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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by mickapoo on August 2, 2008, at 17:23:40
Hello,
I have recently started taking Nardil for social phobia, but since I started reading this board, I wanted to ask fellow users about Klonopin.I was prescribed Klonopin a while ago, and I do use it occasionally when I'm "stressed out"- but this really only helps me at home. I take 1 mg, and if I take 2mg, I'm out like a light. When I go out of the home though, the Klonopin doesn't help me at all.
I am wondering if this is because I am not taking it on a regular basis OR because it simply is only effective for anxiety, not severe phobia.
I have suffered from social phobia since a small child. It's gotten worse over the years. I have failed classes, gotten fired from jobs, missed out on careers, and lost relationships over it. I am phobic not just in social settings, parties, etc..., but while driving, going to a store, etc... I do not go out to get my mail during the day. I wait until it gets dark to venture out. And this is embarrassing but...I have actually wet my pants in school because I was too afraid to walk to the front and get the bathroom pass. I've actually faked fainting and getting admitted to the hospital to get out of social events. I have gotten drunk in the mall parking lot just to get the courage to go Christmas shopping. I wanted to be a physician but couldn't get past the first chemistry class that had a lab. I also couldn't take any courses that had oral presentations. It has affected my life in every way!
I just wanted anyone to reads this to know how severe it is. If anyone also suffers from social phobia in the way that I do, please respond and let me know what your treatment is. Like I said, I'm currently on Nardil (after exhausting every other option), but would be curious to hear from those who are on Klonopin as it never really helped me but maybe I'm just not taking it in the right manner.
Thank you!
Posted by ricker on August 2, 2008, at 17:54:20
In reply to Taking Klonopin for severe social phobia, posted by mickapoo on August 2, 2008, at 17:23:40
Hello,
I found the ssri's to be most effective for social phobia treatment, mainly paxil and zoloft.
I've been taking klonopin (rivitrol) for approx. 21 years.
I was taking 2mg - 4x/day years ago, but I'm now at 0.5mg - 3x/day.
I've been on that dose for probably 10 years. When I first started taking it, I thought less is more so only took it when required.
I soon learned that maintaing a theraputic residual was much more effective. Your required dose may differ, and decrease with time? So, for me, taking klonopin 3 x day has worked much better than taking only when needed. It is a mood stabilizer as well, so it's possible to help with your overall mood in general.
Like I mentioned, it's my daily vitamin... 20 years and no side effects.
Good luck with your treatment.Regards, Rick
Posted by mickapoo on August 2, 2008, at 19:09:17
In reply to Re: Taking Klonopin for severe social phobia, posted by ricker on August 2, 2008, at 17:54:20
> Hello,
>
> I found the ssri's to be most effective for social phobia treatment, mainly paxil and zoloft.
> I've been taking klonopin (rivitrol) for approx. 21 years.
> I was taking 2mg - 4x/day years ago, but I'm now at 0.5mg - 3x/day.
> I've been on that dose for probably 10 years. When I first started taking it, I thought less is more so only took it when required.
> I soon learned that maintaing a theraputic residual was much more effective. Your required dose may differ, and decrease with time? So, for me, taking klonopin 3 x day has worked much better than taking only when needed. It is a mood stabilizer as well, so it's possible to help with your overall mood in general.
> Like I mentioned, it's my daily vitamin... 20 years and no side effects.
> Good luck with your treatment.
>
> Regards, Rick
>
>
Thanks for the response, Rick. Unfortunately I've tried almost every SSRI on the planet, and none of them helped my social phobia. I think I'm going to try to take the Klonopin on a regular basis and see if that helps over time. Did you also suffer from depression?
Posted by bulldog2 on August 2, 2008, at 19:59:25
In reply to Taking Klonopin for severe social phobia, posted by mickapoo on August 2, 2008, at 17:23:40
> Hello,
> I have recently started taking Nardil for social phobia, but since I started reading this board, I wanted to ask fellow users about Klonopin.
>
> I was prescribed Klonopin a while ago, and I do use it occasionally when I'm "stressed out"- but this really only helps me at home. I take 1 mg, and if I take 2mg, I'm out like a light. When I go out of the home though, the Klonopin doesn't help me at all.
>
> I am wondering if this is because I am not taking it on a regular basis OR because it simply is only effective for anxiety, not severe phobia.
>
> I have suffered from social phobia since a small child. It's gotten worse over the years. I have failed classes, gotten fired from jobs, missed out on careers, and lost relationships over it. I am phobic not just in social settings, parties, etc..., but while driving, going to a store, etc... I do not go out to get my mail during the day. I wait until it gets dark to venture out. And this is embarrassing but...I have actually wet my pants in school because I was too afraid to walk to the front and get the bathroom pass. I've actually faked fainting and getting admitted to the hospital to get out of social events. I have gotten drunk in the mall parking lot just to get the courage to go Christmas shopping. I wanted to be a physician but couldn't get past the first chemistry class that had a lab. I also couldn't take any courses that had oral presentations. It has affected my life in every way!
>
> I just wanted anyone to reads this to know how severe it is. If anyone also suffers from social phobia in the way that I do, please respond and let me know what your treatment is. Like I said, I'm currently on Nardil (after exhausting every other option), but would be curious to hear from those who are on Klonopin as it never really helped me but maybe I'm just not taking it in the right manner.
>
> Thank you!
>>
I thought that nardil was good for social phobia. As far as klonopin goes it will work better if taken on a regular basis so it will than work as a mood stabilizer. When certain events would occur like speaking in front of a crowd I simply upped the dose so i could cope with the event. I remember once needing 3 milligrams to speak before a large audiance.
I don't know your dose of nardil but you may have to be on it longer and at a higher dose to be effective for social phobia.
Posted by ricker on August 2, 2008, at 20:03:12
In reply to Re: Taking Klonopin for severe social phobia, posted by mickapoo on August 2, 2008, at 19:09:17
Yes, depression as well. I experienced my first panic attack when I was 15 years old. That was 34 years ago. And back then, valium was the first meal from most docs I saw?
I did not experience any type of depression at the time, only panic attacks, although I was somewhat anxious with social situations.
I believe I was about 28 when I became depressed.
I was on a 2 month course of Acutane --- and now that's one of the cautions they list as a side effect! If I'd only known then?
While on the accutane, I became sick with mononucleosos - sp? and my life has never been the same.
6 months after recovering from mono, if you can say recover, I was put on antidepressants and the marry-go-round has never stopped.
So, ya, 13 years dealing with an anxiety disorder followed by 21 years of anxiety plus depression.
I was hospitalized twice in the late 80's.
That's when I tried ECT, did not do much for me.I do however swear by klonopin. I will probably be on it for life, unless some new fangled drug hits the market and actually performs like the manufacturer claims! lol.
I would not say klonopin on it's own would be a sure bet to rid one of social phobia. However, it does work well with many drugs and has few side effects, for me anyway. :)
It's too bad you did not find an a/d that helped. Sometimes people give up too early, exspecially if they have chronic anxiety, as their ability to cope with the intial side effect may be limited somewhat.
Hang in there, I'm sure you will find the right combination. It can seem hopeless at times, but you will get better.
Regards, Rick
Posted by Phillipa on August 2, 2008, at 20:28:16
In reply to Re: Taking Klonopin for severe social phobia, posted by ricker on August 2, 2008, at 20:03:12
Rick been on benzos for over 35 years and they still work for you? First panic attack at age 24 in 60's now and back on valium. Pdoc just gave a script for xanax. I once became suicidal although I wasn't on klonopin. Can you direct me as I've googled so much to see if I could find something on klonopin as a mood stabalizer. My depression started with lymes disease and thyroid disfunction . Thanks Phillipa
Posted by Chris O on August 2, 2008, at 21:02:42
In reply to Taking Klonopin for severe social phobia, posted by mickapoo on August 2, 2008, at 17:23:40
I suffer from pretty bad GAD. For me, it's a desire to avoid people and social situations if at all possible. I can manage, but my brain chemistry makes it painful. It's like I'm fighting a critical super-ego
(which I am, in the form of my mom! blah!), but I know it's just brain chemistry now.I've been taking 1-2mg of generic Klonopin a day for the past month or so. It provides some relief for my social anxiety, but it's not very strong, in my opinion. It's also...all the benzos for me...sort of gloss over the surface of my anxiety. The SSRIs attack it at a deeper level, and I am also on Prozac, but just starting again after years of not taking anything. So far, I've had a little, but not huge improvement. Sorry to hear of your suffering, and lack of luck with SSRIs. I've always heard good things about Paxil for anxiety disorders, but have avoided it because of the weight gain. I guess the SNRIs (Effexor, Cymbalta) are good for some people too, but for me they are (especially Effexor) a bit stimulating. I hope you find the right drug or drug combo to nip your social anxiety in the bud. It sounds like a real pain. I empathize.
Chris
Posted by Justherself54 on August 2, 2008, at 22:05:27
In reply to Re: Taking Klonopin for severe social phobia » mickapoo, posted by Chris O on August 2, 2008, at 21:02:42
I had to discontinue Nardil due to a strange side effect, however, I am a self-isolator and with Nardil I became very social. I was a little uncomfortable the first couple of times I went where there were a lot of people I didn't know, but that passed. I hope it works well for you...
Posted by ricker on August 2, 2008, at 23:13:28
In reply to Re: Taking Klonopin for severe social phobia » ricker, posted by Phillipa on August 2, 2008, at 20:28:16
> Rick been on benzos for over 35 years and they still work for you? First panic attack at age 24 in 60's now and back on valium. Pdoc just gave a script for xanax. I once became suicidal although I wasn't on klonopin. Can you direct me as I've googled so much to see if I could find something on klonopin as a mood stabalizer. My depression started with lymes disease and thyroid disfunction . Thanks Phillipa
Hi Phillipa,
Can you imagine if we had todays support system back then? Internet chat rooms, an educated public .... I often thought I was the only person in the world with this strange "freaking out" disorder!
I was certain I would not fly over the the cuckoo's nest, I was heading straight for the funny-farm!Anyway, I really believe rivitrol is as much a mood stabilzer as it is a sedative. Granted when I first started on it, there was no doubt I felt a calming effect to that of valium, but to a lesser degree.
I found that with continued use over many years, it's primary function was that of a stabilizer.
That's not to say I don't experience the up's and down's of typycal chronic depression, rather I am able to rationalize my thoughts in a healthier manner.
I am cautious whith the term "benzo" for to me it represents a certain class of drug that will deliver a sedating effect for a given period of time.
Valium and zanax fit that bill, for me. I was on valium in the 70's for my panic attacks. I used zanax in the late 80's, but keep in mind I did not suffer from depression at the time.
As I previously mentioned, the onset of my depression began shortly after my 3 month illness...mono.
Since then, I noticed a direct link with my "intensive" depressive episodes and benzo's.
It seemed all the positive A/D results were somewhat hindered by the benzocycle?Rivitrol does not act in that manner for "ME". Yes, at first there was a slight benzo effect then as time passed, I had noticed that I'd probably get more of a buzz from coffee than the rivitrol. I'm serious when I refer to it as my "brain vitamin". It is not a benzo. for me. :)
So, my biggest challenge is finding the right A/D's to supplement my brain vitamin? I'm certainly no different than other suffer's.... poop-out, bad reactions etc.
I usually get a couple of years out of a cocktail before the dreaded poop-out but it seem there's more choices comming down the pipeline, thank God!
It has been my experience that up to 90% of my anxiety is managed by the right A/D's. The rivitrol aides in the process simply by "stabilizing" my mood. At least that's my theory, and I'm sticking with it. :)
Over the years I've tried eliminating the rivitrol while on different A/D's. I probably could of pulled it of while on Paxil but that didn't last due to the chronic nausea I encountered with Paxil. I certainly needed it while on Effexor, anafranil and zoloft.
The only time I was able to discontine rivitrol was during Luvox.
I must say though, while on Luvox, it was all I could do to stay awake during the day...extreme chronic fatigue.I guess we have something in common in that we suffered with an anxiety disorder for years prior to the onset of depression, that reared it's head after a lenghty illness.
I apologize if I "babbled" to much. I hope I didn't make matters worse for you. If I can be of more help, please don't hesitate to ask. Here's a link to rivitrol as a mood stabilizer.
http://sciencelinks.jp/j-east/article/200320/000020032003A0617820.php
Regards, Rick
Posted by mickapoo on August 3, 2008, at 7:20:08
In reply to Re: Taking Klonopin for severe social phobia » mickapoo, posted by Chris O on August 2, 2008, at 21:02:42
Thank you everyone for your input. I was initially asking about Klonopin not because Nardil wasn't working, but just because it's a safer drug to take than an MAOI and if I could go that route, I rather would. And obviously, less side effects. I guess maybe I can try to take a small dosage (and increase as tolerated) 3xday as some suggested (along with the Nardil) and see if that would help.
On a different note, some of you mentioned mood stabilizers. I'm on Lamictal for that, in addition to the Nardil, but it doesn't seem to be helping. I'm up, I'm down... I'm happy, I'm sad... and I think another earlier poster brought up that Klonopin might work well for that too.
Posted by Down on the Upside on August 3, 2008, at 9:13:35
In reply to Taking Klonopin for severe social phobia, posted by mickapoo on August 2, 2008, at 17:23:40
I hear you mate, I've had severe Social Phobia since I was thirteen. I underperfomed at school, dropped out of uni, never had a meaningful relationship, couldn't hold onto a job...all because of SP.
Clonazepam is the anti-anxiety of choice for SP. I used to take clonazepam for a number of years and it helped a lot with the anixety, but it was very dulling. Clonazepam sort of anesthetized my mind - it reduced anxiety but also my motivation and capacity to feel anything. I came off it before starting my current combo and I feel a lot better emotion-wise.
Nardil is also the AD of choice for severe SP so if you're starting it then it's time to feel hopeful (which is really hard for us SPs) The only thing I would suggest is to go up to highest dose and if you're still not responding to Nardil, take a break from the Klonopin, wait till it washes out of your system, and then reevaluate it.Keep us posted.
Posted by mickapoo on August 3, 2008, at 16:38:29
In reply to Re: Taking Klonopin for severe social phobia » mickapoo, posted by Down on the Upside on August 3, 2008, at 9:13:35
> I hear you mate, I've had severe Social Phobia since I was thirteen. I underperfomed at school, dropped out of uni, never had a meaningful relationship, couldn't hold onto a job...all because of SP.
>
> Clonazepam is the anti-anxiety of choice for SP. I used to take clonazepam for a number of years and it helped a lot with the anixety, but it was very dulling. Clonazepam sort of anesthetized my mind - it reduced anxiety but also my motivation and capacity to feel anything. I came off it before starting my current combo and I feel a lot better emotion-wise.
>
> Nardil is also the AD of choice for severe SP so if you're starting it then it's time to feel hopeful (which is really hard for us SPs) The only thing I would suggest is to go up to highest dose and if you're still not responding to Nardil, take a break from the Klonopin, wait till it washes out of your system, and then reevaluate it.
>
> Keep us posted.You have really given me hope! Thank you! So are you on Nardil and has it significantly improved your SP? How long have you been on it? Are you on Klonopin as well? I agree with the motivation problem. I mentioned this to my dr in the past and she said yes, that's pretty much what it does- make you want to lay around on the couch all day! At least that's what it did to me anyway!
Posted by Phillipa on August 3, 2008, at 19:38:18
In reply to Re: Taking Klonopin for severe social phobia, posted by ricker on August 2, 2008, at 23:13:28
Rick thank's we are very similar xanax in 80's for me too and ativan at one time and no ad's. But have not been able to give up benzos. And thanks for the link. I definitely will read and babblemail it always open. Love Phillipa
Posted by Down on the Upside on August 3, 2008, at 20:16:13
In reply to Re: Taking Klonopin for severe social phobia » Down on the Upside, posted by mickapoo on August 3, 2008, at 16:38:29
You're very welcome. Probably the first important step in battling SP is discovering that you are not screwed up in some ultraspecial way, that there are people out there who have the same devastating fear and avoidance that we have and most importantly, that there is a way back. This community is a great resource for battling SP, there's also http://www.psychforums.com/viewforum.php?f=137 which describes Avoidant Personality Disorder (AvPD) that describes my behaviour to a T
I never was able to make a trial of Nardil as apparently it's not available in my country.
My current regimen is:
300mg amitriptyline - single dose at night
50 mg sulpiride - single dose at night
37.5 mg tianeptinee - 3 x 12.5mg doses during the dayI've gotten a great mood lifting and anti-anxiety response from this novel combo after 18 years of debilitating depression and anxiety. I'm thinking of adding fluoexetine to help with the obsessions ruminations I have but I read some scary reports of fluoxetine dangerously potentiating the toxic effects of amitriptyline.
There are lots of people in this community like ace and SLS that have had a tremendous response to Nardil. I think the key to to Nardil's potency in treating SP is that it targets three neurotransmitters simultaneously - serotonin, norepinephrine and dopamine. This might explain why SSRIs do not work very well for severe SP as they only target one or max two of these neurotransmitters.
I used to take Clonezam for a number of years but I came off it before starting this combo because it made me anhedonic and inhibted all the positive mood lifting and anti-anxiety respone of the other meds. The benzos help tremendously with anxiety and are considered first-line treatment for people peresenting SP symptoms but I'm not too happy with them for long term use. In my case the seemed only to treate the 'surface' anxiety symptoms of SP, not the underlying morbid thoughts and memories and emotions. And when I didn't take it the anxiety returned as bad as ever. But some people swear by Nardil + Klonopin for SP. If K makes you anhedonic and you don't need it for day-to-day survival maybe you could come off it during you trial of Nardil? At least you could be sure there is no negative interaction between the two drugs, and you can always augment the Nardil with K later.
So I really hope you have a response to the Nardil. You have at least one person who's with you on this long journey to reclaim our lives. and never give up hope, even in the darkest hours.
I
> > I hear you mate, I've had severe Social Phobia since I was thirteen. I underperfomed at school, dropped out of uni, never had a meaningful relationship, couldn't hold onto a job...all because of SP.
> >
> > Clonazepam is the anti-anxiety of choice for SP. I used to take clonazepam for a number of years and it helped a lot with the anixety, but it was very dulling. Clonazepam sort of anesthetized my mind - it reduced anxiety but also my motivation and capacity to feel anything. I came off it before starting my current combo and I feel a lot better emotion-wise.
> >
> > Nardil is also the AD of choice for severe SP so if you're starting it then it's time to feel hopeful (which is really hard for us SPs) The only thing I would suggest is to go up to highest dose and if you're still not responding to Nardil, take a break from the Klonopin, wait till it washes out of your system, and then reevaluate it.
> >
> > Keep us posted.
>
> You have really given me hope! Thank you! So are you on Nardil and has it significantly improved your SP? How long have you been on it? Are you on Klonopin as well? I agree with the motivation problem. I mentioned this to my dr in the past and she said yes, that's pretty much what it does- make you want to lay around on the couch all day! At least that's what it did to me anyway!
Posted by dcruik518 on August 4, 2008, at 8:35:46
In reply to Re: Taking Klonopin for severe social phobia » mickapoo, posted by Down on the Upside on August 3, 2008, at 20:16:13
You can't do much better than Nardil and Clonazepam for Social Phobia. You do need to take the Clonazepam regularly, though, in order for it to really calm our anxiety and all decrease all those anticipatory anxiety thoughts, which occur BEFORE you "go outside." Be aware, however, that Clonazepam, will reach a steady blood level state fairly quickly. Once that happens you won't necessarily "feel" any different each time you take the pill. It's still working; it's just working all the time.
Posted by mickapoo on August 5, 2008, at 11:20:39
In reply to Re: Taking Klonopin for severe social phobia » mickapoo, posted by Down on the Upside on August 3, 2008, at 20:16:13
> I've gotten a great mood lifting and anti-anxiety response from this novel combo after 18 years of debilitating depression and anxiety. I'm thinking of adding fluoexetine to help with the obsessions ruminations I have but I read some scary reports of fluoxetine dangerously potentiating the toxic effects of amitriptyline.
>I was on fluoxetine and amitriptyline for a very long time, but my dosage of amitriptyline was very low- 20 mg. Perhaps that is why it was safe.
Posted by clint878 on August 7, 2008, at 12:44:21
In reply to Re: Taking Klonopin for severe social phobia » mickapoo, posted by Chris O on August 2, 2008, at 21:02:42
I tried Klonopin for social anxiety, but stopped it because it was ineffective. In social situations, my opinion is that you want to present your best face to others, and Klonopin caused poor memory, which made me come off worse than when I wasn't taking the drug. It also didn't resolve the issue I had with a lack of drive to interact with people.
However, Depakote worked great, even though it wasn't prescribed for this purpose. I simply no longer had any anxiety about dealing with people. However, I still had no drive to interact, so Focalin was added to the mix, and with that I can both concentrate on what the other person is saying, and also be interested in actually going out and doing things with people.
Posted by blueboy on August 8, 2008, at 7:40:55
In reply to Taking Klonopin for severe social phobia, posted by mickapoo on August 2, 2008, at 17:23:40
Klonopin in small doses does a great job for me. I wouldn't call my social anxieties "severe" however, but after I'm with a group of people for say half an hour I get withdrawn, paranoid, etc. And afterwards, I can get physically ill.
Anyway, 1mg of Klonopin really does the trick for me, easing my symptoms without making me dumb or drowsy. I'm big and rather resistant, though.
Nardil did nothing whatsoever for my social anxiety problems. I'd still have to take the exact same dose of Klonopin.
This is the end of the thread.
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