Posted by AMenz on June 2, 2001, at 11:08:20
In reply to Re:SOC PHOBIA COCKTAIL--WOW!!: Survey... » AMenz, posted by Rick on June 2, 2001, at 2:32:58
Thankx for your response.
First let me answer your quesetions re Zoloft.
Zoloft was titrated up to 100mg (25, 50, 100). At each stage after a couple of weeks it had the desired effect of eliminating completely social anxiety (I don't know if concomitant use of 1mg of Lorezapam daily created a synergistic effect).
After becoming accustomed to the level the social anxiety (milder though) returned and the level was upped the next notch. I assumed that upwards of 100 (don't know 150, 200, whatever the effect might be permanent.
What it did was to take away all fear in social interactions, it became very easy to be nice and supportive to people, to listen to their conversation, to appreciate their jokes, etc. All the things that make people like you and in turn be willing to extend the same to you. (That has been my experience with people) I also became extraordinarily calm. Other people seemed to me overexited, prone to take offense, etc. What a trip!!!
Calm seems to have a great effect on others. I became popular. That was a new experience for me believe me.
Of course the issue with all these medication induced personality changes, is one of identity. Is this me, or am I taking former symptoms as my personality. Who is she, the lady or the tiger? Know what I mean.
I find it interesting that other people on the board have not discussed ( or I have not seen) the issue of identity and medication.
Maybe I've told you more than you wanted to hear.
BTW did you plug provigil in a particular search engine and come up with monographs, or are there sites you can recommend.
> AMenz -
>
> I'm not really qualified to answer your questions. But after sifting through lots of posts on the neton the net, I've only seen one or two cases where someone was concerned about rapid cycling on Provigil, and even then it was conjecture.
>
> As with just about any med, some bipolar II users praised modafinil, and others found it ineffective or bothersome. Actually, Provigil seems to disagree with fewer bipolar users than unipolar.
>
> Medline shows no study abstracts associating modafinil with crapid cycling, even though I could see how one would wonder. To the contrary, in the small Medline-reported study where Provigil worked extremely well in quickly kick-starting AD's (and alleviating med-induced fatigue as a bonus), almost half of the responders were bipolar patients who had not repsonded prior to augmentation with provigil.
>
> Beyond the monographs, I can't find anything relating to movement disorders induced by modafinil, which is not to say it never happens. I'm personally very prone to these kinds of side effects, and haven't had a problem at 100 mg. most days and 200 mg about 25% of the time. Actually the 2% incidence of dyskenesias reported for Provigil is a lot lower than for many meds commonly used in bipolar depression and schizophrenia. I've never seen anyone report a problem. But again the disclaimer: these aren't areas where I feel particularly qualified to comment.
>
> BTW, regarding Zoloft treatment of your Social Phobia, how much did you take? How long did it take to start "working wonders"? What else were you taking at the same time? What, if any, were your your primary persistent side effects?
>
>
> Thanks,
> Rick
>
>
> > Rick I have social anxiety and BPII. Zoloft did wonders for social anxiety but created mixed mania which was unabearable.
> >
> > Two questions: does Provigil promote cycling?
> > Also looked in following site:http://www.nursespdr.com/members/database/ndrhtml/modafinil.html
> >
> > As a possible side effect of provigil they mention
> > oro-facial dyskenesia. This sounds dangerously close to tardive dyskenesia although I have not looked it up.
> >
> > Please your thoughts if any on above.
> >
> > AMenz
> >
> > > Lucy --
> > >
> > > Unfortunately, my areas of casual self-study, as well as my self-experience with meds has all been primarily in the area of anxiety. (Although, as you know, many AD's and other meds are useful across different classes of mental disorders.) And while I might call myself "highly informed", I would by no means call myself an "expert", even with respect to anxiety treatment. I personally know almost nothing about Borderline Personality Disorder, although I'm sure there are many Psycho-Babble posters who do.
> > >
> > > Klonopin is called Paxam in Australia. I would imagine that generic clonazepam is available to you as well, but this is one drug for which many people swear that the branded version is better -- or at least stronger. I can tell you that, even though I have the generalized form of social phobia, my most dramatic and prompt response to Klonopin was in alleviating what had developed into near-panic when giving presentations. And, as I alluded to before, this relief comes without any sedation, mind-dulling, or "buzz". (Those things may have occurred a bit initially, but quickly went away with daily dosing.)
> > >
> > > If your Social Phobia is very strongly tilted towards performance situations, have you tried beta blockers such as propranolol (one of the most common for this purpose) or the serotonin-friendly pindolol? Beta Blockers can be taken on an as-needed basis, and work by directly reducing physical performance-situation symptoms such as a racing heart. For me they weren't anywhere near as effective as daily Klonopin, although they do provide a very calming effect to some people.
> > > I had been taking pindolol every day with the Klonopin, and found it added a very nice dimension. However, I had to stop taking it, because once I successfully shed 60 pounds the beta blocker made my blood pressure too low. Also, they can cause some fatigue, especially when taken on an as-needed basis.
> > >
> > > Of course, you must talk to your doctor, and make sure any combo you take isn't likely to cause unsafe interactions. That said, I'm shocked at how many doctors (at least in this country) both fail to identify potentially dangerous interactions AND claim that some drugs shouldn't be combined when the combination can be perfectly safe and beneficial. I've successfully challenged doctors on such matters several times, armed with info from the net (official monographs,
> > > articles or Medline abstracts from respected medical journals, drug-interaction dictionaries, and posts from patients).
> > >
> > > Good luck to you, and let us know how things work out. If you don't get any further responses form this thread, why not try starting a new thread? There may be some people who never make it to this thread, but who are successfully
> > > dealing with a combo of challenges which are very similar to your own. In fact, I wish Dr. Bob allowed the subject headings to be longer (read: more detailed) to catch the eye of more readers who have the most relevant advice or experiences to share!!
> > >
> > > Say "Hi" to my Aussie uncle for me! Hint: He used to host a popular TV news-magazine there, although if you're young you might not remember it. Oh, and he has an American accent.
> > >
> > > Rick
> > >
> > > ------
> > > > Hi Rick
> > > > I hope you don't mind me posting a request for your knowledgeable feedback about my meds cocktail. I'm diagnosed with borderline personality disorder, i suffer from intermittent extreme rage, complete lack of motivation, depression, social phobia especially with public speaking which has held me back from achieving so much. I have had to quit Uni because of my phobia. I have been on Paxil 20mg and Imovane(zopiclone hydrochloride) to help me sleep 15mg. My psychiatrist has recently put me on depakote to regulate my moods and anger outbursts but I,m worried it worsens my depression which I think it is but it's hard to tell, it's only been 1 month. I'm on 400mg in the morning and 600mg at night. I feel I need to tackle the phobia and depression more than anything else in order to get ahead in life and I'm interested in the meds you mentioned. I am in Australia, do you know if they are available here? Could you please tell me what you think as I value your opinion after reading your other posts! By the way, I totally agree with your views on Paxil withdrawals- absolutely terrifying! and they told me it was non- addictive, yeah right.
> > > > Look forward to your reply
> > > > Take care
> > > > >
poster:AMenz
thread:36883
URL: http://www.dr-bob.org/babble/20010530/msgs/65158.html