Posted by Cam W. on March 20, 2000, at 7:30:06
In reply to Panic and social phobia, posted by Anderson on March 19, 2000, at 17:35:00
Anderson - I have to agree with Carolyn. Sometimes medications need to be taken. The one to take is the one that works for you. I know this is extremely vague, but our medicine isn't good enough yet to make exact choices. As to classes of antidepressant drugs; as a whole, the SSRIs are safer (ie safer in overdose, far less potential cardiac problems), but they are not as effective as the TCAs or MAOIs in some instances. The rule of thumb is: if it has worked before, it will probably work again. TCAs work on a spectrum of inhibiting serotonin reuptake more than norepinephrine reuptake (eg Anafranil) or vice versa (eg Desipramine). Social phobia and panic disorder are thought to be problems with serotonin regulation, so that is probably why Anafranil worked for you. Anafranil is similar in action to the SSRIs, but has a few more actions than the newer class. Anafranil may work better for you than the SSRI class, but in my opinion they are similar in efficacy for social phobia and panic disorder to Anafranil. Do not be surprized if the doc puts you on an SSRI rather than Anafranil, but do tell him/her that Anafranil has worked in the past. Also, your concerns about long term effects is appropriate. Recent studies suggest that it is better to be treated with these drugs and live a relatively 'normal' life than have another year like you have just had. Last year was probably worse for your body than the drugs would be. Hope this helps - Cam W.
poster:Cam W.
thread:27591
URL: http://www.dr-bob.org/babble/20000312/msgs/27626.html