Posted by Rick on August 18, 1999, at 18:27:14
In reply to Re: Social Anxiety , posted by bones on August 18, 1999, at 7:37:00
Bones -
First off, according to sources such as rxlist.com, SELEGELINE IS NOT TO BE TAKEN WITH SSRI's! I know that sometimes these warnings are overstated, especially when we're talking very low doses of Selegeline, but I would NOT take a chance without proper guidance from a qualified expert.
Also, if you end up taking Selegeline, realize that it switches from a selective (dopamine) to non-selective (dopamine and seratonin) irreversible MAOI at higher doses, and in that case the food and OTC drug restrictions required with Nardil must be observed with Selegeline as well. (I personally have no intention of moving in that direction. I want my aged cheese!) To be on the safe side, I'd caution even caution against a move as small as 5mg to 10mg without adding the food/drug restrictions, because I've read in several places that Benzo's can potentiate MAOI's (maybe that's one reason for my success with the combination?). Conversely Pindolol/Viskenis often used specifically to try to speed up and improve response from almost all types of AD's.
Believe it or not Selegeline's primary, and only official, indication in the U.S. is as an adjunct medication in Parksinson's disease. I did a little surfing and found that it is indeed available in Canada. Other names for the same medication include Eldepryl and (apparently in Canada only) Parkinyl (sp?). It is also called l-deprenyl, and is favored by life-extensionists for protection against the natural deterioration of brain cells (thus the Parkinson's connection??). This popularity follows from a highly publicized German study showing an immense increase in life-expectancy among rats given Selegeline. This was later replicated, but to a lesser degree, in a Canadian study. Last year, a British study (which was widely criticized as methodologically flawed and filled with spurious conclusions) showed somewhat *decreased* life expectancy among PARKINSON'S PATIENTS who used Selegeline -- but importantly, this only applied to those who were concurrently taking the Parkinson's med levadopa (sp?).
Ironically, I took the Selegeline alone for four weeks for Social Phobia (I think my pdoc was using me as a guinea pig to see if dopamine defecit drives SP), and it had NO beneficial effect on my Social Anxiety by itself. But as you've seen from my other posts, using it in combo with Klonopin (and Visken/Pindolol) is quite a different story for me! There is currently a controlled study analyzing using low-dose Selegeline (alone) to treat SP; I'll be amazed if THAT produces positive results.
Ahhh, Nardil. For a short time, I thought this was going to be my "answer". So did my pdoc, who is an MAOI "vet". It could very well work wonders for you (though be careful of the food and OTC drug restrictions, even though the hypertensive crisis dangers are greatly exaggerated per my pdoc, especially for men).
Nardil was great at relieving Social Anxiety when it was "working", but unfortunately it only "worked" sporadically. For me, it was almost as if Nardil was working only when it made me feel a little high. My guess is that that's not how it's *supposed* to work. My theory is that it was simply "inebriating" me in a mild sense, thus lowering my inhibitions like alcohol, but without dumbing me down or tiring me more than a bit. I sometimes enjoyed this feeling, but started getting pretty nervous when I once felt like I was stuck in a dream for over 24 hours before escaping. I doubt these are typical reactions from Nardil. Oh yeah, it also made my do strange, involuntary jerky motions in bed sometimes.
Then, after three weeks, I no longer got any benefit from Nardil. I was very disappointed then, but in retrospect glad it happened because the Klonopin effects are (at least so far) more -- and much more consistently -- beneficial, without making me feel strange in any way. I just feel "normal" physically, like the "real me" that's been afraid to "take the stage" because of social anxiety.
As for side effects, I sure bucked the trend re Nardil's infamous weight gain. I embarked on my (first-ever) serious weight loss attempt almost simultaneously with starting the Nardil. But instead of balooning, my diet went unusually well; lost 1-3 pounds per week without too much trouble, for a total of 40 pounds loss to date. I'm glad I did'nt hear about the weight gain reputation until AFTER I started; maybe that would have psyched me out.
But as for the other possible Nardil side effects, you name it - I got it (once dosage reached 45mg): complete anorgasma; dry mouth; constipation; an absolutely unbelievable transformation from hypertensive to hypotensive. (apparently this effect isn't quite THAT severe in most folks, although I have heard such complaints).
And the postural hypotension (a common effect) was a real trip. I would often get super-dizzy upon standing, and actually fell to the floor three times (twice in the bathroom and once at my client's office!) A few other times people saw me wobbling or walking into walls, asked me to sit down, and asked if I was O.K. There was one (in my opinion) GREAT side effect: I no longer dreamed (or if I did, they were wiped from memory. My dreams tend to drive me crazy. (Interesting point, though: although the dreaming has returned with Klonopin, the dreams tend to be SO much less troubling and frantic than before.)
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> Bones again ... I forgot to ask you. How did Nardil react with your Social Anxiety?? Were the side-effects atrocious? Did you gain enormous amounts of weight. (Vanity, vanity.)
>
> > > Rick, thanks for your advice. I had read your previous contribution about your marvellous concoction! I've never tried Klonopin and have stayed away from the "Benos" fearing addiction. (Although I tell you I've longed for them at times.) I don't think that Selegeline (sp??) has been approved for sale in Canada. I'll do a little more research. I remember reading about it earlier and thinking, hey this might be a great drug to augment the SSRI's with. (With the malaise, apathy, fogginess they seem to cultivate.) Anyway .. again, thanks for your advice ... there has to be a pharmacological answer!! (Not just a band-aid solution.)
> > > While everyone's different, I highly disagree with the posts by Cass and Yardena. I've tried Nardil (considreded the "gold standard" AD for Social Anxiety in research, despite the lack of the official FDA designation that Paxil spent big bucks to get); Xanax (a Benzo); and more.
> > >
> > > But now I'm on Klonopin, and it is nearly a wonder-drug for me, with no sedation after the first few days (carefully-timed, gradual dose-up schedule essential to ensure this) and NONE of those awful AD side-effects or weird sensations. And I've NEVER been able to think more clearly. (the latter effect could also be related to the low dose -- no food-restrictions required -- Selegeline that I am taking concurrently). And, unlike the AD's, it all happened so fast!
> > >
> > > If you've had alcohol or drug dependency problems, Benzos definitely aren't for you, but in most people they are very safe if used (and discontinued) PROPERLY. I'm really sorry to see the bad rap Klonopin sometimes gets when controlled studies have shown it to be the single most effective Social Anxiety medication for most people. Wish I had time to lead you to all the good, rational literature and the aforementioned studies, but I don't at the moment. But do see my posts a bit further up under "Social Phobia - Side Effects of Celexa".
> > >
> > > Good Luck. Hope you get to experience the (L-O-O-O-N-G AWAITED) relief I've been experiencing with Klonopin as my key med.
> > >
> > > Rick
> > > -------
> > > > > I haven't seen a lot written about Social Anxiety in Psychobabble. (Occasional references.) If you are reading this and have Social Anxiety. Can you tell me which med. has worked best for you?? (I also have OCD - but that's another "thread".) Thanks guys!!
> > > >
> > > >
> > > > I've taken the whole gamut of tranquilizers for social anxiety. Valium, Xanax, Klonopin, Lorazepam and others I can't even remember. They help a little with anxiety, but I hate the muddled cognitive skills (although I get that from depression, too). Inevitably, I become addicted. I don't like that either. Right now, I'm not on a sedative and still have the ever present battle with social anxiety. For me, it's a trade off, addiction or social anxiety. Neither is fun. Maybe it would be different for you. In the past, I have overdone it with tranquilizers. and the addictions may be partly my own fault. Coincidentally, I think I may also have OCD, although I haven't been diagnosed with it. I just thought I would give you my experiences. I hope that you find something that works for you. I hope you will share it if you do. Best wishes.
> > > >
> > > >
> > >
> > > -----
> > > > > I haven't seen a lot written about Social Anxiety in Psychobabble. (Occasional references.) If you are reading this and have Social Anxiety. Can you tell me which med. has worked best for you?? (I also have OCD - but that's another "thread".) Thanks guys!!
> > > >
> > > >
> > > > I've taken the whole gamut of tranquilizers for social anxiety. Valium, Xanax, Klonopin, Lorazepam and others I can't even remember. They help a little with anxiety, but I hate the muddled cognitive skills (although I get that from depression, too). Inevitably, I become addicted. I don't like that either. Right now, I'm not on a sedative and still have the ever present battle with social anxiety. For me, it's a trade off, addiction or social anxiety. Neither is fun. Maybe it would be different for you. In the past, I have overdone it with tranquilizers. and the addictions may be partly my own fault. Coincidentally, I think I may also have OCD, although I haven't been diagnosed with it. I just thought I would give you my experiences. I hope that you find something that works for you. I hope you will share it if you do. Best wishes.
> > > >
> > > >
poster:Rick
thread:10256
URL: http://www.dr-bob.org/babble/19990814/msgs/10298.html