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Dr. Bob is Robert Hsiung, MD,
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Posted by Rick on January 15, 2002, at 17:27:56
In reply to Re: MAOI diet short list, posted by djmmm on January 15, 2002, at 16:23:01
Great to hear that Nardil has been a miracle drug for you!A few questions and comments:
> Well...actually, I had a bit of positional/orthostaic hypotension for the first few weeks
Nardil turned me from (untreated) hypertensive to hypotensive within days. The postural hypotension was so bad that I was falling down, including in public.
>I also started taking Inderal at the time
Do you think the Inderal adds to the anti-social-anxiety effect?
>I havent gained any weight
We both seem to be in a distinct minority on this one. I actually found it *easier* to lose weight when I was on Nardil, and I didn't really cut out many foods due to the cheese effect
>and as far as sexual side effects, I would take Nardil over Paxil or Effexor or even Wellbutrin ANY DAY
So do you/did you have any sexual dysfunction at all on Nardil? Nardil gave me such severe anorgasmia that it continued for almost four weeks after I dropped the Nardil
>on the SSRIs I felt like an emotion-less zombie...yeah I was no longer anxious, or depressed, but I wasn't happy either, I was lost somewhere in the middle, and very uncomfortable there.
I was being treated strictly for SP, not depression, but I can sure relate to your SSRI reactions based on my Celexa trial.
> nardil, for me, at least, has been a miracle drug, far less side effects than the SSRIs, or Effexor, Wellbutrin
Did either Effexor or Welbutrin help at all with the SP?
> I do have memory difficulties, but I can not attribute them to Nardil, I take Neurontin and Topamax for epilepsy and both of these medications have adverse effects on memory.
Again, I wonder if either of these, especially the Neurontin, add to the highly effective treatment of your SP?
> I take:
> Nardil 60mg
> Neurontin 1800mg
> Topamax 200mg
> Inderal 40mgAny problems with energy or cognition (other than memory) with this combo?
Posted by Seamus2 on January 15, 2002, at 21:49:17
In reply to Re: MAOI diet short list » djmmm, posted by spike4848 on January 15, 2002, at 7:31:57
I took Nardil solely for depression, not SP, for 5+ years before trying Parnate because of the anorgasmia Nardil caused. I really like the Parnate better, the only drawback is the increased tension and sympathomimetic agonism.
Nardil caused pronounced postural hypotension for me.
> Weight gain
If I rememeber correctly, I had carbo-cravings on Nardil, but didn't gain any weight.> Sexual dysfunction
Complete anorgasmia at 60/mg day. No fun! :(> Insomnia
Can't remember any.> Memory difficulties
Can't remember any. < g > (no joke, I don't think it impaired my memory at all)Seamus
Posted by Lisa01 on January 15, 2002, at 22:15:07
In reply to Re: MAOI diet short list, posted by Seamus2 on January 15, 2002, at 21:49:17
I thought I was well-versed in my disorder, but I've never come across the term "sympathomimetic agonism" before. Since I'm on Parnate, I'm curious to know what that is. Also, could you tell me how long you were taking it before you began to feel its benefits? I've been on it almost a month and feel the same anticipatory anxiety and physical systems as before.
Lisa
Posted by djmmm on January 15, 2002, at 23:04:54
In reply to Re: MAOI diet short list » djmmm, posted by Rick on January 15, 2002, at 17:27:56
>
> Great to hear that Nardil has been a miracle drug for you!
>
> A few questions and comments:
>
> > Well...actually, I had a bit of positional/orthostaic hypotension for the first few weeks
>
> Nardil turned me from (untreated) hypertensive to hypotensive within days. The postural hypotension was so bad that I was falling down, including in public.
>
> >I also started taking Inderal at the time
>
> Do you think the Inderal adds to the anti-social-anxiety effect?
>
> >I havent gained any weight
>
> We both seem to be in a distinct minority on this one. I actually found it *easier* to lose weight when I was on Nardil, and I didn't really cut out many foods due to the cheese effect
>
> >and as far as sexual side effects, I would take Nardil over Paxil or Effexor or even Wellbutrin ANY DAY
>
> So do you/did you have any sexual dysfunction at all on Nardil? Nardil gave me such severe anorgasmia that it continued for almost four weeks after I dropped the Nardil
>
> >on the SSRIs I felt like an emotion-less zombie...yeah I was no longer anxious, or depressed, but I wasn't happy either, I was lost somewhere in the middle, and very uncomfortable there.
>
> I was being treated strictly for SP, not depression, but I can sure relate to your SSRI reactions based on my Celexa trial.
>
> > nardil, for me, at least, has been a miracle drug, far less side effects than the SSRIs, or Effexor, Wellbutrin
>
> Did either Effexor or Welbutrin help at all with the SP?
>
> > I do have memory difficulties, but I can not attribute them to Nardil, I take Neurontin and Topamax for epilepsy and both of these medications have adverse effects on memory.
>
> Again, I wonder if either of these, especially the Neurontin, add to the highly effective treatment of your SP?
>
>
> > I take:
> > Nardil 60mg
> > Neurontin 1800mg
> > Topamax 200mg
> > Inderal 40mg
>
> Any problems with energy or cognition (other than memory) with this combo?To answer your questions...
the Inderal most def. helps with the "physical" aspect of social anxiety.. the increased heart rate, sweating.I found that once my heart wasn't beating out of my chest, I wouldn't start sweating, and then I wouldn't start blushing..and this helped tremendously....but psychologically I was still having the same distorted "self-centered" social phobic thoughts.
as for sexual side-effects, rarely I have had problems with anorgasmia...maybe 10 times in the 1.5 years I have been taking the Nardil... The SSRIs destroyed my libido, and being only a teen/early 20's at the time (im 23 now) that was just unacceptable...Effexor and Wellbutrin weren't any better...
...also Effexor, surprisingly, did not work at all for me, neither did wellbutrin, and wellbutrin sr gave me hives.
I do think that the Neurontin and Topamax have contributed to my recovery...
Posted by djmmm on January 15, 2002, at 23:28:44
In reply to Re: MAOI diet short list-Seamus2, posted by Lisa01 on January 15, 2002, at 22:15:07
> I thought I was well-versed in my disorder, but I've never come across the term "sympathomimetic agonism" before. Since I'm on Parnate, I'm curious to know what that is. Also, could you tell me how long you were taking it before you began to feel its benefits? I've been on it almost a month and feel the same anticipatory anxiety and physical systems as before.
>
> LisaHey Lisa
sympathomimetic is a term typically used to describe drugs that stimulate the central nervous system, like ephedrine, pseudofed,...here, he is using the term "sympathomimetic agonism", when refering to the drug Parnate.Until recently, it was believed that the metabolites of Parnate were Amphetamine and Methamphetamine, which would fit the definition of "sympathomimetic agonists"
Most research does not support the amphetamine metabolite theory. However, there is still a lot to learn about MAOI pharmacology.
Posted by Elizabeth on January 16, 2002, at 20:40:18
In reply to Re: MAOI diet short list, posted by Lisa01 on January 14, 2002, at 20:46:11
> I gave up red wine (my favourite), beer, pizza, nachos with cheese & sour cream... I read on one web site that wine was okay, but only quantities of 1/2 cup or less!
Jeez. There's no evidence that *any* wine is dangerous with MAOIs. There is one thing on your list there that you might want to be cautious about: the nachos. Sometimes restaurants use cheddar cheese, which is something you should generally avoid (while on MAOIs, that is).
> Regarding Parnate, I have notice an increase in anxiety/nervousness. For someone taking this for SP, this is quite unwelcome. Any idea if this will dissipate?
I'd expect it to, yes. You might back off to a lower dose and then increase it slower.
> Also, I don't feel any benefits although it's been almost a month. I'm on the min. dosage.
What do you mean by "the min. dosage?" I certainly think it's possible you would do well on a higher dose.
> Also, has anyone tried Corona, an imported beer from Mexico, on an MAOI? It's not a dark beer so I'm wondering if it might be okay.
I'm not sure that the color of the beer has any relationship to tyramine content. But I can't say anything about Corona specifically, sorry.
-elizabeth
Posted by Elizabeth on January 16, 2002, at 20:45:23
In reply to Re: MAOI diet short list-Seamus2, posted by Lisa01 on January 15, 2002, at 22:15:07
> I thought I was well-versed in my disorder, but I've never come across the term "sympathomimetic agonism" before. Since I'm on Parnate, I'm curious to know what that is.
I think he just means that Parnate has mild amphetamine-like effects -- it enhances the activity of the sympathetic nervous system (which results in some of the "jittery" side effects like tension, increased heart and respiration rates, etc.).
Posted by Elizabeth on January 16, 2002, at 20:50:23
In reply to Re: MAOI diet short list » djmmm, posted by Rick on January 15, 2002, at 17:27:56
> Nardil turned me from (untreated) hypertensive to hypotensive within days. The postural hypotension was so bad that I was falling down, including in public.
A big change in baseline BP will do that. I had a couple of fainting spells when I first started taking Nardil. I got used to it after a little while, though. Did you continue having this problem, or did it get better for you too?
> We both seem to be in a distinct minority on this one. I actually found it *easier* to lose weight when I was on Nardil, and I didn't really cut out many foods due to the cheese effect
Lucky! I've heard that men are less likely to gain weight on Nardil than women are, although I suspect this perception might result from women being more likely to report this side effect.
-e
Posted by Rick on January 16, 2002, at 23:03:00
In reply to Re: MAOI diet short list » Rick, posted by Elizabeth on January 16, 2002, at 20:50:23
> A big change in baseline BP will do that. I had a couple of fainting spells when I first started taking Nardil. I got used to it after a little while, though. Did you continue having this problem, or did it get better for you too?
After two weeks of blacking out and falling down (wish I was onto the pretzel excuse back then), and one especially unpleasant incident where I hit my head, my pdoc prescribed Florinef. It really felt weird to be a recent hypertensive taking something to raise my blood pressure!
After a few weeks I was able to wean off the Florinef and my BP stabilized at about 100/55. At that point, the weakness, staggering, and falling stopped, and I'd just have occasional fleeting dizziness upon standing up -- as I later did with Serzone.
>Lucky! I've heard that men are less likely to gain weight on Nardil than women are, although I suspect this perception might result from women being more likely to report this side effect.
Could be. Regardless, I think the key is to pick the right diet to go with the particular med. I can tell you that Nardil is tailor-made for the "fall down before you can get to the refrigerator" diet.
Rick
Posted by Augusta on January 17, 2002, at 18:35:33
In reply to Re: MAOI diet short list P.S. » Lisa01, posted by Elizabeth on January 16, 2002, at 20:45:23
Just to clarify, what foods are still known to be risky when one is taking an MAOI?
(Are there any foods that are outright dangerous?)
Posted by Lisa01 on January 17, 2002, at 19:18:45
In reply to Re: MAOI diet short list » Lisa01, posted by Elizabeth on January 16, 2002, at 20:40:18
> What do you mean by "the min. dosage?" I certainly think it's possible you would do well on a higher dose.I take only 10 mg. of Parnate once a day. When I upped it to twice a day (after 3 weeks at once) I had severe dizzy spells and was always cold. I have low blood pressure when not on meds so I didn't think it was a good thing to make it too low...
As I understand it, it can take 4-6 weeks to perceive therapeutic benefits even at higher doses, right?
Lisa
Posted by Elizabeth on January 18, 2002, at 10:12:45
In reply to Re: MAOI diet short list » Elizabeth, posted by Rick on January 16, 2002, at 23:03:00
> After two weeks of blacking out and falling down
That would be fainting or "syncope."
> (wish I was onto the pretzel excuse back then), and one especially unpleasant incident where I hit my head, my pdoc prescribed Florinef.
The "pretzel excuse?" This is one I'm not familiar with (and I try to keep up with the latest research in excuses!).
Did the fludrocortisone have any bad side effects?
> After a few weeks I was able to wean off the Florinef and my BP stabilized at about 100/55.
Yeah, that's about what mine tended to run when I was on MAOIs.
> Could be. Regardless, I think the key is to pick the right diet to go with the particular med. I can tell you that Nardil is tailor-made for the "fall down before you can get to the refrigerator" diet.
< g >
-elizabeth
Posted by Elizabeth on January 18, 2002, at 10:31:35
In reply to So, what is left on the danger list? , posted by Augusta on January 17, 2002, at 18:35:33
> Just to clarify, what foods are still known to be risky when one is taking an MAOI?
>
> (Are there any foods that are outright dangerous?)Sure there are. I'm not trying to claim that you can eat whatever you want while taking MAOIs. I think I mentioned cheddar cheese; other aged cheeses can also cause problems. Here's the list of dietary restrictions that I used (evidence-based):
Avoid altogether:
- tap beer
- foreign bottled beers
- aged cheeses (some modestly aged cheeses may be okay in moderation, but exercise caution)
- spoiled or improperly stored dairy (e.g., milk or yogurt past the expiration date) or meat
- aged, smoked, or fermented meats (e.g., salami, bologna, summer sausage)
- fava beans (I *think* that it's just the pods that are a problem, but I'm not positive)
- banana peels (what a loss!)
- sauerkraut
- miso soup
- yeast and protein extracts (e.g., Marmite, Bovril)
- certain herbal teas containing ingredients such as "ma huang" (ephedrine)Exercise caution:
- wine and beer
- soy products (e.g., tofu), especially soy sauce
- liver (seems to be implicated in a lot of reactions even when it doesn't seem to be spoiled)
- coffee and other high-caffeine beveragesThis list isn't necessarily exhaustive and shouldn't be taken as such; it's just what I can think of off the top of my head. I hope it helps.
-elizabeth
Posted by Elizabeth on January 18, 2002, at 10:37:51
In reply to Re: MAOI diet short list-Lisa01, posted by Lisa01 on January 17, 2002, at 19:18:45
> I take only 10 mg. of Parnate once a day. When I upped it to twice a day (after 3 weeks at once) I had severe dizzy spells and was always cold.
I'm generally intolerant to cold, but I think that Parnate made it worse. The dizziness should subside after a while. Some people find that taking salt tablets relieves MAOI-induced dizziness.
> I have low blood pressure when not on meds so I didn't think it was a good thing to make it too low...
It's really not dangerous unless you start fainting, then you have to worry about falls!
> As I understand it, it can take 4-6 weeks to perceive therapeutic benefits even at higher doses, right?
It can, although I've encountered a number of people for whom it worked faster. But I wouldn't expect 10 mg/day to be a sufficient dose. 30 mg/day is generally the minimum effective dose, I think (some people might notice partial effects at 20).
-elizabeth
Posted by Seamus2 on January 18, 2002, at 22:01:59
In reply to So, what is left on the danger list? , posted by Augusta on January 17, 2002, at 18:35:33
Salami was the only thing I had a bad reaction to while on Nardil.
But I was, and am (now on Parnate), still pretty careful.
Like Elizabeth, I still steer clear of
- sauerkraut
- miso soup
- yeast and protein extracts (e.g., Marmite, Bovril)
- certain herbal teas containing ingredients such as "ma huang" (ephedrine)as well as
- liver (seems to be implicated in a lot of reactions even when it doesn't seem to be spoiled)But I have no problem with
- coffee and other high-caffeine beverages
Seamus
Posted by Seamus2 on January 18, 2002, at 22:11:19
In reply to Re: MAOI dose and dizziness » Lisa01, posted by Elizabeth on January 18, 2002, at 10:37:51
> I'm generally intolerant to cold, but I think that Parnate made it worse.< <
Jeez, you can say that again! I restarted on Dec 18 and have been freezing ever since. I take thyroid, on top of it, too, but the peripheral circulation just shuts down completely. Maybe if I quit smoking .... and that 1.5 cups of coffee in the morning doesn't help, I don't think.
> > I have low blood pressure when not on meds so I didn't think it was a good thing to make it too low...
>
> It's really not dangerous unless you start fainting, then you have to worry about falls!
>I have naturally low BP too. Just get used to bending over and putting your head between your legs. Actually, nobody realy looks at you funny, and it beats passing out! (Was doing this long before MAOI therapy)
> > As I understand it, it can take 4-6 weeks to perceive therapeutic benefits even at higher doses, right?
>
> It can, although I've encountered a number of people for whom it worked faster. But I wouldn't expect 10 mg/day to be a sufficient dose. 30 mg/day is generally the minimum effective dose, I think (some people might notice partial effects at 20).FOr me it kicked in 80% within three weeks, 50% within two; and noticeable at 30 mg/day within one week.
And I get by on 20 mg/day for maintenance, but woe if I think I can get along without it.
Seamus
Posted by Rick on January 19, 2002, at 4:20:14
In reply to Re: MAOI diet short list » Rick, posted by Elizabeth on January 18, 2002, at 10:12:45
> The "pretzel excuse?" This is one I'm not familiar with (and I try to keep up with the latest research in excuses!).
Referring to George W. Bush's recent brief fainting spell after he choked on a pretzel. Not to make light of Mr. Bush's travails, but since this was a Presidential Excuse, I'm shocked that it hasn't surfaced in your excusional research. I suppose you have an excuse?
> Did the fludrocortisone have any bad side effects?No.
Rick
Posted by Lisa01 on January 19, 2002, at 9:11:31
In reply to Re: MAOI dose and dizziness, posted by Seamus2 on January 18, 2002, at 22:11:19
> FOr me it kicked in 80% within three weeks, 50% within two; and noticeable at 30 mg/day within one week.
>
> And I get by on 20 mg/day for maintenance, but woe if I think I can get along without it.
Seamus and Elizabeth: Thanks for all the info. I'm sure you've heard of a book called Feeling Good by David Burns--it's there that I got the idea that 10-20 mg. of Parnate would be sufficient. Also my MD didn't want to put me on any more than 10 at first.Seamus, how long before you reduced to a maintenance dose? I haven't gone to 20 mg. yet. but plan to start next week. Also, do you do, or have you done, any CBT? That is what I hope will be my permanent solution as I hear these meds "poop out" and I don't want to be switching back and forth with other meds. Do you ever fear you are messing with your brain chemistry and may permanently screw it up?
Lisa
Posted by fran on January 19, 2002, at 23:17:44
In reply to Re: MAOI diet short list, posted by Seamus2 on January 15, 2002, at 21:49:17
I'm on Effexor for depression, but do know a
little about MAOI and that they require diet
restrictions which are not necessary for SSRIs.
But now I've been started on Zyvox,which is a new
antibiotic which has been out only about 2 months.
It's used for serious infections with "super-bugs",
i.e. bacteria that are resistant to all other
existing antibiotics. Amazingly, it requires
adherence to an MAOI diet, but I found this out
only by looking it up in the new PDR. My doctor
(an infectious diseases specialist) didn't tell me
and there was no warning on the prescription
bottle. *UNBELIEVABLE!!!*
So, I'm very grateful to all of you for having
already shared your experiences on-line. I had
been following the old MAOI recommendations
(sloppily provided even by my recently trained
pharmacist), and was just resigned to a month or
two of those restrictions (I totally admire all of
you who have been doing this long-term). But even
there, I had a ton of unanswered questions. Now
I'm a much happier camper!
BTW, I did read in a reputable (I think) article
that, if you stop an MAOI, you have to continue
the diet restrictions for an additional 4 weeks.
Have any of you come across any information like
this, or to the contrary?
Thanks again, to all of you!
Posted by Rick on January 20, 2002, at 0:15:34
In reply to Re: MAOI diet short list and Zyvox , posted by fran on January 19, 2002, at 23:17:44
> BTW, I did read in a reputable (I think) article
> that, if you stop an MAOI, you have to continue
> the diet restrictions for an additional 4 weeks.
> Have any of you come across any information like
> this, or to the contrary?It was a couple years ago, but I recall that I had to stay on the diet *at least* a couple weeks after stopping Nardil. Same hold-off period applies to taking meds that are verboten with MAOI's such as other AD's and many OTC cold remedies. Not surprising, then, that some of my side effects, especially severe sexual dysfunction, persisted for more than three weeks afer I stopped Nardil.
Rick
Posted by djmmm on January 20, 2002, at 0:31:33
In reply to Re: MAOI diet short list and Zyvox , posted by fran on January 19, 2002, at 23:17:44
> I'm on Effexor for depression, but do know a
> little about MAOI and that they require diet
> restrictions which are not necessary for SSRIs.
> But now I've been started on Zyvox,which is a new
> antibiotic which has been out only about 2 months.
> It's used for serious infections with "super-bugs",
> i.e. bacteria that are resistant to all other
> existing antibiotics. Amazingly, it requires
> adherence to an MAOI diet, but I found this out
> only by looking it up in the new PDR. My doctor
> (an infectious diseases specialist) didn't tell me
> and there was no warning on the prescription
> bottle. *UNBELIEVABLE!!!*
> So, I'm very grateful to all of you for having
> already shared your experiences on-line. I had
> been following the old MAOI recommendations
> (sloppily provided even by my recently trained
> pharmacist), and was just resigned to a month or
> two of those restrictions (I totally admire all of
> you who have been doing this long-term). But even
> there, I had a ton of unanswered questions. Now
> I'm a much happier camper!
> BTW, I did read in a reputable (I think) article
> that, if you stop an MAOI, you have to continue
> the diet restrictions for an additional 4 weeks.
> Have any of you come across any information like
> this, or to the contrary?
> Thanks again, to all of you!an irreversible covalent bond is formed by conventional MAOIs (non-reversible) so if discontinued, a new MAO enzyme must be resynthesized before "normal" MAO activity resumes... 4 weeks, seems a little excessive, but Im not a doctor.
also..Zyvox interacts with MAOIs because it is a MAOI itself,--so it also has potential interactions with SSRIs, TCAs, bupropion, and Buspar
Posted by Seamus2 on January 20, 2002, at 9:37:49
In reply to Re: MAOI dose and dizziness-Seamus, posted by Lisa01 on January 19, 2002, at 9:11:31
> Seamus, how long before you reduced to a maintenance dose? I haven't gone to 20 mg. yet. but plan to start next week. Also, do you do, or have you done, any CBT? < <
I'll probably drop back at the start of my sixth week.No CBT. I think my brain IS screwed up already, and look on the Parnate as a vitamin to keep it working well.
Seamus
Posted by Krazy Kat on January 20, 2002, at 18:13:42
In reply to Re: MAOI dose and dizziness-Seamus, posted by Lisa01 on January 19, 2002, at 9:11:31
Lisa:
Sorry I'm jumping in here - my understanding is that you can't mess with your brain chemistry - the effects of drugs, legal or otherwise, are fleeting.
Perhaps if we Could change our "chemistries", we could take a med once and then be cured. That Would be nice.
- KK
Posted by djmmm on January 20, 2002, at 18:47:33
In reply to Re: MAOI dose and dizziness-Seamus » Lisa01, posted by Krazy Kat on January 20, 2002, at 18:13:42
> Lisa:
>
> Sorry I'm jumping in here - my understanding is that you can't mess with your brain chemistry - the effects of drugs, legal or otherwise, are fleeting.
>
> Perhaps if we Could change our "chemistries", we could take a med once and then be cured. That Would be nice.
>
> - KKwell, not exactly...the problem is we do mess with our brain chemistry, and the greater problem is, for many, the effect is not fleeting...
many drugs are neurotoxins...drugs like MDMA (Ecstasy) and the popular diet drug Pondomin have the potential to "manipulate" the serotonin system, by destroying axon terminals, and even the very neurons that contain the mitochondria which produce the serotonin.
SSRI, TCAs and all other Psychiatric drugs seem to change brain chemistry, too. They too manipulate the serotonin system, perhaps not to the extent that MDMA does, but the result would be considered long-term downregulation of specific serotonin (or norepineprine) receptor sites.
Posted by Lisa01 on January 20, 2002, at 19:02:47
In reply to Re: MAOI dose and dizziness-Seamus, posted by djmmm on January 20, 2002, at 18:47:33
> > Sorry I'm jumping in here - my understanding is that you can't mess with your brain chemistry - the effects of drugs, legal or otherwise, are fleeting.
> > Perhaps if we Could change our "chemistries", we could take a med once and then be cured. That Would be nice.
> >
That certainly seems to be true in the sense that, once meds are out of our systmes, the original symptoms re-emerge.> well, not exactly...the problem is we do mess with our brain chemistry, and the greater problem is, for many, the effect is not fleeting...
>
> many drugs are neurotoxins...drugs like MDMA (Ecstasy) and the popular diet drug Pondomin have the potential to "manipulate" the serotonin system, by destroying axon terminals, and even the very neurons that contain the mitochondria which produce the serotonin.
>
> SSRI, TCAs and all other Psychiatric drugs seem to change brain chemistry, too. They too manipulate the serotonin system, perhaps not to the extent that MDMA does, but the result would be considered long-term downregulation of specific serotonin (or norepineprine) receptor sites.I can't attest the technical accuracy of these statements but I'll take your word on it!! What I'm simply thinking of is the strange things that occur when beginning a med. When I began Parnate, for example, I had twitching in my left eye, pulsing temples, and a mild, on and off headache. I just kept thinking: what is this doing to me?? It shows you how desperate we are for relief from symptoms--of Social Anxiety in my case--that we will put up with such things. I just sometimes wonder what the long-term result will be.
Best to all of you, and thanks for your input.
Lisa
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