Posted by JonW on August 18, 2003, at 17:01:50
In reply to Jon W: Moclobemide and Liebowitz, posted by Jumpy on August 17, 2003, at 21:19:59
> Still trying to find an alternative to nardil (still fat, dumb and impotent on nardil). Does Dr. Liebowitz like moclobemide? How about the ssris, I haven't tried paxil yet (only 50% relief on zoloft and overstimulated on prozac) .. does Dr. L like paxil?
>
> Thank you in advance! Glad to hear you felting well on paxil.Hi Jumpy,
Actually, I'm on moclobemide now. I finally found a med I can live with, and I love it! Dr. L does not think too highly of moclobemide for SAD, but it works for me -- comparable to the SSRIs and with essentially no side-effects. My impression from seeing Dr. L is that his favorite SSRIs for SAD are Paxil and Zoloft. He's big on combining CBT + meds to get remission, and this approach has changed my life. I pasted an abstract below that might be of interest to you. A more important question is what Dr. L would recommend for your particular situation, and I hope you get to ask him and he's able to help you as much as he's helped me.
Since Dr. L carries such a heavy price tag you may want to try something else first... I'd recommend combining a med that is at least somewhat helpful (like Zoloft) with CBT for social anxiety disorder at Temple University. The AACT is the best place in the country, and also very affordable. Sounds sort of like a free lunch, right? Anyway, here's a link to my post about the AACT:
http://www.dr-bob.org/babble/psycho/20030814/msgs/251806.html
Good Luck,
Jon--------------------------------------------------
Biol Psychiatry. 2002 Jan 1;51(1):109-20. Related Articles, Links
Pharmacotherapy of social anxiety disorder.Blanco C, Antia SX, Liebowitz MR.
Department of Psychiatry, Columbia College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY 10032, USA.
Over the last few years, a number of medications have demonstrated their efficacy in the acute treatment of social anxiety disorder. At present, selective serotonin reuptake inhibitors probably constitute the first line treatment, based on their safety, tolerability, and efficacy in the treatment of social anxiety disorder and common comorbid conditions. Data from single trials suggest that clonazepam, bromazepam, and gabapentin may have efficacy similar to the serotonin reuptake inhibitors, but further studies are needed to confirm these findings. The monoamine oxidase inhibitor phenelzine appears to be at least as efficacious as these other agents, but should be reserved for cases that fail to respond to these safer medications. Among the reversible inhibitors of monoamine oxidase A, brofaromine may also be an effective drug, while moclobemide appears to be less potent.Future research directions should include delineating ways to achieve remission (as opposed to response); developing strategies for augmenting partial responders and treating nonresponders to first line approaches; studying the long-term response to medication and prevention of relapse when medication is discontinued; clarifying ways to integrate psychosocial and pharmacological treatment approaches; developing predictors of which patients do best with which treatments; and the treatment of social anxiety disorder in children and adolescents.
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poster:JonW
thread:251712
URL: http://www.dr-bob.org/babble/20030818/msgs/251903.html