Posted by Elizabeth on September 15, 1999, at 2:14:56
In reply to Re: SOCIAL PHOBIA: ANYTHING BETTER THAN NARDIL?, posted by Rick on September 11, 1999, at 19:13:21
If you haven't been taking the Klonopin for long, give it a chance: the drowsiness is a side effect that may go away with time. (If it doesn't, try switching to another benzodiazepine such as Ativan or Xanax.) What dose are you on?
I'm not sure why you say Parnate's efficacy is "equivocal." There isn't much evidence supporting it (just because SP wasn't recognized as a separate disorder in Parnate's heyday - older studies of MAOIs in phobic disorders tend to mix together patients with agoraphobia, social phobia, etc.), but I don't know of any evidence at all *against* it. Parnate does not cause weight gain and, for me at least, doesn't cause sexual dysfunction either.
Marplan (isocarboxazid), a second hydrazine-type MAOI, may be an option. It does seem to cause weight gain for some people, though. I think an SSRI (or Effexor or Serzone) is worth at least a try, as well. Another thought would be Buspar (although that one really is equivocal - be willing to try high doses or use it with an SSRI and/or pindolol). You mentioned Neurontin (gabapentin) as well; that might be worth trying. It tends to be somewhat sedating (at least, at first) but otherwise has few side effects. Gabitril (tiagabine) is another anticonvulsant that might be worth a shot.
Tricyclic antidepressants aren't seen as being helpful in SP. Reboxetine might well turn out to work, but I doubt it would.
poster:Elizabeth
thread:11383
URL: http://www.dr-bob.org/babble/19990914/msgs/11591.html