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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Janelle on September 3, 2001, at 15:25:56
I've always been on the "timid" side (though I do have my assertive moments), but something has happened and now I experience times of what I'd call "social anxiety" - I start to feel very anxious and nervous if I'm out and about and I'm someplace where there's the possibility of running into people I have not seen in a while (and having to "explain" my absence; I cocooned myself while in the depths of depression and anxiety). I even try to avoid such situations.
No need to recommend Paxil (which has been approved for social anxiety; I've seen the ads), because I've "been there, taken that" (for like 6+ years) it worked great, then pooped out, I went through HORRIBLE withdrawal and do NOT want to go back on it (it may not even work again and then I'd be faced with tapering all over again)
Is there some other med, be it an a-d or something else, that helps with this?
Thanks,
Janelle
Posted by SalArmy4me on September 3, 2001, at 15:46:58
In reply to HELP! I've developed social anxiety!, posted by Janelle on September 3, 2001, at 15:25:56
The British Journal of Psychiatry
Volume 172(5) May 1998 pp 451-452
Moclobemide in social phobia:"Sir: The claim made by Schneier et al (1998) [2] that moclobemide is not indicated as a first-line therapy in social phobia should be challenged. Social phobia is a relatively common anxiety disorder, which rarely presents to psychiatrists even when there is marked impairment in occupational and social functioning (Weiller et al, 1996) [3]. Thus, a first-line therapy for social phobia should be effective, well tolerated and suitable for prescription within primary care.
Addressing the latter two issues, moclobemide has a simple dosing regime and is well tolerated; Schneier et al found eight-week drop-out rates were 24% on moclobemide v. 25% on placebo. Their most serious objection to the use of moclobemide as a first-line treatment is one of efficacy. They found 23% of patients with severe or very severe social phobia treated with moclobemide for eight weeks were rated as much or very much improved (v. 0% in the placebo group), although numbers were too small to reach statistical significance. This finding of greater efficacy in more severe social phobia is also supported by the International Multicenter Clinical Trial Group on Moclobemide in Social Phobia (1997) [1] who found patients with severe social phobia treated with 600 mg moclobemide had a 52% response rate (v. 32% on placebo)."
R. Duffett The Royal London Hospital (St Clement's) 2A Bow Road, London E3 4LL
Posted by Janelle on September 3, 2001, at 16:07:26
In reply to Re: HELP! I've developed SAD - Moclobemide? » Janelle, posted by SalArmy4me on September 3, 2001, at 15:46:58
Posted by SalArmy4me on September 3, 2001, at 16:23:32
In reply to SAL - thanks, what is Moclobemide? (nm), posted by Janelle on September 3, 2001, at 16:07:26
Give me your e-mail address and I'll give you all the info.
Posted by Suricata Suricata on September 3, 2001, at 17:29:39
In reply to Re: HELP! I've developed SAD - Moclobemide? » Janelle, posted by SalArmy4me on September 3, 2001, at 15:46:58
My own brief experience with moclobemide -- I tried
it about six months ago for depression -- was an
unqualified disaster. It caused the worst anxiety
I've ever had and sent me scurrying back to the
relatively warm and fuzzy side effect profile of
imipramine. Xerostomia and fuzzyopia are positively
benign compared to the anxiety that stuff caused.As always, your mileage may vary. Double blind
randomized control studies conclusively establish
that blah, blah, blah.
S. Suricata
Posted by Janelle on September 3, 2001, at 17:57:43
In reply to Re: HELP! I've developed SAD - Moclobemide?, posted by Suricata Suricata on September 3, 2001, at 17:29:39
That Moclobemide = Manerix, some kind of RIMA, a *new and improved* generation of MAOI type a-d's. I hear so much negativity about MAOI's that frankly I'd be afraid of trying even an RIMA. Thanks anyway ....
-Janelle
Posted by Tony P on September 4, 2001, at 1:21:13
In reply to HELP! I've developed social anxiety!, posted by Janelle on September 3, 2001, at 15:25:56
For occasional situational social phobia, which I suffer from, I've found Kava-kava very effective - available OTC in the herbal section of most pharmacies these days. I.e., use it just if you know you're going into a high-risk situation or are feeling really phobic. I don't recommend regular or maintenance use at the doses it takes to get signicantly useful effects. But it can be great to get you over a tough spot.
See my rather lengthy post under "ne1 really helped by herb ..." for the range of dose and way I take it.
Tony P
---------- Janelle's original post
I've always been on the "timid" side (though I do have my assertive moments), but something has happened and now I experience times of what I'd call "social anxiety" - I start to feel very anxious and nervous if I'm out and about and I'm someplace where there's the possibility of running into people I have not seen in a while (and having to "explain" my absence; I cocooned myself while in the depths of depression and anxiety). I even try to avoid such situations.
>
> No need to recommend Paxil (which has been approved for social anxiety; I've seen the ads), because I've "been there, taken that" (for like 6+ years) it worked great, then pooped out, I went through HORRIBLE withdrawal and do NOT want to go back on it (it may not even work again and then I'd be faced with tapering all over again)
>
> Is there some other med, be it an a-d or something else, that helps with this?
> Thanks,
> Janelle
Posted by Andre Allard on September 4, 2001, at 4:19:39
In reply to HELP! I've developed social anxiety!, posted by Janelle on September 3, 2001, at 15:25:56
Moclobemide did little for my social anxiety, depression and borderline personality disorder.
For all three disorders, effexor has been the best compared to paxil, zoloft, celexa, wellbutrin, serzone and moclobemide.
Good luck!
Posted by sar on September 4, 2001, at 7:19:53
In reply to Re: HELP! I've developed social anxiety!, posted by Andre Allard on September 4, 2001, at 4:19:39
prozac + klonopin have helped me a lot.
Posted by Rompy on September 6, 2001, at 10:10:23
In reply to Re: HELP! I've developed social anxiety! Janelle, posted by sar on September 4, 2001, at 7:19:53
> prozac + klonopin have helped me a lot.
I'm on disabilty because of social anxiety.Lorazapam has helped.But it's addictive like you can't imagine.
Posted by cb on September 6, 2001, at 16:32:19
In reply to HELP! I've developed social anxiety!, posted by Janelle on September 3, 2001, at 15:25:56
> My son developed social anxiety that sounds much like yours. His dr believes that it may be due to the meds (probably zyprexa) that he is on. (He is also on lithium and wellbutrin). We consulted with a psychopharmacologist who suggested tegretol and getting off the zyprexa. She explained that sometimes the zyprexa "flips a switch" that turns on the anxiety and just reducing the dose doesn't always end it. He has been on the tegretol for a couple of weeks now and it has really helped..at the same time, he has been reducing his zyprexa (now down to 5 mg/night) and will be off of it next week. If the anxiety still persists, the dr will reduce the wellbutrin.
Hope you are doing better - this has been a real drag for him - the anxiety on top of the depression has really been hard.
Posted by kregpark@yahoo.com on September 9, 2001, at 5:02:35
In reply to HELP! I've developed social anxiety!, posted by Janelle on September 3, 2001, at 15:25:56
I'm 34 male severe SP since 19.
Treatment since 27 when discovered SP and my
diagnosis.Yes, options and more options you will certainly
find things that work. Maybe 2 meds combined
will work best or maybe 1 alone.I do not personally like Paxil at all.
I take medium dose Nardil 60mg, + 2.5 KLonopin +
75 Provigil.Jack Gorman "Essential Guide to Psychiatric Drugs"
v3, 1997 version 3 $8, smaller paperback
amazon . com great book!!!!John Marshall "Social PHobia" 1994 (older I know)
but still GREAT BOOK. < $10, amazon . comI have a new website if you want to check
it out, might give some ideas.I highly recommend the 2 paperbacks and
searching MEDLINE (very very good)Search for "social phobia" and look back
as far as you can if it takes hours. good stuff
there.Believe me, there is all kinds of treatments
especially combinations that can help
immensilely.> I've always been on the "timid" side (though I do have my assertive moments), but something has happened and now I experience times of what I'd call "social anxiety" - I start to feel very anxious and nervous if I'm out and about and I'm someplace where there's the possibility of running into people I have not seen in a while (and having to "explain" my absence; I cocooned myself while in the depths of depression and anxiety). I even try to avoid such situations.
>
> No need to recommend Paxil (which has been approved for social anxiety; I've seen the ads), because I've "been there, taken that" (for like 6+ years) it worked great, then pooped out, I went through HORRIBLE withdrawal and do NOT want to go back on it (it may not even work again and then I'd be faced with tapering all over again)
>
> Is there some other med, be it an a-d or something else, that helps with this?
> Thanks,
> Janelle
Posted by jay on September 14, 2001, at 13:45:39
In reply to Re: HELP! I've developed social anxiety! » Janelle, posted by kregpark@yahoo.com on September 9, 2001, at 5:02:35
Thanks for the link to your website! Great info, and the *best* thing is it gives hope...
Jay :-)
> I'm 34 male severe SP since 19.
> Treatment since 27 when discovered SP and my
> diagnosis.
>
> Yes, options and more options you will certainly
> find things that work. Maybe 2 meds combined
> will work best or maybe 1 alone.
>
> I do not personally like Paxil at all.
> I take medium dose Nardil 60mg, + 2.5 KLonopin +
> 75 Provigil.
>
> Jack Gorman "Essential Guide to Psychiatric Drugs"
> v3, 1997 version 3 $8, smaller paperback
> amazon . com great book!!!!
>
> John Marshall "Social PHobia" 1994 (older I know)
> but still GREAT BOOK. < $10, amazon . com
>
> I have a new website if you want to check
> it out, might give some ideas.
>
> http://www.socialfear.com/
>
> I highly recommend the 2 paperbacks and
> searching MEDLINE (very very good)
>
> Search for "social phobia" and look back
> as far as you can if it takes hours. good stuff
> there.
>
> Believe me, there is all kinds of treatments
> especially combinations that can help
> immensilely.
>
> kregpark@yahoo.com
>
> > I've always been on the "timid" side (though I do have my assertive moments), but something has happened and now I experience times of what I'd call "social anxiety" - I start to feel very anxious and nervous if I'm out and about and I'm someplace where there's the possibility of running into people I have not seen in a while (and having to "explain" my absence; I cocooned myself while in the depths of depression and anxiety). I even try to avoid such situations.
> >
> > No need to recommend Paxil (which has been approved for social anxiety; I've seen the ads), because I've "been there, taken that" (for like 6+ years) it worked great, then pooped out, I went through HORRIBLE withdrawal and do NOT want to go back on it (it may not even work again and then I'd be faced with tapering all over again)
> >
> > Is there some other med, be it an a-d or something else, that helps with this?
> > Thanks,
> > Janelle
Posted by kregpark@yahoo.com on September 15, 2001, at 4:02:34
In reply to Re: HELP! I've developed social anxiety! » kregpark@yahoo.com, posted by jay on September 14, 2001, at 13:45:39
Thanks Jay! :)
It really is true that most people with primary
SP can find significant relief with low side
effects and CBT or other counseling is real
important to consider also.I've been off boards a few years until I recently
started my website which I'm slowly working on
over time, but I have been on Dr. Bob's site
some lately and I think it's great. Rick has a
great success story if you haven't heard his
yet you might want to check it out.Most people follow
the docs suggestions, but the docs, in my opinion,
haven't caught on yet fully that (again my opinion)
moderate to severe SP often needs to be
treated like other dopaminergic related disorders
(ie; bipolar disorder) with polypharmacy (more than
one med) to provide robust results
with minimal or even no side effects. (Rick has talked his
"positive" side effects before).Sorry - went on too long there, but thanks its
nice to hear that it was helpful!> Thanks for the link to your website! Great info, and the *best* thing is it gives hope...
>
> Jay :-)
>
>
>
This is the end of the thread.
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