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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Boba Fatt on November 10, 2002, at 4:29:46
I have been prescribed stelazine for social phobia but I was under the impression that too little dopmane was part of the problem, now I am being prescribed a dopamine blocker. Is this right?
Posted by xjs7 on November 10, 2002, at 18:42:57
In reply to Stelazine for social phobia, posted by Boba Fatt on November 10, 2002, at 4:29:46
Hi Boba Fatt,
Stelazine is not generally used in the treatment of social phobia; rather, it an antipsychotic used mainly to treat psychosis and mania. It has some very serious side effects, such as the irreversable movement disorder tardive dyskinesia.
Stelazine may have an anti-anxiety effect, even at low doses. This may be why you were prescribed it, if you did not present with psychosis or mania. Personally I would refuse to take an antipsychotic agent for a non-psychotic condition such as social phobia. In any case I would carefully consider the decision to take Stelazine before starting it.
No one knows what causes social phobia (or any psychiatric illness for that matter), and I don't recall reading about any connection between social phobia and dopamine in the brain. However, I am not a doctor and don't know everything (actually I know very, very little). I hope this information helps you--and that you soon find something effective in treating your symptoms.
xjs7
Posted by Rick on November 10, 2002, at 23:32:22
In reply to Re: Stelazine for social phobia, posted by xjs7 on November 10, 2002, at 18:42:57
I had never heard of Stelazine. Looked it up on Medscape and RX-List and saw that in addition to treatment of psychosis it does indeed have an indication for *short-term* (less than 12 weeks) treatment of non-psychotic anxiety. (BTW, for psychosis it's sometimes given by injection.)
Didn't say much about the pharmacology, but what did appear gave no indication that it acted via anti-dopaminergic mechanisms like most of the anti-psychotics that are used today.
I did see the warnings xjs7 refers to, specifically re the risk of possibly-irreversible tardive dyskenesias (sp?). This was specifically cited as a drug that shouldn't be a first-line choice for anxiety because of the risks -- even if it *does* have anxiolytic effects.
Maybe your doctor knows what he's doing, but this seems rather surprising, especially since social phobia usually requires longer (or indefinite) treatment. I *have* seen quite a few reports of modern antipsychotics like Zyprexa showing promise for social phobia, perhaps because of post-synaptic 5-HT2 (?) receptor antagonism, a la the anxiolytic antidepressant Serzone (which helped me as part of an SP med cocktail). But -- besides the fact that daily low-dose Klonopin handles my SP so well, especialy in tandem with low-dose Provigil -- I would personally avoid modern antipsychotics because of some potentially troublesome side effects like hyperglycemia.
As for the supposed dopamine deficiency in SP, pro-dopaminergic drugs so far haven't shown much benefit in studies or anecdotally, although I know they've helped some SP-ers (especially those who also have ADD) as part of various med cocktails. In my case, all the usual dopaminergic drugs I tried actually *added* varying degrees of anxiety.
Of course I don't know the particulars of your situation Boba Fatt, but I highly recommend that you investigate Klonopin.
Rick
Posted by oracle on November 11, 2002, at 0:54:48
In reply to Re: Stelazine for social phobia, posted by xjs7 on November 10, 2002, at 18:42:57
It is crazy to put someone on Stelazine (!!!!!!!)
for SA. The risk benifit does not add up.
Stelazine has a well known side effect profile,
it is an OK risk if one is really psychotic
for life. But not for AP.It is cheap, and I have a feeling that is why it is offered.
Posted by Boba Fatt on November 11, 2002, at 8:46:04
In reply to Re: Stelazine for social phobia, posted by Rick on November 10, 2002, at 23:32:22
I have recently mail ordered klonopin over the net as doctors will not prescribe it in the UK. I was hoping that stelazine may help with some of the paranoia associated with social anxiety but I do suffer from attention problems and thought perhaps a dopamine stimulant might be more beneficial
Posted by oracle on November 11, 2002, at 15:33:34
In reply to Re: Stelazine for social phobia, posted by Boba Fatt on November 11, 2002, at 8:46:04
> thought perhaps a dopamine stimulant might be more beneficial
Huh ?
Posted by Boba Fatt on November 11, 2002, at 18:28:14
In reply to Re: Stelazine for social phobia, posted by oracle on November 11, 2002, at 15:33:34
> > thought perhaps a dopamine stimulant might be more beneficial
>
>
> Huh ?You know, wellbutrin, prozac, selegine, l-dopa, ritalin something along these lines.
Posted by oracle on November 12, 2002, at 1:14:47
In reply to Re: Stelazine for social phobia, posted by Boba Fatt on November 11, 2002, at 18:28:14
> You know, wellbutrin, prozac, selegine, l-dopa, ritalin something along these lines.
That list hits everything NT wise !
This is the main risk with Stelazine:
<quote>
Tardive Dyskinesia is a serious, irreversible neurological disorder that can appear at any age. Tardive Dyskinesia is a side effect of taking antipsychotic / neuroleptics drugs. Symptoms can be hardly noticeable or profound. Symptoms involve uncontrollable movement of various body parts, including the body trunk, legs, arms, fingers, mouth, lips, or tongue. Once any symptom of Tardive Dyskinesia appear, the antipsychotic / neuroleptic must be discontinued. About 20 percent of people taking antipsychotic / neuroleptic drugs for more then one year will be affected.
<end quote>Actually at least 20% with the horrable old AP's
like Stelazine and Navane. They are cheap. Do I smell the NHS ?BTW, too little or too much for a brain chem is not the cause of mental illness. It is much more
complex than that, but the Docs throw this about
to help us understand. In truth neuroscience is still new, so the no one knows the full picture yet.It would really help to know a little more than just SA about you and your condition. What issues/problems/feelings do you need help with ?
What is the worst, bugs you the most, ect. Knowing where you live, just the area (UK,USA, ect) helps so we know what health resources you have.
Posted by Kari on November 12, 2002, at 12:37:18
In reply to Stelazine for social phobia, posted by Boba Fatt on November 10, 2002, at 4:29:46
Hi,
If your main problem is social phobia, I don't think it is worth the risk to try an AP. Not even an atypical.
Take care,
Kari.
This is the end of the thread.
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