Posted by HyperFocus on May 7, 2009, at 21:13:22
In reply to Best meds for social anxiety (plus depression)?, posted by AdamCanada2 on May 7, 2009, at 1:08:16
How long did you stay on the Parnate and at what dosage? Sometimes improvements can be non-linear - you get blips of improvement and then worsening over the course of a few weeks, but you can only decide what the drug does for you after a moderate amount on it at a sufficient dosage. A poster called JadeKelly had to wait a while for her Parnate to kick in but it did eventually and now she's improved tremendously. She augmented her Parnate with Ritalin - how does that sound to you? Mixing a stimulant with a MAOI can be dangerous however, so you have to find the right doctor who will administer it and monitor it.
Have you tried augmenting an AD with and AP? Augmenting with Abilify is all the rage now. The writer of this article: http://www.nytimes.com/2009/05/10/magazine/10Depression-t.html?_r=1&hp got a response with Abilify added to an AD after being severely depressed for many years. There are several APs that can be tried - Abilify, Zyprexa, Geodon, Riserdal, sulpiride, in combination with Prozac or Effexor or a TCA. Low dose sulpiride (50-200mg) has been reported to work for people with SP and improves dysthemia greatly. I tend to believe that the nature of SP and its concomitant disorders means that SSRIs or SNRIs or TCAs by themselves will not be effective.
Have you considered a mood stabilizer like Lamictal? Sometimes SP can develop as a result of bipolar II. You might be bipolar and not know it (I most likely am.) Read this: http://www.psycheducation.org/depression/02_diagnosis.html as well as other stuff on that site and see if it strikes a chord with you. You may need to take an AD augmented with Lamictal.
Social phobia is almost always accompanied by atypical depression, which is why it is so hard to treat. I know you're suffering but hang in there. There are too many drugs and drug treatment strategies out there to give up. I have had SP and atypical depression a long time as well and I know how bad it can get. You are not alone in this.
Oh yeah, currently I take 150mg amitriptyline, 150mg imipramine, and 200mg sulpiride. As for how I'm doing on this - well this week I started on an 'upshift' where I feel like I'm getting better.
But I don't know if it will last. But I still have hope.
poster:HyperFocus
thread:894612
URL: http://www.dr-bob.org/babble/20090505/msgs/894707.html