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Dr. Bob is Robert Hsiung, MD,
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Posted by BradD on March 15, 2005, at 5:06:28
Prozac (20mg) helps moderately with my anhedonia and anergy, but does very little for social anxiety. Do you think that by adding Amisulpride or Mirapex would make things even better?
I've tried Klonopin and Xanax for social anxiety-they dont do much for me.
Posted by med_empowered on March 15, 2005, at 10:34:36
In reply to Prozac and Amisulpride/Mirapex, posted by BradD on March 15, 2005, at 5:06:28
Hey! As the SSRI drugs go, Prozac is the least potent, milligram per milligram, although it seems to have an unusally large share of side-effects and an unbelievably long half-life. Sooo, the obvious first step might be upping to Prozac (I think the usual ceiling is 60mgs). Another option would be moving to a higher-potency SSRI and pushing the dose as high as you can stand (I'm assuming here that you can tolerate SSRIs and aren't bipolar or anything). Personally, Zoloft @ 150mgs, while it worked, was great for me. Another option would be to add on or move to a drug that does what you're looking for--serotonin, plus dopamine, maybe some neurepinephrine. Adding Effexor or Cymbalta could work (or a tricyclic), as could adding Wellbutrin or a stimulant (dexedrine, ritalin, adderall) or Provigil/Straterra. Why didn't the bezos work? Of course, they're not for everybody, but it seems like most people can get relief from them if the dosage is worked with enough. Good luck
Posted by TomG on March 15, 2005, at 14:27:28
In reply to Prozac and Amisulpride/Mirapex, posted by BradD on March 15, 2005, at 5:06:28
If you're in the U.S. please tell me where you plan to get Amisulpride. I wanted to try my own trial, and I called the main offices of Sanofi-Aventis in New York and the UK. The UK office told me that a special arrangement might be able to be made with my doctor, and the U.S. office told me that Amisulpride was not going to be released any time soon. My doctor doesn't seem to be too gung-ho about me trying foreign medicines, so I doubt he will go for this. But, hey I guess I could do my own trial if I was able to obtain Amisulpride through other channels.
Posted by ed_uk on March 16, 2005, at 9:38:05
In reply to Re: Prozac and Amisulpride/Mirapex » BradD, posted by TomG on March 15, 2005, at 14:27:28
Hi Tom!
How long have you been on Seroquel now? How are you feeling?
Ed.
Posted by TomG on March 16, 2005, at 16:24:11
In reply to Re: Prozac and Amisulpride/Mirapex » TomG, posted by ed_uk on March 16, 2005, at 9:38:05
Posted by Bill LL on March 17, 2005, at 9:16:07
In reply to Prozac and Amisulpride/Mirapex, posted by BradD on March 15, 2005, at 5:06:28
I just read med_empowered's response and he said some things that I was going to say.
Ususally the first thing to try is a dose increase. Your current 20 mg dose is just a starting dose. You could go up to 40, and then if that doesn't work well enough, to 60 or more.
Another option is Cymbalta. That effects both serotonin and norepinephrine and it very well migh help with your social anxiety.
Do you have ADD symptoms? If so, Ritalin could help with social anxiety.
Do you have high blood pressure? If so, a beta blocker could help with social anxiety.
> Prozac (20mg) helps moderately with my anhedonia and anergy, but does very little for social anxiety. Do you think that by adding Amisulpride or Mirapex would make things even better?
> I've tried Klonopin and Xanax for social anxiety-they dont do much for me.
Posted by JKL on March 19, 2005, at 8:27:22
In reply to Prozac and Amisulpride/Mirapex, posted by BradD on March 15, 2005, at 5:06:28
Don't know much about mirapex, but have tried amisulpride. It is great for social comfort and composedness. It takes a few weeks for that to really come on. Initially it will provide increased energy and enthusiasm and possible anxiety. Any initial anxiety should fade within days. Energy and enthusiasm for life come on quick, then fade, but then return slowly over a period of 3 or 4 weeks, along with social comfort. I took amisulpride with prozac and zyprexa for a while, and with prozac and remeron for a while. Sexual side effects are not usually a problem with amisulpride, but for me they were.
Posted by neo on March 19, 2005, at 12:47:55
In reply to Re: Prozac and Amisulpride/Mirapex, posted by JKL on March 19, 2005, at 8:27:22
Hi JKL,
could you please tell me someting more about your amisulpride trial (f.e. dosage)?
I experienced lot of times a great energy and good feelings the first day i took amisulpride. Then the right effect faded and i was somnolenced and tired. Never went over a week of amisulpride trial, cause didn't report any good effect (only tiredness).
Parhaps i should try to go on for at least 3 or 4 week, if right effects could reappear?
What you think about?
thanx for your share and apologize for my awful English!
Neo
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