Posted by mb on November 29, 1999, at 16:05:31
In reply to Re: Social Phobia: Caffeine and/or Sugar and/or BP, posted by Rick on November 29, 1999, at 15:19:45
hey, rick. yes, i've found caffeine's anxiogenic effects tend to offset the anti-anxiety effect of klonopin. i've also found that more sleep actually makes my social phobia worse. combining more caffeine with the additional sleep during your vacation may be causing the return of symptoms you previously had pretty well under control. also, my guess is that during your "vacation" you probably weren't under much stress or exposed to situations where your social anxiety rears its head. for that reason, you probably found your 1.5 mg/day klonopin combined with pindolol made you feel extra tired. so, you countered that with extra sleep and caffeine. now, your body is probably feeling like it's without any klonopin/pindolol, just like you wanted it to feel during your vacation. by the way, i've fallen into the same trap. i've copied and pasted for you, below, a pubmed article referring to the "sensitivity" of social phobics to caffeine.
regarding the sugar, i haven't noticed any impact on my social phobia. as far as your starting buspar, that sounds like an interesting augmentation strategy. i've heard that pindolol can both potentiate as well as accelerate the effects of buspar, as well as that of klonopin. i've also heard that closer to 60 mg/day of buspar may be necessary to realize a therapeutic effect from buspar. maybe your pindolol lowers that threshold to 30 mg/day.
i'm sure that once you adjust to your regular regimen of work/stress/lack of sleep/no caffeine/etc, your old formula will return to it's effective state. in the meantime, the add'l klonopin sounds like it's probably necessary for the next few days.
also, please post if find buspar to improve the efficacy of your klonopin/pindolol combination.
good luck. mb
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Brain mechanisms of social anxiety disorder.Nutt DJ, Bell CJ, Malizia AL
Psychopharmacology Unit, University of Bristol, United Kingdom.The neurobiology of social anxiety disorder is poorly understood, although preliminary research has suggested several possible biological abnormalities. Challenge studies have demonstrated that subjects with social anxiety disorder have a sensitivity to carbon dioxide, cholecystokinin, and caffeine somewhere between that of panic disorder patients and normal controls. Serotonergic pathways may play a role in social anxiety disorder, as shown by the clinical effectiveness of selective serotonin reuptake inhibitors, plus fenfluramine and m-chlorophenylpiperazine challenge studies. Dopaminergic function and striatal dopamine uptake appear to be reduced in social anxiety disorder. There is also evidence for cardiovascular and adrenergic abnormalities. Recently, positron emission tomography has begun to identify brain regions that appear to be uniquely activated in this condition. These results offer the promise of an understanding of the brain mechanisms of social anxiety disorder, but much further research is needed to fully elucidate the neurobiological cause(s) that exist.
poster:mb
thread:15930
URL: http://www.dr-bob.org/babble/19991123/msgs/15936.html