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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Adam33 on January 19, 2004, at 15:33:12
This question spawns from some great responses I got to a question I asked above.
The way I understand benzo's (like Klonopin) to work against performance anxiety is that they dull your feelings anxiety, thus making you less worried about how you are being percieved.
On the other hand, I thought maybe SSRI's worked by, in a sense, "re-wiring" your brain so that you don't get that initial rush of anxiety because you don't sense or percieve that fear of being negatively percieved.
Is this an entirely specious distinction? Do these drugs in fact work on SA in different ways (that is, with regard to how you FEEL the effect).
This ostensible distinction I drew was the reason I was going to try and combine Klonopin & Lexapro for my severe performance anxiety (along with occassional propranolol). Plus, I have mild OCD, so I thought the Lexapro couldnt hurt on that either.
Oh, and one last question, will SSRI's dumb me down like a heavy dose of Xanax does? That is in part why I also though the SSRI would help...cause I could use a lower dosage of benzos.
As always, thanks for all the wonderful help. I really wish I had found this forum five years ago, and hopefully in the near future I will be able to give as much advice as I am now receiving
Posted by linkadge on January 19, 2004, at 16:20:49
In reply to Do SSRI's Klonopin/Xanax attack SA differently?, posted by Adam33 on January 19, 2004, at 15:33:12
Antidepressants can alerting in some ways. They can help you see the problem for what it is.
In my experience, celexa makes everything seem as it is - very logical. They help you to reason things out, and come up with logical solutions. They help you to run the 'what if's' through right to the end. It may make you aware of your own internal coping mechanisms.
For instance, I play the piano, and performance anxiety has always been a problem.
After taking starting on Celexa for this and depression, I can see and accept what is blatently obvious. Instead of saying, I need to be the best in this, I can say I will do my best, and believe that I will acept myself for what I am.
I find that when you can accept yourself - I mean *really* accept yourself (regardless of weather you pass or fail), then sucess doesn't matter as much.
I also find myself watching Seinfeld more often, and the Golden Girls. When you are in a positive mood - you remember the jokes, and oftentimes you'll blurt themout without really thinking. Good comedy always lightens a social tone.
They also set up a bit of a edge to you.
You are a bit less 'needing' of complements etc. This may or may not be a bad thing.Benzo's also have their place. In many ways once you realize that the 'rush' of adrenaline doesn't come, then you just act because there is little negative consequence possible.
I would use the lexapro daily, and cary around some konapin. Throw yourself into social situations knowing that if a problem arises then the klonazepam is always there.
Best of Luck
Linkadge
Linkadge
Posted by Sad Panda on January 20, 2004, at 0:57:28
In reply to Do SSRI's Klonopin/Xanax attack SA differently?, posted by Adam33 on January 19, 2004, at 15:33:12
> This question spawns from some great responses I got to a question I asked above.
>
> The way I understand benzo's (like Klonopin) to work against performance anxiety is that they dull your feelings anxiety, thus making you less worried about how you are being percieved.
>
> On the other hand, I thought maybe SSRI's worked by, in a sense, "re-wiring" your brain so that you don't get that initial rush of anxiety because you don't sense or percieve that fear of being negatively percieved.
>
> Is this an entirely specious distinction? Do these drugs in fact work on SA in different ways (that is, with regard to how you FEEL the effect).
>
> This ostensible distinction I drew was the reason I was going to try and combine Klonopin & Lexapro for my severe performance anxiety (along with occassional propranolol). Plus, I have mild OCD, so I thought the Lexapro couldnt hurt on that either.
>
> Oh, and one last question, will SSRI's dumb me down like a heavy dose of Xanax does? That is in part why I also though the SSRI would help...cause I could use a lower dosage of benzos.
>
> As always, thanks for all the wonderful help. I really wish I had found this forum five years ago, and hopefully in the near future I will be able to give as much advice as I am now receivingIt's a bit of an oversimplflication, but, Benzos aim to treat the symptoms of anxiety, Antidepressants aim to treat the cause.
Cheers,
Panda.
Posted by Alex2 on January 20, 2004, at 6:33:32
In reply to Do SSRI's Klonopin/Xanax attack SA differently?, posted by Adam33 on January 19, 2004, at 15:33:12
Hi Adam,
Benzos are great for anybody that suffers from anxiety or PD. I don't think they help much for OCD (didn't for me). Benzos have a much better side effect profile than SSRIs.
In my case, I have tried benzos alone, but I sooner or later needed an AD because of subsequent depression. Once I was on the AD, I generally weaned of the benzos, because I didn't need them any more.
SSRIs have always helped me with PD, OCD, and depression. However, as I said in the above post, they do come (maybe not in all cases) with side effects.
I don't really feel dumbed-down on the SSRI, rather I have become more forgetful. The worst side effect for me though is the a-motivation. I don't feel like doing anything, nor do I care. I guess this has its pros and cons. I have always been a goal oriented person with the drive to achive what I set out for - now I hardly have any drive. When I was on a smaller dose years ago this wasn't as much of a problem.
I have pasted a link for you below from the Panic Disorders Institute. Read the "Frequently Asked Questions" section for a different view regarding benzos and SSRIs.
Good luck with whatever you decide.
Alex
Posted by Kon on January 21, 2004, at 1:09:35
In reply to Re: Do SSRI's Klonopin/Xanax attack SA differently? » Adam33, posted by Sad Panda on January 20, 2004, at 0:57:28
>It's a bit of an oversimplflication, but, Benzos aim to treat the symptoms of anxiety, Antidepressants aim to treat the cause.
I'm pretty sure there isn't any real evidence for this claim (even the simplified version)although one comes across it on many forums. A similar claim is that SSRIs work on the cognitive component of SAD while SSRIs work on the physiological component. Again, there is no evidence I've ever come across for these claims. In fact, beta-blockers which work very well on the physiological symptoms of anxiety are pretty useless in generalized SAD. Moreover, tests designed to demonstrate efficacy of a given drug almost always employ the Liebowitz social anxiety scale and other similar tests and to the best of my knowledge, I've never come across any study showing benzos to preferentially improve symptoms of anxiety while SSRI improve other components. If you have any such studies please post them as I would be interested in looking at them.
Posted by Ame Sans Vie on January 21, 2004, at 1:30:46
In reply to Do SSRI's Klonopin/Xanax attack SA differently?, posted by Adam33 on January 19, 2004, at 15:33:12
Benzos provide instant gratification -- they work immediately, from the first dose, and from those offered by barbiturates or ethyl alcohol. Barbs and booze have a generalized central nervous system depressant effect however, where benzos are pretty darn specialized. They specifically target the regions and receptors in the brain that are responsible for calming down an over-active, over-anxious brain.
SSRIs certainly take a more roundabout approach (and, from what I see, are rarely of any significant help in treating social phobia). Rather than getting into the whole 5-HT reuptake explanation, I think you may find it interesting to know that it was recently discovered that Prozac (an [atypical] SSRI) causes the growth of new brain cells with consistent use. This could have to do with the reason these drugs take so long to begin working, considering that reuptake inhibition is achieved with the first dose.
So that's the technical explanation... time for my editorial. Benzos rid anxiety without messing around with the rest of your brain (for the most part). SSRIs, as "selective" as they are, are not at all specifically targeted toward proven biological causes of anxiety. SSRIs seem to "help" social phobes by numbing their emotions; while benzos may do this at first, the degree to which they do so is rarely so severe, and it typically goes away in a short time.possess mechanisms of action not so far removed
But as always, I must make it quite clear -- I love my Prozac, and I mean no disrespect! lol :-) I take it for depression/mild OCD though... my social phobia, agoraphobia, panic, GAD, and most of my depression are treated wonderfully with Klonopin and Adderall.
This is the end of the thread.
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