Posted by SadSuzie on June 16, 2000, at 19:31:31
In reply to Re: Suzie (and Karen!), posted by AndrewB on June 16, 2000, at 5:17:07
I found the following article and thought it very interesting. Do you agree with this theory? Which medication effects this receptor in particular?
Am J Psychiatry 157:457-459, March 2000
(c) 2000 American Psychiatric AssociationBrief Report
Low Dopamine D2 Receptor Binding Potential in Social Phobia
Franklin R. Schneier, M.D., Michael R. Liebowitz, M.D., Anissa Abi-Dargham, M.D.,
Yolanda Zea-Ponce, Ph.D., Shu-Hsing Lin, Ph.D. and Marc Laruelle, M.D.OBJECTIVE: This study compared dopamine D2 receptor binding potential in patients with social phobia and healthy
comparison subjects. METHOD: Dopamine D2 receptor binding potential was assessed in 10 unmedicated subjects with
generalized social phobia and no significant lifetime psychiatric comorbidity and 10 healthy comparison subjects matched for age and sex. Binding potential was
measured in the striatum by using single photon emission computerized tomography and constant infusion of the D2 receptor radiotracer [123I]iodobenzamide
([123I]IBZM). RESULTS: Mean D2 receptor binding potential was significantly lower in the subjects with social phobia than in the comparison subjects. Within the
social phobia group, there was a nonsignificant correlation of binding potential with the Liebowitz Social Anxiety Scale score. CONCLUSIONS: Generalized social
phobia may be associated with low binding of [123I]IBZM to D2 receptors in the striatum.
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> Suzie,
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> Thanks for sharing your story Suzie. It is also nice to know that you have gotten something out of my posts. I don't want to add much to Karen's excellent post. She does have a diagnosis similar to yours, ADHD/atypical but no social anxiety I think. Your condition (atypical, ADHD, social anxiety) is one of those where I really believe you miss some of the foreign drugs out there. This is certainly true if you cannot tolerate Nardil. It is just my guess, but I don't think Nardil is that special. A combination of drugs can do what it does and do it a lot cleaner.
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> I think the adrafinil is a good choice to try. It should provide you with the arousal you need without the anxiety of a stimulant. Like you need more anxiety?
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> Let us know Suzie and Karen if Provigil and adrafinil are able to deal with your ADHD as well. I have my doubts.
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> By the way, I think maybe the reason selegiline didn’t help with the social anxiety is because at the higher doses of the patch it converts significantly into amphetamine, thus countering any social anxiety lessening effect its dopaminergic component may have had.
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> Suzie, you will probably need to add a dopaminergic drug on also. Your diagnosis...all of it - atypical, social anxiety, ADHD..... screams dopamine system malfunction. (In Bob’s Tips an ADHD researcher posts that ADHD is seemingly dopaminergic, as the efficacy of dopaminergic therapies for it indicate.) As Karen said, amisulpride is a good dopamine drug to take. I won’t add to what she said there. I suggest you also add on a low dose selegiline (you too Karen). Selegiline (10mg/day) is a different animal at low doses (no anxiety!) It has been found to have equal efficacy as stimulants in ADHD. Extrapolating from a small study, selegiline at 10mg. also has been found to have about 33% efficacy in social phobia and with an average of 32% improvement in social phobia per person. Selegiline of course doesn’t in itself compare with Nardil’s efficacy in social phobia of over 70%. But I believe when you combine selegiline with the ability of amisulpride, klonopin, and an alpha 1 agonist to reduce social anxiety, (presuming you are a responder).....you will have something that very well may work even better than Nardil for social anxiety without nearly the side effects. And you will also have, hopefully, the ADHD and the atypical depression taken care of; attention, energy, focus, mood.
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> Best wishes,
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> AndrewB
poster:SadSuzie
thread:37329
URL: http://www.dr-bob.org/babble/20000610/msgs/37582.html