Posted by med_empowered on March 15, 2005, at 10:22:18
In reply to Re: Social anxiety - Please give me hope!, posted by Bill LL on March 15, 2005, at 9:16:56
hey! There really IS hope for social anxiety, trust me. As emotional problems go, social anxiety is highly treatable, so rest assured that you can more than likely be helped. Klonopin is, of course, the emerging gold-standard for social anxiety...if it makes you sleepy, that generally means you haven't yet adjusted...try taking it as a sleeping pill FIRST, and then gradually moving it into daytime use. Worked for me, anyway. Inderal (propranolol) is a great ADD-ON med...with benzos, in particular, it seems to work nicely. Anyway, what I think may be necessary for you is to focus less on INDIVIDUAL meds and more on a POLYPHARMACY regimine. Hate to say it, but sometimes social anxiety needs more than 1 med (I've been there, don't worry). If a TCA worked for you in the past, you may want to try that again...sometimes SSRIs just don't have what it takes for some people. It is hard sometimes to get stimulants RX'd, especially in combo with TCAs (they have a synergistic "thing" whereby they tend to boost the effects of one another...good idea for severe depression, but carries additional risks of heart problems, etc.). I personally wouldn't do an MAOI at this point, b/c they're soooo hard to mix with other meds...even though it CAN be done safely, a lot of docs religiously avoid doing so b/c of obvious liability issues. ECT...not my bag. I've had relatives who've had it; it seems to work, then stop working, then you're back to meds or maintenance ECT. Unless you're suicidal..I'd personally avoid it. Anyway, here's the mix that I found worked for my anxiety, which was BAD: 1)mood-stabilizer (Trileptal, in my case) +2) anti-depressant (I respond best to TCAs or new TCA-ish drugs, like duolexitene) 3) benzo(s) (Klonopin, with the occasional Ativan booster) 4) sleeping pill (as needed...Ambien or Neurontin worked best) 5) stimulant (Adderall is best...I don't think they have Adderall in the UK, but dexedrine should work well, too) 6) Propranolol (dosing is kinda tricky: you need it high enough to work, low enough so you don't get too many side-effects). And..that's it. Lots of drugs, I know, but now I just take Trileptal, Adderall, and an occasional benzo for anxiety and/or sleep...it seems like treating really bad anxiety effectively for a while makes it less severe over the long-run. Anyway, good luck!
poster:med_empowered
thread:471211
URL: http://www.dr-bob.org/babble/20050312/msgs/471259.html