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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by Medline on October 5, 2008, at 14:57:35
What has helped you the most and which drugs do you think could be useful for treating Social Anxiety Disorder? SSRIs/SNRIs, irreversible unselective MAOIs, Benzos like Clonazepam, Antiepileptics like Gabapentin/Pregabalin have shown to be effective in clinical trials. GHB/GBL works very well IMHO, but the short have life and high addiction potential limit their use. What about supplements/nootropics like Picamilon/L-Theanine/Phenibut? Controlled substances like Methylphenidate/Amphetamine, Buprenorphine? Any combination of drugs? Do you think drugs can make very shy people pretty outgoing in the long term without doing harm? If yes, which? Imagine you could create your own Anti-Social-Phobia Regimen, what drugs/supplements would you include?
Posted by Sigismund on October 5, 2008, at 15:42:56
In reply to Most effective drugs for Social Phobia?, posted by Medline on October 5, 2008, at 14:57:35
>SSRIs/SNRIs
No good, I wouldn't think>irreversible unselective MAOIs
Everyone says Nardil, but it comes with bad s/e>Benzos like Clonazepam
Yeah, that with Nardil, but life long benzo addiction/dependence is a possibility.>Antiepileptics like Gabapentin/Pregabalin have shown to be effective in clinical trials
What about the withdrawal? Some say it's worse than benzos.>GHB/GBL works very well IMHO, but the short have life and high addiction potential limit their use.
Never tried it. I assume it is illegal because it is effective.>What about supplements/nootropics like Picamilon
Worse than uselss to me>L-Theanine
Useful, but dunno for social phobia. Hydergine actually makes me feel a little better.>Phenibut
I don't much like what I've heard about it.>Controlled substances like Methylphenidate/Amphetamine, Buprenorphine?
Well, very likely, with the usual reservations.>Any combination of drugs?
Just Nardil and clonazepam (some have added Dexedrine to that, but I think that is very heavy duty) but you'd want to have SP bad to justify it.>Imagine you could create your own Anti-Social-Phobia Regimen, what drugs/supplements would you include?
I would chew coca leaf while I walked around the Andes.
Posted by rjlockhart04-08 on October 5, 2008, at 19:20:28
In reply to Re: Most effective drugs for Social Phobia?, posted by Sigismund on October 5, 2008, at 15:42:56
This is off topic, but you know the good old "Alcohol" really will hit the trick for anyone.
Xanax is simliar, but it doesnt "make you drunk".
I take Xanax with Dexedrine (ordered by doctor) for anxiety, because i've been on Xanax long time. It provdies a "relief" feeling with the effect of Dexedrine with out anxiety. Its the best. They used to have some called "Dexamyl" but it was taken off because "Elvis" abused so much, and so did alot of society. (d-amphetamine/amobarbital) That wouldnt work for me....amobarbital is used as truth serum in the US, and isnt available by presciption anymore. I'm glad too, next they need to take off Phenobarbital (the worst sedative)
Xanax and i would say Nardil are the best.
Rj
Posted by desolationrower on October 5, 2008, at 20:15:24
In reply to Re: Most effective drugs for Social Phobia?, posted by rjlockhart04-08 on October 5, 2008, at 19:20:28
i don't find alcohol to help with social anxiety.
-d/r
Posted by Phillipa on October 5, 2008, at 20:57:20
In reply to Re: Most effective drugs for Social Phobia?, posted by desolationrower on October 5, 2008, at 20:15:24
It did for me until told to stop drinking by my pdoc but felt wonderful while on it. Phillipa
Posted by Sigismund on October 5, 2008, at 21:34:06
In reply to Re: Most effective drugs for Social Phobia?, posted by desolationrower on October 5, 2008, at 20:15:24
I think it works best when everyone is equally drunk.
Posted by Tomatheus on October 6, 2008, at 0:34:31
In reply to Most effective drugs for Social Phobia?, posted by Medline on October 5, 2008, at 14:57:35
> Imagine you could create your own Anti-Social-Phobia Regimen, what drugs/supplements would you include?
I would be sure to include the "old" Nardil. As back-up plans, I would also include the "old" Parnate (or Goldshield's tranylcypromine), Marplan, benzodiazepines, and SSRIs.
Tomatheus
Posted by rjlockhart04-08 on October 6, 2008, at 0:42:50
In reply to Re: Most effective drugs for Social Phobia? » Medline, posted by Tomatheus on October 6, 2008, at 0:34:31
Agreed. Forgot to share that. You beat me to it!
Hi-five!
rj
Posted by Tomatheus on October 6, 2008, at 1:03:04
In reply to Re: Tomatheus, posted by rjlockhart04-08 on October 6, 2008, at 0:42:50
> Agreed. Forgot to share that. You beat me to it!
>
> Hi-five!
>
> rjAnd a hi-five back to you!
Tomatheus
Posted by Medline on October 6, 2008, at 1:21:51
In reply to Re: Tomatheus » rjlockhart04-08, posted by Tomatheus on October 6, 2008, at 1:03:04
It's so sick that the most effective drugs for Social Phobia are 50+ years old and have some serious interactions with food or other drugs. What do you think about a combination of Bupropion (Wellbutrin) + Escitalopram (Lexapro) + Clonazepam (Klonopin)? That would hit Serotonin, Norepinephrine, Dopamine and GABA.
Posted by Tomatheus on October 6, 2008, at 1:35:04
In reply to Wellbutrin + Lexapro + Klonopin..., posted by Medline on October 6, 2008, at 1:21:51
> It's so sick that the most effective drugs for Social Phobia are 50+ years old and have some serious interactions with food or other drugs. What do you think about a combination of Bupropion (Wellbutrin) + Escitalopram (Lexapro) + Clonazepam (Klonopin)? That would hit Serotonin, Norepinephrine, Dopamine and GABA.
Medline,
It might make for a good combo in its own right. However, I doubt that it would be equivalent to Nardil. Heck, even the "new" Nardil is less effective and less tolerable for a lot of patients than the old formulation, which is the one that was found to be the "gold standard" for the treatment of social anxiety disorder.
So, I don't know. The combo that you propose makes some sense in theory. But the question is, how effective would it be in practice? I wish I had an answer to that question.
Tomatheus
Posted by mav27 on October 6, 2008, at 1:59:02
In reply to Wellbutrin + Lexapro + Klonopin..., posted by Medline on October 6, 2008, at 1:21:51
Im on lexapro and clonazepam and am doing better than ever before. In the past i have been on every ssri, snri, tricylic and nardil and parnate and didn't have much luck.. the nardil was good but side effects made it impossible to stay on.. my current combo is working slightly better anyway and without the side effects. Bupropion made me worse.. it made me aggitated and easily annoyed. Lexapro has been the only SSRI i can tolerate.
> It's so sick that the most effective drugs for Social Phobia are 50+ years old and have some serious interactions with food or other drugs. What do you think about a combination of Bupropion (Wellbutrin) + Escitalopram (Lexapro) + Clonazepam (Klonopin)? That would hit Serotonin, Norepinephrine, Dopamine and GABA.
Posted by Medline on October 6, 2008, at 2:36:37
In reply to Re: Wellbutrin + Lexapro + Klonopin... » Medline, posted by mav27 on October 6, 2008, at 1:59:02
Escitalopram and Clonazepam have shown to be effective on their own for Social Phobia. Bupropion alone is pretty useless for Social Anxiety IMHO (altough one very small study shows some success: http://www.ncbi.nlm.nih.gov/pubmed/11091936), but it can be used to combat SSRI-induced sexual dysfunction, to augment SSRIs improving response rate (http://www.medscape.com/viewarticle/528228) and to prevent weight gain. Clonazepam reduces the side effects of Bupropion and vice versa.
Next generation antidepressants will have similar action like a SSRI-Bupropion combo (increasing 5-HT, NE and DA levels).
Posted by djmmm on October 7, 2008, at 15:54:40
In reply to Most effective drugs for Social Phobia?, posted by Medline on October 5, 2008, at 14:57:35
> What has helped you the most and which drugs do you think could be useful for treating Social Anxiety Disorder? SSRIs/SNRIs, irreversible unselective MAOIs, Benzos like Clonazepam, Antiepileptics like Gabapentin/Pregabalin have shown to be effective in clinical trials. GHB/GBL works very well IMHO, but the short have life and high addiction potential limit their use. What about supplements/nootropics like Picamilon/L-Theanine/Phenibut? Controlled substances like Methylphenidate/Amphetamine, Buprenorphine? Any combination of drugs? Do you think drugs can make very shy people pretty outgoing in the long term without doing harm? If yes, which? Imagine you could create your own Anti-Social-Phobia Regimen, what drugs/supplements would you include?
As far as Rx medications:
1. Nardil
2. Klonopin
3. Parnate*or, in place of Nardil, the combo of Parnate and Klonopin.
*Inderal or other beta blockers work very well.
*I've also had some success with Neurontin, Topamax and Zonegran.
Herbs/vitamins/supplements (in no particular order):
Bacopa
Fo Ti
Gotu Kola
ALCAR
Rhodiola
Omega 3, 6
Goji (wolfberry)
DHEA
DMAE
l-theanine
guarana (caffeine)Generally, I find that a stimulating drug (or supplement) combined with a benzo (or anxiolytic supplement) is the most effective. For me, at least, a stimulant provides energy, motivation, and a boost in self confidence, while the benzo provides that "calm' needed to socialize.
I suppose that's why Nardil is probably the most effective (being both stimulating--effecting catecholamines, and relaxing--effecting GABA levels)
Posted by merry-dove on October 13, 2008, at 12:29:39
In reply to Most effective drugs for Social Phobia?, posted by Medline on October 5, 2008, at 14:57:35
When Clonazepam was added to my mix it made a HUGE impact on my social anxiety. I was no longer afraid to go out in public and actually started to have a life. I also take Cymbalta, ritalin & vicodin. Unfortunately my anxiety is slowly increasing and my atypical depression is taking over my life quickly. Suicidal thoughts are creeping in with more frequency. I am back to square one after a pretty decent year and a half.
This is the end of the thread.
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Dr. Bob is Robert Hsiung, MD,
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