Posted by Ame Sans Vie on August 26, 2003, at 2:07:53
In reply to Re: SP: info concerning Klonopin and MAOI's???, posted by Psycho D on August 25, 2003, at 23:44:53
> Thanks for the suggestions. I researched some of the benzodiazpines including klonopin and it seems to have a high efficacy raiting. But i've read that you can develope a tolerance to it.
Tolerance is rare when taken as directed by your physician, and when it does occur, it occurs *very* slowly. I've been taking benzodiazepines for years with no development of tolerance. Consider it a non-issue.
>I also read that it is sedating and can dull mental sharpness, which wouldn't be good seeing as i already have ADD-like symptoms and some fatigue. However, I've also heard that ADD is linked to anxiety, and in that case sedatation might be beneficial.
Those side effects dissipate after several weeks of continuous use, though yes, cognitive dulling can be a longterm effect while taking benzos. I'd suggest supplementing with gingko biloba, though I personally find my mental sharpness *increased* on Klonopin, as I can concentrate more on the tasks at hand, rather than the anxiety. Oh, and I might add that I also have ADD, currently treated with Dexedrine Spansules.
>My Practioner said it was potentially addictive.
It's only addictive if you abuse it. It does, however, cause physical and psychological dependence after being taken regularly for a period of time (usually a few months), though that is certainly nothing to worry about. First of all, you'll likely take the Klonopin (or whichever benzo ends up working best for you) the rest of your life anyway (and don't be concerned at all about lifetime use of benzodiazepines -- they're astoundingly benign drugs). Also, should you ever decide to discontinue, there *are* painless methods of doing this (i.e. methods that completely bypass most, if not all, withdrawal symptoms).
>How effective is Klonopin for long term treatment of Social anxiety.. like after it is discontinued?
Typically Klonopin is most effective when taken indefinitely, though there is this study that suggests it may be helpful even if only used short-term:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8994456&dopt=Abstract
A 2-year follow-up of social phobia. Status after a brief medication trial.
Sutherland SM, Tupler LA, Colket JT, Davidson JR.
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 27710, USA.
Although social phobia is thought to be a chronic disorder, little is known about its long-term course in patients who engage in brief treatment studies. We, therefore, conducted a follow-up study of social phobics who had participated in a brief, placebo-controlled treatment trial of clonazepam. Of the original 75 subjects, 56 were assessed through telephone interview and self-report questionnaires that evaluated current social phobia symptoms. Information was also gathered about treatment received in the 2-year interval since the initial pharmacotherapy trial. The group as a whole showed maintenance of the gains acquired during initial treatment. On a number of symptom scales, subjects initially treated with clonazepam exhibited significantly less severe scores compared with placebo subjects. This study provides evidence of long-term benefit for social phobics when treated with a brief medication trial.
> Anyone had any good experiences with MAOI's such as Nardil or Parnate w/ social anxiety? I have grown rather partial to these types of drugs from what i have read. A friend of mine tried Nardil and said he loved it. What is the likely hood that someone could develop a tolerance to these?I didn't respond to Nardil *one bit*, even at the quite high dose of 120mg/day. Hey, if they work for you, great. But if benzodiazepines work just as well, why not stick to them and avoid the dietary/drug restrictions? Tolerance does occasionally occur with MAOIs (especially Parnate), and the poop-out effect is rather common after several years (or less) on the drugs. I probably come off as sounding anti-MAOI, but I am absolutely not... just giving you the facts.
poster:Ame Sans Vie
thread:253710
URL: http://www.dr-bob.org/babble/20030823/msgs/254216.html