Posted by action_jackson on September 5, 2002, at 8:44:49
In reply to tuff case, posted by jonh kimble on September 4, 2002, at 17:48:39
Jon -
I recall you from earlier. (ps - I am now re-emerging back onto treatment after hiatus since Feb 2001 to figure out better the problem with amisulpride caused tardive movements). Things looking more clear (and getting better) now and am re-starting treatment which has helped me greatly last 7-8 years. I have similar symptoms - I think - to you - maybe less of the naturally low energy and depression though.
Anyway - you said you pretty much tried everything I think - even wanted to try amisulpride or other antipsychotics at low dose.
YOu said I think you tried even Nardil to no avail.
I think your comment on Klonopin is probably right - at reasonable sustained dose - for social anxiety, worry, and general anxiety, and some for self esteem, also fear, and dependency or fear of change.. (if that is an issue - ie; moving or changing life situations ... etc).
However klonpin alone won't help your energy or depression.
Low dose nardil (enough to be antiderpessant) will tend to boost energy, motivation, self-esteem. Combined with klonpoin (even high dose) - I believe usually this is not particularly sedating (the combo more than either alone but still I think pretty energetic - you might not even want to sleep more than 5-7 hours a night.
If is too sedating - or energy an issue. You might say you are treatment refractory (self described no?) - very low dose augmentation with dexedrine (you report benefit but then loss without dose increase) - or perhaps very low riatlin or low provigil.
All of those stimulatants - even with low dose nardil - dr's usually will be concerned - despite the lack of official contradication (with cautious use).
even nardil I understand now being pulled off austrailian shelves - apparently significant SP is not worthy of effective treatment in austrilia... nor TRD with neurotic symtpoms or TRD atyical depression (nardil acceptated best there)... - and good side effect profile particularly at less than highest doses.
I only suggest to consider what you already have thought - that klonopin, dexedrine, may help you - but than the maoi is missing - (the stimulating antidepressant is missing - esp. the one preferentially good for SP boosting 5ht-2, and to lesser extent dopamine.
chad
http://www.socialfear.com/
> Hello everyone. I've been dealing with a problem now for four years and still havent found any relief. I know this not usual, but if anyone could offer any insight i would love that. My basic symptoms are excessive daytime sleepiness, poor motivation, overworrying, low self esteem and social anxiety, although i do realize im a decent person with many potential talents. I also have a very poor appetite, poor concentration, and i feel like i am responsible for other peoples problems(overly guilty) although i realize all these things are irrational, and have been to several psychologists and do my best on my own.
>
> Whats strange is that i havent responded to any ad's, only dexedrine, which worked well for a day then pooped out. my tolerance to stimlants is very high, although when they do work, they help every symptom.
>
> My current knowledge tells me that a mood stabilizer or klonopin would help with the tolerance and maybe other symptoms. if you have any info or suggestions at all, i would love to hear them. Thank you
poster:action_jackson
thread:118810
URL: http://www.dr-bob.org/babble/20020829/msgs/118866.html