Posted by SLS on August 5, 2000, at 9:47:16
In reply to FWIW: summary of my Social Anxiety treatments, posted by S.D. on August 1, 2000, at 21:40:30
I'm sure you've explored Nardil, the MAOI most studied and considered particularly effective for social phobia and GAD - especially since Parnate was partially effective.
Peace and Health to You. Thank you very much for such a valuable post.
- Scott
> I probably will not post as often in the future as I have in the past three months or so. So here's a summary, for what it's worth, of my attempts at treating my social anxiety disorder, otherwise known as Social Phobia, generalized type.
>
> Zoloft late 1998 - Spring 1999
> probably no significant impact on social anxiety, except perhaps secondary to remission of depression.
>
> Parnate Summer 1999 - Spring 2000
> probably small decrease in social anxiety, specifically some decrease in inhibition of speaking when desiring to speak but anxious about it due to the context.
>
> Individual Cognitive-Behavioral Therapy Fall 1999 - Winter 2000
> No real help. Mostly I already knew what I needed to do and although going to these sessions motivated me to try some feared things between sessions, I wasn't able to make any progress. Specifically-for-social-anxiety group sessions including therapist-guided exposure might help. Nothing like that exists here. If any therapist can make this work it might be Dr. Thomas Richards and his anxiety clinic in Phoenix AZ. Otherwise it seems like nothing more than you can read in CBT-based self-help books (counter your negative, irrational thoughts with positive ones; expose yourself gradually to the feared situations (doesn't sound much better than 'just do it', does it?))
>
> Kava Kava May 2000
> Natrol brand Kavatrol, though that's not a recommendation. Search for my previous posts about kava.
> Effective in reducing anxiety before and during speaking, which is the usual context of my social anxiety. dosage 800mg - 1000mg per day of kava extract which contained 30% kavalactones (i.e. 240 - 300mg kavalactones per day)
> side effects: initial sleepiness and heartburn, resolves after a few days (work up to max dose over a few days).
>
> Neurontin (generic name gabapentin) June 2000
> Effective similarly to kava at dosage in range of 900mg - 1200mg per day. Perhaps more effective than kava at the high end of the range.
> side effects: unfortunately, had amnesia (forgetfulness/absentmindedness) in this dosage range. This effect might have resolved or I might have been able to find a satisfactory balance in the 900 - 1200mg per day range but instead I tried...
>
> Klonopin - the brand name stuff, not a generic version ( clonazepam ) July 2000
> 1mg - 1.25mg/day.
> Effective!! More than Kava or Neurontin, although for much of this time I've also continued Kava at a lower dose of 180mg kavalactones/day.
> As with the previous effective meds, the effect is to reduce anxiety while speaking and the anticipitory anxiety immediately preceding speaking which otherwise tends to make me hesitate or inhibits me from speaking.
> So now I can "speak up" when I need to. Woohoo! I still don't have any friends; I don't know if this will change my life much. But I can hope to have far fewer new regrets about lost chances to speak or act.
> The anxiety reduction is not by any means total. Difficult things like spontaneously chatting up an attractive female stranger are not within my grasp.
> Side effects: possible forgetfulness, possible other negative cognitive effects (fogginess, dullness or slowness). Difficult to say, owing to (in the first case) my typical forgetfulness and (in the second) mental tiredness that may be due to lack of sleep or amisulpride (see below).
>
> Amisulpride 2nd half of july, 2000
> no noticeable positive effect.
> possible side effects: insomnia (night/early-morning) waking, daytime tiredness (aside from that resulting from lack of sleep)
> Haven't yet sorted out what is or isn't due to the amisulpride but will be discontinuing it and hoping for end of insomnia and tiredness.
> ----------
> Near future:
>
> Adrafinil. Though this is for my anergia, it reportedly can be a benefit for those with social anxiety.
>
> Possibly Sulpiride in spite of the apparent failure of the similar amisulpride. There is a very old article on successfully treating "school phobia" with sulpiride.
>
> CBT - klonopin's effect may allow me to make the progress with cognitive behavioural therapy that I was unable to make without it. This is in line with the recommendations of the aforementioned Dr. Richards of Phoenix AZ.
>
> peace and health,
>
> S.D.
poster:SLS
thread:41964
URL: http://www.dr-bob.org/babble/20000729/msgs/42219.html