Posted by Rick on September 11, 1999, at 19:13:21
In reply to SOCIAL PHOBIA: ANYTHING BETTER THAN NARDIL?, posted by Cynthia on September 10, 1999, at 20:14:29
> HI,
>
> I HAVE TERRIBLE "SOCIAL PHOBIA." MY PSYCHDOC HAS PRESCRIBED NARDIL AND KLONPIN. BOTH ARE VERY EFFECTIVE, BUT THE KNOLONPIN MAKES ME DROWSY. THE PURPOSE FOR USING KLONOPIN AS AN ADJUNCT, I'M TOLD, IS TO SUPPLEMENT THE NARDIL. THAT IS, NARDIL, FIRST, AND THEN LOW STEADY STATE DOSE OF KLONOPIN. MY PROBLEM IS NARDIL HAS CAUSED ME TO GAIN OVER 20 POUNDS, AND HAS ALSO CAUSED 100% ANORGASMIA. HAS ANYONE TRIED ANYTHING ELSE THAT WORKED BETTER THAN NARDIL, WITHOUT THE SIDE EFFECTS. MY SEARCH OF MEDLINE INDICATES THAT THE SSRI'S AND THEIR COUSINS GENERALLY ARE NO BETTER THAN RELIEVING 40-45% OF THE SYMPTOMS, COMPARED WITH PLACEBO EFFECT OF 20-25%. I DON'T WANT THE SAME PROBLEMS ASSOCIATED WITH SSRI'S (SEXUAL DYSFUNCTION), WITH SUCH A LOWER LEVEL OF EFFICACY COMPARED TO NARDIL. BASICALLY, THEY SEEM TO OFFER ALL THE NEGATIVES WITHOUT THE BENEFIT, FOR SOCIAL PHOBIA, THAT IS. I HAVEN'T HEARD ANYTHING ABOUT REBOXETINE (IN TREATING SP), WHICH IS SOON TO BE RELEASED IN THE US (4TH QTR 1999). ALSO, UNDERSTAND GABAPENTIN AND ONDANSETRON DIDN'T MAKE IT THROUGH STAGE III TRIALS DUE TO LACK OF EFFICACY.
>
> THERE HAS TO BE SOMETHING! BY THE WAY, PARNATE'S EFFICACY IN TREATING SP IS EQUIVOCAL.
>
> ANY IDEAS?????????????????I'm having MUCH better and more consistent results with Klonopin (alone) than I did with Nardil (which I used both alone and with various potentiators -- NOT including Klonopin). I feel relaxed and notice improved cognition, perhaps because the release of anxiety allows me to focus more. While I had terrible side effects with Nardil, like complete inability to achieve orgasm, the ONLY negative side effect with Klonopin has been occasional, short-lived drowsiness. I've found that the drowsiness has abated somewhat over time, especially as I've experimented with timing of the doses (I take 1.5-2.5 mg total most days). Surprisingly, Klonopin consistently ENHANCES sex for me.
By the way, I am also taking a very low dose of Pindolol, a rather weak, non-selective beta blocker for mild hypertension. My pdoc suggested it (vs. other anti-hypertensives) for its reputed seratonergenic (sp?) effects. It is often used to potentiate and "speed up" AD's (especially SSRI's), but my guess is that it does NOT potentiate the Klonopin -- just possibly causes more fatigue. Of course, non-selective beta blockers (usually Propanalol) are sometimes prescribed for "performance anxiety"-specific social phobia, so who knows??
poster:Rick
thread:11383
URL: http://www.dr-bob.org/babble/19990914/msgs/11438.html