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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 woolav on September 4, 2004, at 18:25:26
I dont think this is the right board for this post, but i dont know where else to post it..
I have read that those with social phobia, or other phobia's for that matter didnt just get it out of the blue..What I read was that it came from untreated panic disorder..So, I am wondering if once you have the phobia, can it be reversed ever?? (like maybe if the panic disorder is treated)??
Any info appreciated.
S
Posted by zeugma on September 4, 2004, at 18:48:04
In reply to ? for those with SP--------anyone?, posted by woolav on September 4, 2004, at 18:25:26
dont think this is the right board for this post, but i dont know where else to post it..
I have read that those with social phobia, or other phobia's for that matter didnt just get it out of the blue..What I read was that it came from untreated panic disorder..So, I am wondering if once you have the phobia, can it be reversed ever?? (like maybe if the panic disorder is treated)??
Any info appreciated.
S
That's an excellent question. What I do know is that social phobia generally starts early, often before the age of ten, and is often accompanied by panic attacks. But medications that are effective in panic disorder (desipramine, nortriptyline for example) are ineffective for SP, implying a different underlying pathology.
Posted by Michael Bell on September 4, 2004, at 23:40:59
In reply to ? for those with SP--------anyone?, posted by woolav on September 4, 2004, at 18:25:26
The current thinking is that Panic Disorder and Social Phobia have different etiologies and probably different root causes as well. It is possible to have both SP and panic attacks, but is not always the case. People with panic disorder fear the PHYSICAL SYMPTOMS of their disorder, whereas true social phobics fear the act of social interaction itself. Also, people with social phobia know that their fear is unreasonable, but no matter how much they tell themselves that, the fear always comes up in social situations.
Posted by King Vultan on September 5, 2004, at 12:09:14
In reply to Re: ? for those with SP--------anyone? » woolav, posted by zeugma on September 4, 2004, at 18:48:04
> dont think this is the right board for this post, but i dont know where else to post it..
> I have read that those with social phobia, or other phobia's for that matter didnt just get it out of the blue..What I read was that it came from untreated panic disorder..So, I am wondering if once you have the phobia, can it be reversed ever?? (like maybe if the panic disorder is treated)??
> Any info appreciated.
> S
>
>
> That's an excellent question. What I do know is that social phobia generally starts early, often before the age of ten, and is often accompanied by panic attacks. But medications that are effective in panic disorder (desipramine, nortriptyline for example) are ineffective for SP, implying a different underlying pathology.
Actually, both nortriptyline and desipramine were relatively effective for my social phobia, probably reducing the incidence and symptoms by 80%. In response to the original poster, my opinion is that SP absolutely can be reversed, either through therapy or drug treatment, or some combination thereof.Todd
Posted by TheOutsider on September 5, 2004, at 12:56:59
In reply to Re: ? for those with SP--------anyone?, posted by King Vultan on September 5, 2004, at 12:09:14
> > dont think this is the right board for this post, but i dont know where else to post it..
> > I have read that those with social phobia, or other phobia's for that matter didnt just get it out of the blue..What I read was that it came from untreated panic disorder..So, I am wondering if once you have the phobia, can it be reversed ever?? (like maybe if the panic disorder is treated)??
> > Any info appreciated.
> > S
> >
> >
> > That's an excellent question. What I do know is that social phobia generally starts early, often before the age of ten, and is often accompanied by panic attacks. But medications that are effective in panic disorder (desipramine, nortriptyline for example) are ineffective for SP, implying a different underlying pathology.
>
>
> Actually, both nortriptyline and desipramine were relatively effective for my social phobia, probably reducing the incidence and symptoms by 80%. In response to the original poster, my opinion is that SP absolutely can be reversed, either through therapy or drug treatment, or some combination thereof.
>
> ToddI have to say that my Social anxiety/phobia was not proceeded by panic disorder, or general anxiety.
Nor did it develop at age ten or anywere around that time, it really started when I was seventeen.I'm really interested in Todds assertion that desipramine and nortryptaline can be effective for social anxiety. I always thought that they were quite ineffective.
My social anxiety doesn't seem to benefit from serotonin drugs, I've triad clomipramine, celexa and prozac without having good results, they just seem to make me tired.
Curiesly I got some relief from Adrafinal which effects noradrenaline.
Also from dexedrine.
I also possibly have ADHD, maybe I have a noradrenaline/dopamine disfunction rather than serotonin.Feel a bit hopless about it at the moment because doctors here (UK) are so bad! Also desipramine is not available.....:(
Posted by zeugma on September 5, 2004, at 15:21:20
In reply to Re: ? for those with SP--------King Vultan, posted by TheOutsider on September 5, 2004, at 12:56:59
Lofepramine is available in the UK which is metabolized into desipramine. Lofepramine is actually considered the safest tricyclic on the market.
Todd had luck with desipramine and nortriptyline for SP, but I did not. On the other hand nortriptyline began blocking my panic attacks almost immediately, probably because a major precipitant of panic attacks for me is nausea, and nortriptyline is a powerful antinauseant, for me at least. The TCA's in general are much better for those with GI problems than other classes of AD's.
The fact remains, however, that the medications that are considered to be most generally effective for SP are Klonopin and Nardil. My social anxiety has lessened on Klonopin, to a greater extent than on any other med, in fact in my experience it is in a class by itself (I have never tried Nardil). I still struggle with the anxiety, however.
-z
Posted by Donia on September 5, 2004, at 18:37:55
In reply to Re: ? for those with SP--------anyone?, posted by Michael Bell on September 4, 2004, at 23:40:59
I have had depression and social phobia since about age 10. In my late 20's I started having panic attacks. They got to the point of being daily. I took zoloft and it helped with all symptoms. I now take lexapro and I am starting college Tuesday. Years ago I wouldnt have been able to do this. Now I cant stop talking to people. I will even strike up conversations with strangers in the grocery store. The trade off for me is being very LAZY on these meds. I hope we all can find answers for our problems. I dont care anymore where it comes from, I just want to control the best I can.
Donia
Posted by King Vultan on September 5, 2004, at 21:59:47
In reply to Re: ? for those with SP--------King Vultan, posted by TheOutsider on September 5, 2004, at 12:56:59
> > >
>
> I have to say that my Social anxiety/phobia was not proceeded by panic disorder, or general anxiety.
> Nor did it develop at age ten or anywere around that time, it really started when I was seventeen.
>
> I'm really interested in Todds assertion that desipramine and nortryptaline can be effective for social anxiety. I always thought that they were quite ineffective.
>
> My social anxiety doesn't seem to benefit from serotonin drugs, I've triad clomipramine, celexa and prozac without having good results, they just seem to make me tired.
>
> Curiesly I got some relief from Adrafinal which effects noradrenaline.
> Also from dexedrine.
> I also possibly have ADHD, maybe I have a noradrenaline/dopamine disfunction rather than serotonin.
>
> Feel a bit hopless about it at the moment because doctors here (UK) are so bad! Also desipramine is not available.....:(
Some people's SP does show remarkable improvement on SSRIs, as Donia's did, while for others such as me, they seem to be much more marginal. My estimation is that SSRIs and Effexor only reduced my social phobia about 50%, and it wasn't until I got to the tricyclics that I realized that the serotonergic drugs had just been treating the symptoms (and not very well), while nortriptyline and desipramine seemed to actually go right to the problem at its source and nuke the heck out it.However, my particular problem may have more similarity to panic attacks than does most people's SP, as one of the manifestations of mine is progressively increasing sweating that I seem largely powerless to control. It happens in certain situations where I feel trapped, such as standing in lines, eating in a restaurant with someone, or in other social situations where I feel that I'm under scrutiny. I actually don't have a great fear of people and feel that my social skills are relatively good overall; it's this blasted stupid phobia that is my problem.
Todd
Posted by TheOutsider on September 6, 2004, at 16:28:46
In reply to Re: ? for those with SP--------King Vultan » TheOutsider, posted by King Vultan on September 5, 2004, at 21:59:47
My Social anxiety sounds quite different to yours Todd, with me its much more of a mental thing were I feel depressed and uncomfortable/nervous in social situations.
This is the end of the thread.
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