Posted by Iansf on November 5, 2004, at 19:30:27
In reply to Re: Stimulants and Social Anxiety? » Ted Brosnan, posted by jboud24 on November 5, 2004, at 14:10:54
I eny you having such an open-minded doctor. When I brought up Klonopin to my doctor, he said he NEVER prescribes benzodiazepines. When I brought up Ritalin he said he NEVER prescribes stimulants and scoffed at the idea they might help with social phobia. Unfortunately he's the only psychiatrist available under my health plan. Good luck.
John
> For Ted and all those interested in stimulants and social anxiety:
>
> I saw my new pdoc on tuesday. He reviewed my case history from previous pdocs and my current psychologist. After that we got down to the meds.
> I was already on 300mg zoloft and 30mg remeron. He directly told me that dopaminergic dysfunction played a role in social anxiety disorder for many people with this illness. He was very keen on adding a pro-dopaminergic to my med regimen, and he first suggessted wellbutrin. I declined the wellbutrin because it has proven quite anxiogenic in many people on this board. He then mentioned ritalin which I said I might want to try, but he himself said ritalin tends to also promote anxiety in predisposed social-phobics from his own clinical experiences. So I casually asked what he though about amphetamines as a means to increase the dopamine and norepinephrine. He said that amps were definitely the least anxiogenic of the meds out there, with little difference between Adderall and Dexedrine, except that the comedown on adderall was less pronounced becuase it seems to last a bit longer. He said they were fairly equal in their anti-anxiety/pro-social effects. Of course YMMV as I always say.
>
> So now I'm on my third day of Klonopin and adderall and here is what I've noticed:
>
> How I Feel:
> On a 1-10 scale of anxiety I feel like a 0. This is the least anxiety I've felt in 10 years. There is definitely a very special interaction between the Klonopin and the Adderall that augment each other and potently correct the GABA/dopamine imbalance. I also feel a less pronounced but still significant pro-socializing effect that I never felt before on Adderall when I took it (recreationally) with xanax.
>
> What I've noticed/researched and learned about how to treat social phobia:
> SSRI's are an important factor in my success right now I believe. There is research proving that administration of an SSRI at theraputic doses enhances the subjective and stimulant effects of amphetamine up to 4 times. I believe also that serotonin, while never having solely reduced anxiety before, is allowing the adderall to work more effectively.
>
> I also take Remeron, of which I take 30mg, at night for sleep. For anyone out there with problems with insomnia on stims, Remeron will knock out the stim effect in 30 minutes and get you ready for bed in a hurry. In addition, chronic daily dosing with remeron has been shown to increase the effects of amphetamines during the day, due to serotonin 2c receptor blockade and adrenergic alpha-2 antagonism. Remeron does not make me irritated or agitated or restless. It has always been a good non-poop-out sleep aid and anxiolytic for me, even at doses up to 60mg.
>
> To recap, my magical cocktail for SP is:
> Zoloft 300mg (at night)
> Remeron 30mg (at night of course)
> Klonopin 4mg (2mg AM, 1mg at noon, 1mg PM)
> Adderall XR 20mg (AM)
>
> Justin
>
poster:Iansf
thread:411178
URL: http://www.dr-bob.org/babble/20041103/msgs/412351.html