Posted by Joe Schmoe on July 5, 2001, at 14:16:38
In reply to Imipramine for social anxiety???, posted by tina on July 5, 2001, at 9:36:33
I was on imipramine for about a year. That was over a decade ago before all this SSRI stuff started. I was in pretty bad shape then, I was diagnosed with panic disorder although I realize now it was really social phobia since it did not occur at random.
Bottom line is it helped me a lot, enabled me to go to work and go to the store, etc. whereas before taking it, I was rapidly approaching the point where I could not function at all, couldn't make eye contact and so forth. The imipramine just stopped it cold. I could feel the "attack" trying to come on at times, it feels like a kind of tingly rush from my neck up into my head, kind of a spreading surreal feeling, I read recently that that is where the serotonin neurons are so I guess it makes sense, but anyway on imipramine I could feel the panic start and then sputter out. The tingle was weak and could not get very far.
This increase in functionality continued even after I discontinued the imipramine, even though I had no psychotherapy at all. It did something to my brain that made me a lot less vulnerable than I was before, something permanent.
Now, it did not cure me; while I can function well enough now that nobody suspects I have social phobia, I still cannot handle personal confrontations or tense situations and I need some benzodiazepine help with things like job interviews and giving presentations in front of an audience. I can, however, give a presentation to an audience even without benzos if I really have to, although it is a miserable experience and I don't perform nearly as well. Before the imipramine - no way.
The imipramine was what I needed at that time of my life. I had to take 300 mgs/day which is a large dose. Unlike the newer ADs, for some of the older ones they have blood tests where they can check whether you have an effective level of it in your system or not and see how well you are absorbing it. In my case I absorbed it very poorly and they had to keep upping the dose based on the tests. Ramping up was slow and in the meantime I was on xanax day and night for a month. Coming down from that was no fun, let me tell you.
Anyway, the imipramine allowed me to function for the most part, although I still could not handle really stressful things without benzos like xanax. Imipramine is a harsh drug with all sorts of side effects. For me the worst ones were: rapid heartbeat, often in bed at night (makes it hard to sleep); night terrors (nightmares you can't wake up from even though you try); and orgasms became much less pleasureable.
The night terrors thing was the worst. As I understand it, when you go to sleep, your body turns off your voluntary control of your muscles. This is so you do not try to physically act out your dreams (like sleepwalkers do). When you wake up this voluntary control comes back on, sometimes slowly (i.e. muscle weakness in your grip strength when you first wake up). Well, on imipramine, the voluntary control does not come back on right away. You can wake up from a nightmare in the middle of the night and be paralyzed - can't open your eyes or move, or your movements are difficult. I have memories of thrashing my head back and forth trying to wake up from a nightmare and not being able to wake up. You can't "sit straight up in bed" the way you normally can to wake up from a nightmare. That was what drove me off the imipramine in the end. I don't know how common this side effect is.
Today, with the "cleaner" SSRIs like Paxil, which does not affect your heart like imipramine does, I would not try imipramine until I had already tried the SSRIs first. I tried Paxil myself recently but the sexual side effects were too much to take. Right now I am starting on a regimen of Wellbutrin for dysthymia and Klonopin for the social anxiety. Klonopin has the greatest ( >82%) success rate of any drug for social anxiety, so I am anxious to see how I do on it. Paxil is supposed to be pretty good too, but losing the ability to climax was just too high a price to pay.
poster:Joe Schmoe
thread:69035
URL: http://www.dr-bob.org/babble/20010701/msgs/69055.html