Posted by Rick on November 10, 2002, at 23:32:22
In reply to Re: Stelazine for social phobia, posted by xjs7 on November 10, 2002, at 18:42:57
I had never heard of Stelazine. Looked it up on Medscape and RX-List and saw that in addition to treatment of psychosis it does indeed have an indication for *short-term* (less than 12 weeks) treatment of non-psychotic anxiety. (BTW, for psychosis it's sometimes given by injection.)
Didn't say much about the pharmacology, but what did appear gave no indication that it acted via anti-dopaminergic mechanisms like most of the anti-psychotics that are used today.
I did see the warnings xjs7 refers to, specifically re the risk of possibly-irreversible tardive dyskenesias (sp?). This was specifically cited as a drug that shouldn't be a first-line choice for anxiety because of the risks -- even if it *does* have anxiolytic effects.
Maybe your doctor knows what he's doing, but this seems rather surprising, especially since social phobia usually requires longer (or indefinite) treatment. I *have* seen quite a few reports of modern antipsychotics like Zyprexa showing promise for social phobia, perhaps because of post-synaptic 5-HT2 (?) receptor antagonism, a la the anxiolytic antidepressant Serzone (which helped me as part of an SP med cocktail). But -- besides the fact that daily low-dose Klonopin handles my SP so well, especialy in tandem with low-dose Provigil -- I would personally avoid modern antipsychotics because of some potentially troublesome side effects like hyperglycemia.
As for the supposed dopamine deficiency in SP, pro-dopaminergic drugs so far haven't shown much benefit in studies or anecdotally, although I know they've helped some SP-ers (especially those who also have ADD) as part of various med cocktails. In my case, all the usual dopaminergic drugs I tried actually *added* varying degrees of anxiety.
Of course I don't know the particulars of your situation Boba Fatt, but I highly recommend that you investigate Klonopin.
Rick
poster:Rick
thread:127105
URL: http://www.dr-bob.org/babble/20021108/msgs/127211.html