Posted by Rick on June 10, 2000, at 2:41:01
In reply to Celexa, Serzone? (Re: Social Phobia Cocktail...) » Rick, posted by S.D. on June 9, 2000, at 14:40:46
SD -SSRI's are typically the first-line meds tried for Social Phobia today, whether the patient has depression or not (although my pdoc prescribed Nardil first, with Xanax as-needed). The first-line use of SSRI's could be for a variety of reasons, including:
-- They are popular, have big marketing budgets, and are viewed as safe and tolerable (hmmm....)
-- Many (most?) Social Phobics ARE depressive and/or have other comorbid condtions such as Panic Disorder, which SSRI's can frequently treat efectively.
-- Many docs and patients are (usually unreasonably) benzo-phobic and don't want to have the patient take something like Klonopin on an ongoing basis.
-- Similarly, many doctors and patients shy away from MAOI's like Nardil because of the (somewhat overstated) safety/liability issues. Also, the side effects can be pretty severe for some people, like me.
I tried Celexa for a couple of reasons. One is that it showed great success in a Social Phobia study. However, that was a small open (non-placebo-controlled) study in South Africa. Another reason is that I knew two people who had great success with it, although that was for depression (with generalized -- not social -- anxiety in one case). Also, the manufacturer and researchers have claimed that Celexa has a more benign side-effect profile than other SSRI's, e.g., with less sexual dysfunction. Also, I had heard lots of horror stories about Paxil side effects (although some people seem to tolerate it very well, especially after the first 2-4 weeks).
At 20mg/day, the Celexa definitely seemed to add some benefit, but not a great amount. Raising the dose only seemed to cause side effects (especially fatigue and moderate sexual dysfunction) without increasing efficacy.
While technically an antidepressant, Serzone is known as having strong anti-anxiety qualities, and a few open studies have shown promising results for Social Phobia. As you may know, while Serzone increases serotonin (and to a lesser extent nor
poster:Rick
thread:36517
URL: http://www.dr-bob.org/babble/20000603/msgs/36797.html