Posted by med_empowered on February 11, 2005, at 17:02:26
In reply to Re: What's working well for social anxiety these days?, posted by Phillipa on February 11, 2005, at 16:49:09
hey! You're right that no stimulant is yet FDA approved as adjunctive therapy or anything else for anxiety, and conventional wisdom holds that stimulants=anxiety, depressants=less anxiety. And you're right...benzos can clear your head. When my mind was racing left and right with anxiety, Klonopin stopped it and cleared my head. My personal theory, just based on my own experience, is that sometimes stimulants aren't so much anti-anxiety as they are pro-social, pro-self-confidence, etc...its indirect. Amphetamines in particular are known for giving a slight bump in one's outlook when given in appropriate doses (this is why they were used for depression and sometimes are used to augment anti-depressant therapy). Sooo, here's my theory: benzos are known to relieve anxiety through GABA, which inhibits to some extent the release of a number of neurochemicals. Barbiturates do pretty much the same thing, and things like neurontin..well, nobody really knows about that. BUT, look at the success of SSRIs for anxiety; they're now first-line treatment for mild-to-moderate anxiety. They BOOST serotonin. They don't tranquilize the anxiety away; they get rid of it by boosting feel-good chemicals in your brain, so some people who take them feel considerably less anxious. Now, amphetamines cause the release of a number of neurochemicals, most notably dopamine, and then they act to block the re-uptake of these same just-released chemicals, so your brain cells kind of soak in their own feel-good juices. What you get, assuming there aren't underlying problems like psychosis or drug-addiction or heart disease to complicate the picture, and assuming the dosing is done correctly, is improved overall MOOD and OUTLOOK, and enhanced concentration and motivation. Again, there are all kinds of problems with amphetamines-some people abuse them to no end, some people get anxious, some people get high blood pressure, some people go psychotic (usually a sign of abuse, but it can happen at prescribed doses). That said, for most of people, small doses of amphetamine are pleasant...add an anxiolytic, like Klonopin, in carefully calibrated doses to the amphetamine, and you end up killing off excess sedation (thanks to the amphetamine), preventing jitteriness or nervousness (thanks to the sedative), and, hopefully, balancing quelling anxiety with improving concentration/motivation. In the past, when barbiturates ruled the earth and drug companies pushed the hard stuff, there were all kinds of sedative+barbiturate combos for both dieting (appetite suppression without the jitters of pure stimulants) and depression (mood elevation with minimal sedation or jitteriness). Among these were: Dexamyl (amytal+dexedrine), desbutal, and, I think, Eskatrol.
poster:med_empowered
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