Posted by Rick on September 15, 1999, at 15:01:23
In reply to alternatives to Nardil, posted by Elizabeth on September 15, 1999, at 2:14:56
Elizabeth--
MY current sedation from Klonopin isn't a major problem, but it's still strong enough to be a bit of a bother, and detracts somewhat from the drug's relief of my most troublesome Social Phobia symptom (tremulous voice in certain meetings/presentations/center-of-attention situations/phone or at-the-counter discussions with strangers -- especially one-on-ones "authority figures" (!!) like operators or clerks -- and most especially if there's some contentious situation involved).
How long a "chance" does the sedation need to go away? I've been at 1.5-3.0 mg of Klonoin per day for almost 2 months, ususally 1.5-2.5. No other meds except just 5mg Pindolol in the morning. I don't want to take either med after dinner, because they could worsen whatever severe sleep apnea I have remaining afetr losing 40-50 pounds. I know this would only worsen nervous reactions (not to mention being a detriment to my health).
Thanks,
Rick
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> 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:Rick
thread:11383
URL: http://www.dr-bob.org/babble/19990914/msgs/11615.html