively social phobia? Is there such a drug? I want to do what everyone probably wants to do: cut to the chase- find the best med right away to avoid wasting time. I want the major, not the minor. But that is unrealistic, isn't it? Yeah. I just don't have a year to try ten different meds, my kids need to get out. I need to get out. I want to be social but I have such bad anxiety around people. Back when I was much younger and went out alot, partying, doing the late-teens thing, I was never afraid of people. I was downright boisterous. I could talk to anyone and everyone. Anytime. But now, my kids need to get out to the park, and I want so much to take them but I'm just so afraid of people ovserving me, I don't want to look like a dork playing with my kids. Maybe I'm having a midlife crisis. No longer a young girl, I may feel more self conscious getting old. I'm afraid of secondary people- WHY? I mean, I'll probably never see them again, so why do I care what they think? I get so angry, like, how dare they judge me. I don't judge them. I'm a mess, aren't I? I can go on my errands with no problem, unless stress hits me then I become the picture of squirrely- I drop my purse, contents fall out, my hands shake, frustrated that I can't handle five different things at once. Panic sets in. Then I don't want to go to the grocery store anymore. It's like, I left my mark there- everyone will remember the clutz dropping her money, hands shaking, can't even sign a check. No wonder I like to sit at home. I feel safe here. But we're bored. I admit that. If there were no people out there, I'd be out ALL the time like there was no tomorrow. So I'm not agoraphobic. I'm people-phobic. Does anyone know of the #1 med for this problem? I'd like to start at the best and work my way down to the ones less likely to work.
Posted by dove on September 9, 2000, at 14:39:58
In reply to Re: Squirrely? Donna Lynn, posted by Donna Lynn on September 9, 2000, at 14:14:09
First thing, I was under the impression that Serzone (Nefazodone) and Trazodone should ideally, not be combined, as they have the same metabolites? I could be off-base here, but that is what I've read.
Second thing, I have been taking Serzone for a while now, in combination with Amitriptyline (Elavil), Gabapentin (Neurontin), and Adderall. I've had no major negative drug interactions, and really minimal and transient side-effects, most noticable with dose increases.
The Serzone helped me the most right at first, which is not the norm for most people on this board. I seem to grow resistant to the med's positive influences the longer I take it. I no longer feel like the Serzone is really working, and my p-doc aggrees. Which is why the Neurontin (Gabapentin) was added to the mix.
I was really hoping to see some improvement, but I've been on this combo for at least two months now and am very disappointed with the results. I am taking the Serzone for anxiety/panic attacks, depression, agitation, and social anxiety. I'm taking the Neurontin for the same reasons plus mood-stabilization.
The Serzone is taken throughout the day, the last dose being taken right before bed with all of the Amitriptyline. I'm suppose to be taking all of the Neurontin at that same time (right before bed) but have been taking half of that around 3 in the afternoon. The Serzone has really improved my sleep, which is one great side-effect I'd hate to give up.
As to Social Anxiety and Serzone, everyone is different, so the only way to find out is to try it and see. I will say that I know of no one single person that has given Serzone the number one spot for social anxiety/phobia treatment, but Serzone generally seems to help social anxiety much more than depression. And it does seem to help when combined with other meds, and it's very good for the libido.
dove
Posted by Donna Lynn on September 9, 2000, at 15:03:50
In reply to Re: Squirrely? Donna Lynn, posted by dove on September 9, 2000, at 14:39:58
> First thing, I was under the impression that Serzone (Nefazodone) and Trazodone should ideally, not be combined, as they have the same metabolites? I could be off-base here, but that is what I've read.
>
> Second thing, I have been taking Serzone for a while now, in combination with Amitriptyline (Elavil), Gabapentin (Neurontin), and Adderall. I've had no major negative drug interactions, and really minimal and transient side-effects, most noticable with dose increases.
>
> The Serzone helped me the most right at first, which is not the norm for most people on this board. I seem to grow resistant to the med's positive influences the longer I take it. I no longer feel like the Serzone is really working, and my p-doc aggrees. Which is why the Neurontin (Gabapentin) was added to the mix.
>
> I was really hoping to see some improvement, but I've been on this combo for at least two months now and am very disappointed with the results. I am taking the Serzone for anxiety/panic attacks, depression, agitation, and social anxiety. I'm taking the Neurontin for the same reasons plus mood-stabilization.
>
> The Serzone is taken throughout the day, the last dose being taken right before bed with all of the Amitriptyline. I'm suppose to be taking all of the Neurontin at that same time (right before bed) but have been taking half of that around 3 in the afternoon. The Serzone has really improved my sleep, which is one great side-effect I'd hate to give up.
>
> As to Social Anxiety and Serzone, everyone is different, so the only way to find out is to try it and see. I will say that I know of no one single person that has given Serzone the number one spot for social anxiety/phobia treatment, but Serzone generally seems to help social anxiety much more than depression. And it does seem to help when combined with other meds, and it's very good for the libido.
>
> doveYes, I think you are right about mixing the Serzone and the Trazodone. When I picked up the new prescription (Serzone) the pharmacist asked me if I was still on the Traz and I said yes. He said they are both so similar that I should not need to be on both. But I don't want to give up the Traz, it works so well for me. I'll ask my doctor at the next meet. I'm sure he wants me to stay on both.
Those other two medications you take, do they help with social anxiety? How long did they take to work for you?
Also, I was thinking about it and I realized that one reason I may have become a social phobic is due to negative responses I got from people in the past. I am, by nature, a very friendly person and when I'm around my kids or my parents, or my husband, I'm great. Even two close friends, I'm bubbly and generally happy. The depression started about 7 mos ago due to a crisis in my life, but it never affected my relationships with people I know and trust. I was just very down in the dumps, "woa is me..." But alot of times, out in public, my friendliness to people was met with suspicion (what does she want from me, she's too nice..), or hostility (get out of my face), or just nastiness (not saying thanks if I held open a door). So I think I just shut down. I gave up on the general public. I just got too much crap from people, nasty people, and it affected me, I took it to heart. Most people would shake it off, but I didn't. Maybe that's what happened to me.
Posted by annie8 on September 10, 2000, at 13:53:16
In reply to Re: Squirrely? Donna Lynn, posted by Donna Lynn on September 9, 2000, at 15:03:50
>
paxil is suppossed to be a great drug for social anxiety, check that one out, my best friend is on it and it has worked wonders, there is how-ever sometimes a sexual side effect, so consider that as well
> First thing, I was under the impression that Serzone (Nefazodone) and Trazodone should ideally, not be combined, as they have the same metabolites? I could be off-base here, but that is what I've read.
> >
> > Second thing, I have been taking Serzone for a while now, in combination with Amitriptyline (Elavil), Gabapentin (Neurontin), and Adderall. I've had no major negative drug interactions, and really minimal and transient side-effects, most noticable with dose increases.
> >
> > The Serzone helped me the most right at first, which is not the norm for most people on this board. I seem to grow resistant to the med's positive influences the longer I take it. I no longer feel like the Serzone is really working, and my p-doc aggrees. Which is why the Neurontin (Gabapentin) was added to the mix.
> >
> > I was really hoping to see some improvement, but I've been on this combo for at least two months now and am very disappointed with the results. I am taking the Serzone for anxiety/panic attacks, depression, agitation, and social anxiety. I'm taking the Neurontin for the same reasons plus mood-stabilization.
> >
> > The Serzone is taken throughout the day, the last dose being taken right before bed with all of the Amitriptyline. I'm suppose to be taking all of the Neurontin at that same time (right before bed) but have been taking half of that around 3 in the afternoon. The Serzone has really improved my sleep, which is one great side-effect I'd hate to give up.
> >
> > As to Social Anxiety and Serzone, everyone is different, so the only way to find out is to try it and see. I will say that I know of no one single person that has given Serzone the number one spot for social anxiety/phobia treatment, but Serzone generally seems to help social anxiety much more than depression. And it does seem to help when combined with other meds, and it's very good for the libido.
> >
> > dove
>
> Yes, I think you are right about mixing the Serzone and the Trazodone. When I picked up the new prescription (Serzone) the pharmacist asked me if I was still on the Traz and I said yes. He said they are both so similar that I should not need to be on both. But I don't want to give up the Traz, it works so well for me. I'll ask my doctor at the next meet. I'm sure he wants me to stay on both.
> Those other two medications you take, do they help with social anxiety? How long did they take to work for you?
> Also, I was thinking about it and I realized that one reason I may have become a social phobic is due to negative responses I got from people in the past. I am, by nature, a very friendly person and when I'm around my kids or my parents, or my husband, I'm great. Even two close friends, I'm bubbly and generally happy. The depression started about 7 mos ago due to a crisis in my life, but it never affected my relationships with people I know and trust. I was just very down in the dumps, "woa is me..." But alot of times, out in public, my friendliness to people was met with suspicion (what does she want from me, she's too nice..), or hostility (get out of my face), or just nastiness (not saying thanks if I held open a door). So I think I just shut down. I gave up on the general public. I just got too much crap from people, nasty people, and it affected me, I took it to heart. Most people would shake it off, but I didn't. Maybe that's what happened to me.
Posted by Rick on September 11, 2000, at 2:35:30
In reply to Re: Squirrely? Donna Lynn, posted by annie8 on September 10, 2000, at 13:53:16
Donna -
Everyone reacts differently to different meds. But in placebo-controlled, double-blind studies, NO med has ever shown a greater Social Phobia response rate (near 80%) than the benzo Klonopin.
And that response comes FAST -- for me it was virtually immediate, and never let up. (Let me know if you'd like to see the actual study from Duke University.)Initially, my pdoc tried several different AD's and even a few other benzos for my severe but non-depressive Social Phobia. But almost as soon as I started Klonopin, I got my life back. 70% of my people-fear disappeared, and the remaining 30% became less acute (although I hardly became a "party animal"). Klonopin is a godsend for me.
The fear of scrutiny just dissolved away to normal, non-phobic levels.If you need QUICK (let alone the most effective) relief, try it! A psychiatrist will be much more likely to let you take it long-term than a general practitioner would.
After some week-one sedation, I have had no *negative* side effects from Klonopin, EXCEPT when doses were taken too close together (for me that's less than four hours apart), or when I took too much in one day. While optimal dosage varies widely by person, I think you would want to take 2mg/day MAX (in two or three doses), especially if you're also taking an AD. Indeed, I learned early on that Klonopin actually worked *better* for me when I *reduced* the daily dosage from 2.5-3.0 mg/day to 1.5-2.0 mg/day. Now, after a year, I take 1.25 mg/day (maybe up to 1.75 on days with extra-challenging events like big presentations or social events filled entirely with strangers). My pdoc (practicing 22 years) says that few people are prone to future withdrawal symptoms as long as they consistently stayed under 3.0 mg/day.
BUT...if you have abused drugs or if you drink more than a moderate (preferably low-to-none) amount of alcohol, let your doctor know this and be extra-careful not to take too much. (I've never taken the generic - clonazepam - but some people have suggested it's not quite as potent as the brand and may require a somewhat higher dosage).
As for sleep, you likely won't need sleep aids anymore, especially if you take some Klonopin at bedtime. The downsides to bedtime dosing are that you may become dependent on it for sleep; and that it's better to have peak blood levels of Klonopin when social challenges are apt to arise, rather than while you're sleeping. I have always taken most in the morning -- and none after 2 or 3 p.m. -- yet it instantly eliminated 95% of my insomnia (partly because it also reduces general anxiety). If you have sleep apnea or resiratory problems, try to take your last dose on the early side, since Klonopin can aggravate respiratory disorders.
You and I actually have some interesting parallels med-wise. After six months of Klonopin, with 70% relief of my Social Phobia symptoms day-to-day, I decided to see if I could "go for the gold" and close in on 100%. (BTW, if I gave you the FULL history, this post would become even lengthier.) But the first AD I tried adding (not counting a few PRE-Klonopin AD trials) was Celexa. This seemed to help a bit after eight weeks at 20 mg, but the extra relief wasn't worth the frequent fatigue, mental slowness, and moderate sexual dysfunction I was experiencing at this lowish dose.So I replaced the Celexa with -- you guessed it -- Serzone. There have been some small-scale studies suggesting Serzone's effectiveness in Social Phobia. Serzone seems to be a real wildcard in general, with some people experiencing major side effects/lack of efficacy in depression or anxiety...while it's been a no-side-effect but potent-relief med for others.
When I started Serzone (continuing the Klonopin, of course!), I started sensing some added benefits ater a few weeks. But (to a lesser degree than the Celexa) it sometimes made me feel a little lethargic and unmotivated. I convinced my pdoc to let me add the fairly new (to the U.S.) medication Provigil, whose only "official" designation is for narcolepsy. It is unrelated to potentially addicting and side-effect-prone traditional stimulants like Ritalin and aphetamines. While others on this board have had some problems with Provigil (sometimes related to concurrent or recent use of other stimulants, in my opinion), it has been a wonderful addition to my Social Phobia "cocktail". I have had no significant side effcts, and it started working on day one. Provigil eliminated the frequent lethargy (but had NO effect on my ability to sleep when I WANT to), and made me feel more alert, sharp, and -- here's the best part -- a lot more sociable. While Klonopin and Serzone removed the people-FEAR, concurrent Provigil made me gravitate TOWARDS people, made me more enthusiastic, proactive, assertive, and talkative. (Still no "party animal" by any stretch!)
Once again, it's essential to work towards the individulaized optimal dosage -- not too low, and not too high. (For me, "not too high" applies especially to the Provigil. Taking too much can cause a tinge of nervousness on a stressful day.) Right now, I've stabilized at 450mg/day Serzone, 100mg Provigil (occasionally 200), and of course 1.25 mg Klonopin (occasionally a little higher).
It's hard to say how much of that "go for the gold" benefit comes from the Serzone and how much comes from the Provigil. AD's often take a long time to begin working for Social Phobia (when they work at all). Indeed, the latter of the two Serzone Social Phobia studies showed the biggest leap in efficacy coming between weeks eight and twelve! Based on some recent studies (including some I cited in a new-topic post submitted here a few hours ago), I think the Provigil and Serzone are working synergistically. But I'm confident that at this point the Serzone would be helping even without the Provigil -- certainly a lot more than the Celexa did.
But, bottom line is still: If you need quick and effective relief, Klonopin is by far your best bet. And, whatever you do, don't let a doctor try to prescribe it on an "as-needed" basis! Regular use provides much better relief and eliminates sedation as your body gets used to the med. Also, no other benzos (e.g., Xanax, which I tried) compare to Klonopin for Social Phobia. (One placebo-controlled study showed some benefit from Ativan and/or Xanax, but with far less consistent relief than seen in the Klonopin study.)Good luck to you, Donna. You'll get through this!
Sorry for rambling a bit...
RickP.S. It is has been suggested that Serzone *may* increase the amount of Klonopin in the blood by delaying its metabolism. But this is only a hypothesis, based on Serzone's demonstrated doubling of Xanax concentrtions, as well as Serzone's MAJOR increase in Halcion levels (contra-indicated). But the official Serzone monograph has no warning to avoid concurrent Klonopin use. I know that I've experienced no problems. My decrease to 1.25 mg of Klonopin came back when I tried Celexa, not the Serzone.
P.S. #2 If anyone writes back about the dangers of sustained benzo use, I will not respond because we've been through this tiresome debate too many times. Sure, there are some people have difficulties due to a variety of factors, but I've seen fewer people complaining of low-dose benzo withdrawal than of Paxil or Effexor withdrawal. Used responsibly, benzos are very safe. Most (not "all") studies from respected researchers debunk the benzo myths...which even many pdocs cling to, unfortunately.
Posted by Cindy W on September 11, 2000, at 9:06:31
In reply to Squirrely with social anxiety/Serzone gd?, posted by Donna Lynn on September 8, 2000, at 21:36:23
> I'm suffering from very bad depression and social phobia.The doc had me on Trazodone and Celexa, the Traz is helping with the depression but my social problem has not improved one bit. So instead of Celexa he put me on Serzone. Did anyone have any luck with Serzone and this sort of problem? Has anyone taken both Traz and Serzone? I need to stop being afraid of people watching me as I play with my kids, or pay at a grocery checkout. Does anyone relate? Why do I care what people think of me? What's the best med for this?
Donna, I've taken Serzone, but not Trazodone, and found Serzone to really help with both depression and social anxiety. Read about Serzone, though, and see previous posts by others...it takes some time (2 weeks for me) to adjust to the Serzone, and it should be increased very slowly. For the first two weeks, I felt worse (mood changes, angry); then I felt GREAT and could do groups at work with no anxiety (before, I just dreaded talking in front of a group of people). If you aren't seeing a therapist, too, you might consider psychotherapy; behavior therapy especially can be helpful, with social anxiety.--Cindy W
Posted by Donna Lynn on September 11, 2000, at 9:52:07
In reply to Re: Squirrely? Donna Lynn, posted by Rick on September 11, 2000, at 2:35:30
> Donna -
>
> Everyone reacts differently to different meds. But in placebo-controlled, double-blind studies, NO med has ever shown a greater Social Phobia response rate (near 80%) than the benzo Klonopin.
> And that response comes FAST -- for me it was virtually immediate, and never let up. (Let me know if you'd like to see the actual study from Duke University.)
>
> Initially, my pdoc tried several different AD's and even a few other benzos for my severe but non-depressive Social Phobia. But almost as soon as I started Klonopin, I got my life back. 70% of my people-fear disappeared, and the remaining 30% became less acute (although I hardly became a "party animal"). Klonopin is a godsend for me.
> The fear of scrutiny just dissolved away to normal, non-phobic levels.
>
> If you need QUICK (let alone the most effective) relief, try it! A psychiatrist will be much more likely to let you take it long-term than a general practitioner would.
>
> After some week-one sedation, I have had no *negative* side effects from Klonopin, EXCEPT when doses were taken too close together (for me that's less than four hours apart), or when I took too much in one day. While optimal dosage varies widely by person, I think you would want to take 2mg/day MAX (in two or three doses), especially if you're also taking an AD. Indeed, I learned early on that Klonopin actually worked *better* for me when I *reduced* the daily dosage from 2.5-3.0 mg/day to 1.5-2.0 mg/day. Now, after a year, I take 1.25 mg/day (maybe up to 1.75 on days with extra-challenging events like big presentations or social events filled entirely with strangers). My pdoc (practicing 22 years) says that few people are prone to future withdrawal symptoms as long as they consistently stayed under 3.0 mg/day.
>
> BUT...if you have abused drugs or if you drink more than a moderate (preferably low-to-none) amount of alcohol, let your doctor know this and be extra-careful not to take too much. (I've never taken the generic - clonazepam - but some people have suggested it's not quite as potent as the brand and may require a somewhat higher dosage).
>
> As for sleep, you likely won't need sleep aids anymore, especially if you take some Klonopin at bedtime. The downsides to bedtime dosing are that you may become dependent on it for sleep; and that it's better to have peak blood levels of Klonopin when social challenges are apt to arise, rather than while you're sleeping. I have always taken most in the morning -- and none after 2 or 3 p.m. -- yet it instantly eliminated 95% of my insomnia (partly because it also reduces general anxiety). If you have sleep apnea or resiratory problems, try to take your last dose on the early side, since Klonopin can aggravate respiratory disorders.
>
> You and I actually have some interesting parallels med-wise. After six months of Klonopin, with 70% relief of my Social Phobia symptoms day-to-day, I decided to see if I could "go for the gold" and close in on 100%. (BTW, if I gave you the FULL history, this post would become even lengthier.) But the first AD I tried adding (not counting a few PRE-Klonopin AD trials) was Celexa. This seemed to help a bit after eight weeks at 20 mg, but the extra relief wasn't worth the frequent fatigue, mental slowness, and moderate sexual dysfunction I was experiencing at this lowish dose.
>
> So I replaced the Celexa with -- you guessed it -- Serzone. There have been some small-scale studies suggesting Serzone's effectiveness in Social Phobia. Serzone seems to be a real wildcard in general, with some people experiencing major side effects/lack of efficacy in depression or anxiety...while it's been a no-side-effect but potent-relief med for others.
>
> When I started Serzone (continuing the Klonopin, of course!), I started sensing some added benefits ater a few weeks. But (to a lesser degree than the Celexa) it sometimes made me feel a little lethargic and unmotivated. I convinced my pdoc to let me add the fairly new (to the U.S.) medication Provigil, whose only "official" designation is for narcolepsy. It is unrelated to potentially addicting and side-effect-prone traditional stimulants like Ritalin and aphetamines. While others on this board have had some problems with Provigil (sometimes related to concurrent or recent use of other stimulants, in my opinion), it has been a wonderful addition to my Social Phobia "cocktail". I have had no significant side effcts, and it started working on day one. Provigil eliminated the frequent lethargy (but had NO effect on my ability to sleep when I WANT to), and made me feel more alert, sharp, and -- here's the best part -- a lot more sociable. While Klonopin and Serzone removed the people-FEAR, concurrent Provigil made me gravitate TOWARDS people, made me more enthusiastic, proactive, assertive, and talkative. (Still no "party animal" by any stretch!)
>
> Once again, it's essential to work towards the individulaized optimal dosage -- not too low, and not too high. (For me, "not too high" applies especially to the Provigil. Taking too much can cause a tinge of nervousness on a stressful day.) Right now, I've stabilized at 450mg/day Serzone, 100mg Provigil (occasionally 200), and of course 1.25 mg Klonopin (occasionally a little higher).
>
> It's hard to say how much of that "go for the gold" benefit comes from the Serzone and how much comes from the Provigil. AD's often take a long time to begin working for Social Phobia (when they work at all). Indeed, the latter of the two Serzone Social Phobia studies showed the biggest leap in efficacy coming between weeks eight and twelve! Based on some recent studies (including some I cited in a new-topic post submitted here a few hours ago), I think the Provigil and Serzone are working synergistically. But I'm confident that at this point the Serzone would be helping even without the Provigil -- certainly a lot more than the Celexa did.
>
> But, bottom line is still: If you need quick and effective relief, Klonopin is by far your best bet. And, whatever you do, don't let a doctor try to prescribe it on an "as-needed" basis! Regular use provides much better relief and eliminates sedation as your body gets used to the med. Also, no other benzos (e.g., Xanax, which I tried) compare to Klonopin for Social Phobia. (One placebo-controlled study showed some benefit from Ativan and/or Xanax, but with far less consistent relief than seen in the Klonopin study.)
>
> Good luck to you, Donna. You'll get through this!
>
> Sorry for rambling a bit...
> Rick
>
> P.S. It is has been suggested that Serzone *may* increase the amount of Klonopin in the blood by delaying its metabolism. But this is only a hypothesis, based on Serzone's demonstrated doubling of Xanax concentrtions, as well as Serzone's MAJOR increase in Halcion levels (contra-indicated). But the official Serzone monograph has no warning to avoid concurrent Klonopin use. I know that I've experienced no problems. My decrease to 1.25 mg of Klonopin came back when I tried Celexa, not the Serzone.
>
> P.S. #2 If anyone writes back about the dangers of sustained benzo use, I will not respond because we've been through this tiresome debate too many times. Sure, there are some people have difficulties due to a variety of factors, but I've seen fewer people complaining of low-dose benzo withdrawal than of Paxil or Effexor withdrawal. Used responsibly, benzos are very safe. Most (not "all") studies from respected researchers debunk the benzo myths...which even many pdocs cling to, unfortunately.Rick--
Thank you so much for all of this information. It is what I've been waiting for. I've had social phobia for a long time but nothing ever helped me, I've had it for about 10 years, mild at first then worse and worse as years passed. My doc sees my life falling apart all around me, and he knows I have to get it together for the sake of my kids, so I'm pretty sure he will let me try klonopin. However, I've only tried the selzone for less than a week, so he may tell me to give it more time, which is fair. I'll probably lose 10 lbs by my next visit, though. I don't understand what it is about long term use of klonopin- does it cause liver damage or something? Or is long term use discouraged due to possible addiction? What is the big deal about addiction if it is what one needs to feel normal? Heck, I'll stay on anything for the rest of my life if it means I'll live again. If I can get by on under 1mg per day of klonopin, would long term use still be a threat? I need a quick fix, fast. I'm starting to give up on my meds, because I still have no life. The trazodone I take helps the depression but now I'm so discouraged on the Serzone that it hampers my depression relief, I just can't stop feeling like the world sucks because I CAN'T GET OUT OF THE FREAKIN' HOUSE! So, how can I get out of the depression? Hense, my main problem is really social phobia, not depression. My depression is aggravated by the phobia and not getting out. So, if I get on the klonopin, maybe it'll solve both my problems. I hope my doc will let me try it. I have no drug abuse problems and I rarely drink anymore because the meds i'm on make me just want water. I can't even look at a glass of wine. I used to be on Xanax about 15 years ago and I never got addicted, I took them sparingly and only as needed and I was only on them for 3 or 4 months. Valium, I have a slightly addictive nature towards those but I probably couldn't even get them if I wanted them. Anyway, I know you don't want to re-hash all the rebuttals you have to those who have said long term use of klonopin is really bad, but could you give me an idea so I know the whole picture. I mean, are my kidneys gonna shut down or something if I'm on it for 2 years? I really want to try this stuff, I see my doc on the 25th, I want to know all about this med so I'm ready for anything he says if he tries to talk me out of it. In the meantime, I'll do some research on my own. W/B when you can, I think you can give me the whole picture. Thanks again for all of your info!! D.
Posted by Rick on September 12, 2000, at 2:03:31
In reply to Re: Squirrely? Donna Lynn, posted by Donna Lynn on September 11, 2000, at 9:52:07
Donna --
Yes, I would absolutely prefer the risk of drug dependence over remaining miserable! While a small but significant number of people have developed severe withdrawal symptoms when trying to get off a benzo, these problems are temporary and can be minimized by weaning off properly, under your doctor's supervision. Very often, the perceived "withdrawal" symptoms are really the acute return of anxiety after the benzo is completely discontinued and gone from the body.
And no, I wasn't suggesting that long-term Klonopin (or other benzo) use will damage the body or vital functions! To the contrary, Klonopin is very safe in this regard -- as safe as today's most-touted antidepressants (and much safer than some old-line AD's). Virtually ANY med -- even aspirin -- can cause severe physical problems in rare instances.Unfortunately, I won't much time to visit this site or answer e-mails for awhile. But please do look at these links, which give a capsule summary of the placebo-controlled study of clonazepam (Klonopin) in Social Phobia:
Another follow-up, which I didn't provide the link for, showed that much of the Social Phobia benefit from limited-time Klonopin use persisted for years after the med was discontinued. While there's no guarantee that Klonopin will help you as much as it helped me, I'm sure it's your best bet, especially for quick relief.
One more point: You're likely on track that the Social Phobia led to your depression. And it's also a good bet that helping lessen the Social Phobia WILL lead to remission of the depression. But that's by no means a given, so you *might* need more than Klonopin, which does not have antidepressant qualities. Remember, while I was feeling kind of "down" about my anxiety and the stress it caused, I was NOT (and never have been) clinically depressed. Similarly, those in the study did not have concurrent depression, even though depression commonly eminates from severe Social Phobia. Wha I'm saying is, keep an open mind about depression treatment. But on the flip side, be careful NOT to do what so many patients and their doctors do: namely, jump to the conclusion that fatigue other symptoms during combined AD/benzo use are due to the benzo, rather than the AD or a combination effect.
Finally, for support in terms of situation/idea sharing with other Social Phobics, visit the link below (run by the Anxiety Disorders Association of America; requires free instant, anonymous registration).
http://www.adaa.org/consumerresources/login.cfm
Good Luck,
Rick
Posted by KarenB on September 13, 2000, at 21:16:28
In reply to Re: Squirrely? Donna Lynn, posted by Rick on September 12, 2000, at 2:03:31
Donna Lynn,
Rick's right about Klonopin - it is effective. I only take 1mg per day now and it is working well for me. You may experience a little sleepiness at first but that has slowly gone away for me after the first week or so.
Another one to try, if you are adventurous about ordering overseas meds, is the neuroleptic/antidepressant, Amisulpride. It is highly effective in low doses (50-150mg per day)for social anxiety and has mild antidepressant action. I have found nothing else like it in the States. Or...any other neuroleptics (antipsychotics) taken in low doses will work BUT most, like Zyprexa, can cause some pretty hefty weight gain, unless you are thin enough not to care. Even Amisulpride can cause weight gain, to a lesser extent and even complete cessation of menses. Sanity has it's price. Not that I mind not having periods but if you ever stop the med - it can be some kind of nightmare PMS for several months.
Ziprasidone is in the process of acceptance by the FDA and is supposed to have all the benefits of Zyprexa without the weight gain. As soon as that is released, I will try to replace the Amisulpride with this newly released med, if it is effective for me. I don't actually LIKE having to order from overseas but when a med is superior to what we've got here, that's what I'm going to take. I've lost too much time to my illness already.
Funny, what you call social anxiety, I would describe similarly in myself as neurosis. For instance, I also have wondered WHY I was concerned about what the grocery store cashier was thinking about me. It is as if I am entirely vulnerable to the judgments of strangers - whether real or imagined. Well, with the right medication, I just don't give a rip. Not in a numb, uncaring kind of way but in what I believe may be as close to "normal" as I have ever been. I have not had any emotional "flattening," I can still cry at movies, I can still get my feelings hurt but I just don't take EVERYTHING so personally anymore. If someone is watching me with my children, I don't imagine they are judging, just observing. Maybe they're even thinking, "Hey, she's having a great time with her kids." And I've got to tell you - that feels good.
I wish the best for you, Donna Lynn. Keep us posted.
Karen
Posted by Donna Lynn on September 14, 2000, at 10:36:02
In reply to Re: Squirrely? Donna Lynn, posted by KarenB on September 13, 2000, at 21:16:28
> Ay, Karen. Thanks for the post! I'm doing a little better...depression-wise. But my doc doesn't know what to do about the social anxiety, I keep calling and bugging him to let me try this and that. He refuses to put me on klonopin, he said that's a last resort in my case. But, I'm very interested in that med you mentioned, but how do I get it overseas? I'm surprised our Big Brother will give us any open path to getting a drug outside the US, but I sure would give it a try if I knew how to go about doing it. Somebody else mentioned a different one (don't have the name or it handy) that sounded good too. But it's from Europe. So, anybody got some tips for ducking the Big Bro? In the meantime, I'm scurrying to the doc's office to pick up some samples of Effexor today, and the way I feel today I'm really not in the mood to try something new, I feel like crap. Dizzy, headachy, weak, nauseous. Must be from withdrawal off the Serzone. I only lasted 4 days on it, so I didn't see a reason to wean. Guess that was a mistake. Oh well. Thanks Karen, for your help. I hope to have some good news soon (I HOPE!) D.
>
Posted by KarenB on September 18, 2000, at 18:52:18
In reply to How do I order meds from overseas?, posted by Donna Lynn on September 14, 2000, at 10:36:02
Donna Lynn,
If you e-mail AndrewB, he'll send you an informative piece on amisulpride, including ordering info.
Good luck.
K
Posted by Rick on September 22, 2000, at 2:35:10
In reply to How do I order meds from overseas?, posted by Donna Lynn on September 14, 2000, at 10:36:02
Sorry if you already mentioned this, but are you seeing a general practitioner/family doctor or a psychiatrist? There are plenty of psychiatrists who would let you try Klonopin, especially in a large metro. Even pdocs (and some GP's) who don't like to prescribe benzos long-term DO prescribe them during the first month of AD use, to quickly reduce concurrent anxiety (some of which may be worsened by the AD itself before your body adjusts).
Maybe I'm overly cautious about these things, but I'd go with a relatively inexpensive, rigorously tested, safety-proven, FDA-approved U.S. drug before ordering from overseas. BTW, Klonopin does not generally cause weight gain. Are you required to stick with this doctor, or do you simply like her/him a lot?
> > Ay, Karen. Thanks for the post! I'm doing a little better...depression-wise. But my doc doesn't know what to do about the social anxiety, I keep calling and bugging him to let me try this and that. He refuses to put me on klonopin, he said that's a last resort in my case. But, I'm very interested in that med you mentioned, but how do I get it overseas? I'm surprised our Big Brother will give us any open path to getting a drug outside the US, but I sure would give it a try if I knew how to go about doing it. Somebody else mentioned a different one (don't have the name or it handy) that sounded good too. But it's from Europe. So, anybody got some tips for ducking the Big Bro? In the meantime, I'm scurrying to the doc's office to pick up some samples of Effexor today, and the way I feel today I'm really not in the mood to try something new, I feel like crap. Dizzy, headachy, weak, nauseous. Must be from withdrawal off the Serzone. I only lasted 4 days on it, so I didn't see a reason to wean. Guess that was a mistake. Oh well. Thanks Karen, for your help. I hope to have some good news soon (I HOPE!) D.
> >
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