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Re: Terrible fear has return even with xanax! » tepiaca

Posted by jedi on June 11, 2006, at 17:44:21

In reply to Re: Terrible fear has return even with xanax! » jedi, posted by tepiaca on June 11, 2006, at 16:00:35

> Until Nardil start to work jedi?
Hi Tepi,
If your worst problem is the severe social anxiety, then I have found nothing better than Nardil combined with Klonopin. Maybe some of the other MAOIs and benzos will work also but I believe that Nardil and Klonopin are the most researched.

> But do you have social fear????
Yes, I have had severe social anxiety since my teenage years. I didn't even date in high school because of the social anxiety and the fear of rejection. Until I started using Nardil with Klonopin my palms used to sweat terribly. I would have to wipe my palms before I could even shake hands with someone.

> > Is your depression diagnosed as atypical? Do you oversleep and overeat when depressed?
> Nothing of that
I asked that because the MAOIs are so much more effective than the tricyclics for atypical depression. I'm not saying that Nardil won't work for other kinds of depression, but it is proven more effective for the atypical variety. Again, for social anxiety, nothing beats Nardil with Klonopin; IMHO.
>
> With or without Nardil? . I wont leave nardil again , I almost killed myself last time I did . I just need this Fear togo away, I dotn care if i have to take marijuana or cocaine
>
I sure would not recommend the use of cocaine. It may help you feel better in the short term, but long term it will probably prevent you from feeling any pleasure in life. Some people swear that pot makes them feel less anxious. But with the high THC content of marijuana today, it can worsen anxiety and even lead to paranoia.

I have combined nortiptyline(a tricyclic) with Nardil in the past. For me, it didn't work any better than Nardil by itself, but again my depression is atypical. I am not sure what combination of medications would work best for somone with severe anxious depression. The use of MAOIs and tricyclics together is officially contraindicated. Combining the two without the services of a qualified MD could be dangerous.
Wishing you better days ahead,
Jedi

Anxious depression, from Psychology Today:
Anxious depression covers the large gray area where symptoms of depression and anxiety co-exist or overlap. Patients typically have feelings of worthlessness and pessimism, excessive worrying and guilt, and are unable to enjoy things. The disorder is expressed physically in diminished appetite, poor sleep with frequent awakenings, and restlessness and psychomotor agitation.

In one study of 255 depressed outpatients that he conducted, psychiatrist Maurizio Fava, M.D., of Harvard reported at the symposium, 51% were found to have anxiety along with their depression. It's not clear whether the anxiety follows on the heels of feelings of worthlessness. But in 40% of the anxiously depressed, the anxiety disorder started first.

Among those whose anxiety takes the form of social phobia and generalized anxiety disorder, the anxiety tends to precede major depressive disorder. But in the case of panic disorder it usually follows the onset of the depressive disorder.

Patients are young -- average age 20.6 versus 28.4 among those with major depression alone -- significantly functionally impaired, and take more time to recover. They are less likely to respond to treatment and more likely to relapse, and experience less change in their depressive symptoms with treatment.

The disorder may have its origins early in life among children of a distinct temperament type who are frightened by novelty. Both the anxiety and depression may be the outcome of abnormaly high levels of hormones driving the body's stress response system.

Anxious depression typically poses a treatment dilemma for doctors. Many seek to use antidepressants that have sedating properties, although it's not clear that they need to, said Dr. Fava. Studies show that all of the antidepressants work equally well against this type of depression, although high doses may be needed. Still, in practice physicians tend to prescribe a combination of drugs for such patients, usually a tranquilizer along with an antidepressant.

Given their anxiety quotient, depressives of this type are unusually sensitive to bodily sensations. As a result, common drug side effects -- such as gastrointestinal distress -- are often cause for discontinuing treatment. Even when treatment continues, remission can be a long time coming. Cognitive therapy can be very helpful.


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