![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 63. This is the beginning of the thread.
Posted by z on June 4, 2000, at 12:46:20
DOES ANYONE KNOW IF NARDIL IS MORE EFFECTIVE AGAINST
SOCIAL PHOBIA THAN PAXIL?! I KNOW EVERYONE REACTS
DIFFERENTLY TO MEDICATIONS, BUT WHAT SEEMS TO USUALLY
BE THE MOST EFFECTIVE MED FOR SOCIAL PHOBIA?!
ANY INPUT WOULD BE GREATLY APPRECIATED!!THANX,
Z
Posted by SLS on June 4, 2000, at 14:15:19
In reply to MOST EFFECTIVE MED FOR SOCIAL PHOBIA!, posted by z on June 4, 2000, at 12:46:20
> DOES ANYONE KNOW IF NARDIL IS MORE EFFECTIVE AGAINST
> SOCIAL PHOBIA THAN PAXIL?! I KNOW EVERYONE REACTS
> DIFFERENTLY TO MEDICATIONS, BUT WHAT SEEMS TO USUALLY
> BE THE MOST EFFECTIVE MED FOR SOCIAL PHOBIA?!
> ANY INPUT WOULD BE GREATLY APPRECIATED!!
>
> THANX,
> Z
Hi Z.Can you describe what you experience?
- Scott
Posted by S.D. on June 4, 2000, at 21:46:48
In reply to MOST EFFECTIVE MED FOR SOCIAL PHOBIA!, posted by z on June 4, 2000, at 12:46:20
(sorry in advance for the length of this reply, in case it becomes tedious ;^) It was originally intended to be very short).
"at week 16 ... 91% of the phenelzine-treated patients were almost asymptomatic."
This response is the most dramatic I've seen reported. Although I recall having read summaries of results of other phenelzine (brand name: Nardil) trials, this is the only one I found just now in a medline search of journal abstracts.
BTW the study shows almost as good a response from moclobemide; but while the Nardil response rate in other studies has been fairly consistantly good (though not *as good*; sorry I have no links, so don't trust me, but this is my recollection and belief), the moclobemide studies have had inconsistant results and ultimately left many psychopharmos in America deciding it wasn't much good.There have been articles published about studies done with Paxil. Some of them have fairly impressive-sounding response percentages and Paxil is being heavily advertised by the manufacturer. But personally, in aggregate as I read them carefully they didn't seem as good; besides somewhat lower percentages, a particular study might for instance have had a low standard for what makes a 'responder'.
You'll have to look for yourself ( http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed ) but I think the numbers point to Nardil as the king.
Some call it "the big gun" because it works often, and apparently often more completely than most meds when it does work, but for many people has more difficult side effects than most.There is another med that showed a very high effectiveness in the one controlled trial done with it: Klonopin (or it might have been with the generic form, clonazepam. I don't remember. Anecdotally, the brand name may be better or at least stronger than the generic.) An abstract of the clonazepam/Klonopin controlled trial can probably also be found on medline. Also, doctor Bob's psychopharmacology tips (elsewhere on drbob.org) has some stuff on social phobia regarding nardil, klonopin, paxil and more.
Hope this helps. Keep in touch via email if you feel like it I try to talk to other people with social phobia but usually without much success, due I guess to the nature of the disease. In any case, you've found a good crowd here in case you are new here. Good luck.
peace and health,
S.D.
----
Here is The Abstract:Br J Psychiatry 1992 Sep;161:353
Pharmacotherapy of social phobia. A controlled study with moclobemide and phenelzine.
Versiani M, Nardi AE, Mundim FD, Alves AB, Liebowitz MR, Amrein R
In a double-blind, parallel group trial, 78 subjects with social phobia received moclobemide (a new reversible inhibitor of monoamine oxidase A) phenelzine, or placebo. After eight weeks, both active drugs-phenelzine somewhat more than moclobemide--were clinically and statistically significantly more effective than placebo, as assessed by rating scales. There was some further improvement between weeks 8 and 16, particularly in the moclobemide group; at week 16, 82% of the moclobemide and 91% of the phenelzine-treated patients were almost asymptomatic. Moclobemide was, however, much better tolerated than phenelzine. Patients withdrawn from active drugs had relapsed by week 24, providing additional support for the efficacy of the active drugs.
Publication Types:
Clinical trial
Randomized controlled trialPMID: 1393304, UI: 93006780
----------
Posted by Orin on June 4, 2000, at 23:10:36
In reply to MOST EFFECTIVE MED FOR SOCIAL PHOBIA!, posted by z on June 4, 2000, at 12:46:20
> Z:
Social phobia could be partly treated with whatever med blocks panic and reduces anxiety without causing heavy sedation, euphoria, or cogitive problems. The other half of an effective treatment would surely include several sessions with a CBT specialist.
Posted by JohnL on June 5, 2000, at 5:24:01
In reply to MOST EFFECTIVE MED FOR SOCIAL PHOBIA!, posted by z on June 4, 2000, at 12:46:20
> DOES ANYONE KNOW IF NARDIL IS MORE EFFECTIVE AGAINST
> SOCIAL PHOBIA THAN PAXIL?! I KNOW EVERYONE REACTS
> DIFFERENTLY TO MEDICATIONS, BUT WHAT SEEMS TO USUALLY
> BE THE MOST EFFECTIVE MED FOR SOCIAL PHOBIA?!
> ANY INPUT WOULD BE GREATLY APPRECIATED!!
>
> THANX,
> ZDisclaimer: We do all respond differently, depending on what chemistry is at fault causing the social phobia.
Having said that, the best 100% effective medication I've ever taken for social phobia symptoms is Adrafinil. You can mailorder it for about $30 from overseas. I've tried EVERYTHING except Nardil or Parnate. Adrafinil is far superior to anything else normally prescribed for social phobial.
Here is a little info I found on it. Notice how it says passive people become more outgoing and talkative. I can personally attest to that as being true. I've always been the shy guy in the corner, all my life. Not any more. I'm perfectly comfortable in any group of people. What's the secret? Adrafinil.
ADRAFINIL (Olmifon)Rapidly restores vigilance and alertness in older people and the physically and mentally tired. Has a powerful
antidepressant action far superior to that of fluoxetine (Prozac) and clomipramine (Anafranil) and is without any serious
side effects. Adrafinil restores your powers of concentration, memory and intellectual function. When administered to
older people who have lost interest in life, adrafinil makes them want to take part in life again and they find that they
have renewed energy and vigor. Adrafinil may be correctly described as an anti-aging drug because it directly combats
degeneration in the part of the brain that allows you to take pleasure in life. Elderly people very often have disturbed
sleep patterns and take many naps during the day. Adrafinil restores a youthful sleep/wake cycle of full alertness in the
daytime and deep restorative sleep at night. After several weeks of treatment with Adrafinil daytime sleepiness
disappears, interest in intellectual activity is restored and depression lifts. It is very important to note that this improved
quality of alertness is NOT accompanied with mental excitation and insomnia as occurs with amphetamine or caffeine.
The correct dosage is 300 to 600 mg per day. The dosage can be adjusted according to response. Remember it takes
three weeks for all the effects of Adrafinil to become apparent. Do not use Adrafinil if you have any type of kidney or liver
problem or if you suffer from epilepsy.
ADRAFINIL: What is; (a.k.a. Olmifon) (Description & information below)
NOTE:not to be confused with "Anafranil (a.k.a. clomipramine)" the Antidepressant.Adrafinil provides alertness in most without the feeling often felt with stimulants that usually are prescribed for a person with
narcolepsy. Such as amphetamines etc. Also the possibility of tolerance is low with its continued use. There is however a
need for certain Liver function tests
on a regular basis with its continued use. Normally the same types of required testing as with the medication " cylert " which is
commonly prescribed in the USA. It is also used in certain parts europe as a "antidepressant". It is the combination of
Adrafinil's releasing stimulantive arousal effect(s), and its antidepressant effects that some doctors in europe recommend
Adrafinil over its newer form of Modafinil. There have been studies done in the United States "measuring depression in
individuals with sleep disorders",. In one study it was suggested that the
"rate of narcolepsy and depression is estimated to be between 30-52%".ADRAFINIL
Adrafinil: Alertness Without StimulationAdrafinil is the prototype of a new class of smart drug - the eugeroics (ie, "good arousal") - designed to promote vigilance
and alertness. Developed by the French pharmaceutical company Lafon Laboratories, adrafinil (brand name, Olmifon) has
been approved in many European countries for treating narcolepsy, a condition characterized by excessive daytime sleepiness
and other unusual symptoms.Non-narcoleptic users generally find that adrafinil gives them increased energy and reduces fatigue, while improving cognitive
function, mental focus, concentration, and memory. It has been reported that quiet people who take adrafinil become more
talkative, reserved people become more open, and passive people become more active.Of course, many stimulant drugs, ranging from caffeine to methamphetamine, are known to produce similar alerting/energizing
effects. Adrafinil has been described by some users as a "kinder, gentler" stimulant, because it provides these benefits but
usually with much less of the anxiety, agitation, insomnia, associated with conventional stimulants.Adrafinil's effects are more subtle than those of the stimulants you may be used to, building over a period of days to months.
They appear to be based on its ability to selectively stimulate 1-adrenergic receptors in the brain.2 These receptors normally
respond to norepinephrine (noradrenaline), a neurotransmitter linked to alertness, learning, and memory. This is in contrast to
conventional stimulants, which stimulate a broader spectrum of brain receptors, including those involving dopamine. Its more
focused activity profile may account for adrafinil's relative lack of adverse side effects.Dosing
The standard dose is 2 to 4 300-mg tablets per day for improving cognitive function, although some people may find lower
doses produce a desirable degree of improvement. Higher doses have been used to treat narcolepsy.
Posted by SLS on June 5, 2000, at 10:50:28
In reply to Re: MOST EFFECTIVE MED FOR SOCIAL PHOBIA!, posted by Orin on June 4, 2000, at 23:10:36
> > Z:
>
> Social phobia could be partly treated with whatever med blocks panic and reduces anxiety without causing heavy sedation, euphoria, or cogitive problems. The other half of an effective treatment would surely include several sessions with a CBT specialist.
I agree that Nardil is probably the drug most likely to succeed. If you are comfortable with the idea of using an MAO inhibitor right away, then go for it. The reason I inquired about how you experience social-phobia is because I don't think there is enough attention paid to the fact that a psychological component often exists. Currently, it seems that drugs are the answer to everything. I'm glad Orin proposed a treatment that included psychotherapy. I think Cognitive Behavioral Therapy is well suited for it.I'm not sure I would steer in the direction of equating social-phobia with panic-disorder. I don't think the drug treatments are interchangeable.
Good luck.
- Scott
Posted by OrinJ on June 6, 2000, at 16:05:22
In reply to Re: Most Effective Med for Social Phobia!, posted by SLS on June 5, 2000, at 10:50:28
> I'm not sure I would steer in the direction of equating social-phobia with panic-disorder. I don't think the drug treatments are interchangeable.<
Good point. I'm sure the two conditions differ in many ways, although I'm not sure how, exactly.
I know panic disorder and its treatment well. Same with agoraphobia and a couple of other chronic problems. Various meds have helped both conditions. But meds combined with counseling, and my application of the counseling, have really snuffed out the agoraphobia. Thank goodness.
BTW, I changed my posted name a bit. Seems that my tinkering with linux (on this same drive) eliminated my cookies, along with my password index, and other useful files. Regards.
Posted by SLS on June 6, 2000, at 17:33:47
In reply to Re: Most Effective Med for Social Phobia! » SLS, posted by OrinJ on June 6, 2000, at 16:05:22
> I know panic disorder and its treatment well. Same with agoraphobia and a couple of other chronic problems. Various meds have helped both conditions. But meds combined with counseling, and my application of the counseling, have really snuffed out the agoraphobia. Thank goodness.
Orin, it is wonderful that you have been able to treat your agoraphobia so well. Success stories are so heartening to read. I hope things remain well for you.
Is propanolol useful for agoraphobia?
I watched a pretty cool segment on one of those 20/20 type shows that featured a story about a girl (teens or early twenties) who beat her panic attacks through some sort of desensitization therapy. She had a particularly difficult time driving her car on unfamiliar roads and highways. No drugs. It changed her life.
> BTW, I changed my posted name a bit. Seems that my tinkering with linux (on this same drive) eliminated my cookies, along with my password index, and other useful files. Regards.
Is linux difficult? Are you still using MS Windows?
Nice chatting with you.
Sincerely,
Scott
Posted by OrinJ on June 7, 2000, at 22:16:08
In reply to Re: Most Effective Med for Social Phobia! » OrinJ, posted by SLS on June 6, 2000, at 17:33:47
Scott:
I don't recall getting much benefit for my agoraphobia from inderal. It helped with panic. But agoraphobia is so linked to one's habits of thinking. To get at that, one needs a therapist.
The linux distributions out now are quite easy to set up. Especially the one from Caldera. These new distributions have windows-like workstation shells that work great. The only problem is the lack of interesting software written for the os. So, I do continue using MS products for that very reason.
Regards. Orin
Posted by Lynne on June 8, 2000, at 0:03:12
In reply to Re: MOST EFFECTIVE MED FOR SOCIAL PHOBIA!, posted by JohnL on June 5, 2000, at 5:24:01
> > DOES ANYONE KNOW IF NARDIL IS MORE EFFECTIVE AGAINST
> > SOCIAL PHOBIA THAN PAXIL?! I KNOW EVERYONE REACTS
> > DIFFERENTLY TO MEDICATIONS, BUT WHAT SEEMS TO USUALLY
> > BE THE MOST EFFECTIVE MED FOR SOCIAL PHOBIA?!
> > ANY INPUT WOULD BE GREATLY APPRECIATED!!
> >
> > THANX,
> > Z
>
> Disclaimer: We do all respond differently, depending on what chemistry is at fault causing the social phobia.
>
> Having said that, the best 100% effective medication I've ever taken for social phobia symptoms is Adrafinil. You can mailorder it for about $30 from overseas. I've tried EVERYTHING except Nardil or Parnate. Adrafinil is far superior to anything else normally prescribed for social phobial.
>
> Here is a little info I found on it. Notice how it says passive people become more outgoing and talkative. I can personally attest to that as being true. I've always been the shy guy in the corner, all my life. Not any more. I'm perfectly comfortable in any group of people. What's the secret? Adrafinil.
>
>
> ADRAFINIL (Olmifon)
>
> Rapidly restores vigilance and alertness in older people and the physically and mentally tired. Has a powerful
> antidepressant action far superior to that of fluoxetine (Prozac) and clomipramine (Anafranil) and is without any serious
> side effects. Adrafinil restores your powers of concentration, memory and intellectual function. When administered to
> older people who have lost interest in life, adrafinil makes them want to take part in life again and they find that they
> have renewed energy and vigor. Adrafinil may be correctly described as an anti-aging drug because it directly combats
> degeneration in the part of the brain that allows you to take pleasure in life. Elderly people very often have disturbed
> sleep patterns and take many naps during the day. Adrafinil restores a youthful sleep/wake cycle of full alertness in the
> daytime and deep restorative sleep at night. After several weeks of treatment with Adrafinil daytime sleepiness
> disappears, interest in intellectual activity is restored and depression lifts. It is very important to note that this improved
> quality of alertness is NOT accompanied with mental excitation and insomnia as occurs with amphetamine or caffeine.
> The correct dosage is 300 to 600 mg per day. The dosage can be adjusted according to response. Remember it takes
> three weeks for all the effects of Adrafinil to become apparent. Do not use Adrafinil if you have any type of kidney or liver
> problem or if you suffer from epilepsy.
>
>
> ADRAFINIL: What is; (a.k.a. Olmifon) (Description & information below)
> NOTE:not to be confused with "Anafranil (a.k.a. clomipramine)" the Antidepressant.
>
> Adrafinil provides alertness in most without the feeling often felt with stimulants that usually are prescribed for a person with
> narcolepsy. Such as amphetamines etc. Also the possibility of tolerance is low with its continued use. There is however a
> need for certain Liver function tests
> on a regular basis with its continued use. Normally the same types of required testing as with the medication " cylert " which is
> commonly prescribed in the USA. It is also used in certain parts europe as a "antidepressant". It is the combination of
> Adrafinil's releasing stimulantive arousal effect(s), and its antidepressant effects that some doctors in europe recommend
> Adrafinil over its newer form of Modafinil. There have been studies done in the United States "measuring depression in
> individuals with sleep disorders",. In one study it was suggested that the
> "rate of narcolepsy and depression is estimated to be between 30-52%".
>
> ADRAFINIL
>
>
> Adrafinil: Alertness Without Stimulation
>
> Adrafinil is the prototype of a new class of smart drug - the eugeroics (ie, "good arousal") - designed to promote vigilance
> and alertness. Developed by the French pharmaceutical company Lafon Laboratories, adrafinil (brand name, Olmifon) has
> been approved in many European countries for treating narcolepsy, a condition characterized by excessive daytime sleepiness
> and other unusual symptoms.
>
> Non-narcoleptic users generally find that adrafinil gives them increased energy and reduces fatigue, while improving cognitive
> function, mental focus, concentration, and memory. It has been reported that quiet people who take adrafinil become more
> talkative, reserved people become more open, and passive people become more active.
>
> Of course, many stimulant drugs, ranging from caffeine to methamphetamine, are known to produce similar alerting/energizing
> effects. Adrafinil has been described by some users as a "kinder, gentler" stimulant, because it provides these benefits but
> usually with much less of the anxiety, agitation, insomnia, associated with conventional stimulants.
>
> Adrafinil's effects are more subtle than those of the stimulants you may be used to, building over a period of days to months.
> They appear to be based on its ability to selectively stimulate 1-adrenergic receptors in the brain.2 These receptors normally
> respond to norepinephrine (noradrenaline), a neurotransmitter linked to alertness, learning, and memory. This is in contrast to
> conventional stimulants, which stimulate a broader spectrum of brain receptors, including those involving dopamine. Its more
> focused activity profile may account for adrafinil's relative lack of adverse side effects.
>
> Dosing
>
> The standard dose is 2 to 4 300-mg tablets per day for improving cognitive function, although some people may find lower
> doses produce a desirable degree of improvement. Higher doses have been used to treat narcolepsy.
What doseage did you start out with?did you take it all at one time? How long before you noticed the effects?
Thanks, Lynne
Posted by Rick on June 8, 2000, at 1:29:55
In reply to MOST EFFECTIVE MED FOR SOCIAL PHOBIA!, posted by z on June 4, 2000, at 12:46:20
First of all, please see my 6-8 post entitled "Social Phobia Cocktail -- WOW!!!"
On average, Nardil is probably more effective than Paxil, but for most people (including me) its side-effects are even worse than Paxil's. Proving again that YMMV, Nardil worked wonderfully for me for all of two weeks, followed by complete poop- out. I didn't like the food restrictions anyways, even though they do tend to be overstated.
In various combinations, I've tried Celexa, Neurontin, Xanax, Tranxene, beta blockers, Wellbutrin (an odd choice, but my pdoc wanted me to try it to counter Celexa fogginess), Selegiline, and BuSpar.
But none of those worked nearly as well, consistently, and side-effect-free as daily Klonopin of 2 mg or less (taking too much can LESSEN its SP benefits).
But as you'll see in my above-referenced post, adding Serzone and Provigil to the Klonopin has produced far and away the best Social Phobia relief for me, with NO lasting side effects to-date.
Incidentally, Provigil (modafinil) is kin to the adrafinil mentioned in another response. Both have been available in France for awhile, but Provigil was introduced in the U.S. a little over a year ago. Unlike adrafinil, Provigil does not require quarterly liver-function checkups.
Rick
------
> DOES ANYONE KNOW IF NARDIL IS MORE EFFECTIVE AGAINST
> SOCIAL PHOBIA THAN PAXIL?! I KNOW EVERYONE REACTS
> DIFFERENTLY TO MEDICATIONS, BUT WHAT SEEMS TO USUALLY
> BE THE MOST EFFECTIVE MED FOR SOCIAL PHOBIA?!
> ANY INPUT WOULD BE GREATLY APPRECIATED!!
>
> THANX,
> Z
Posted by SLS on June 8, 2000, at 6:30:50
In reply to Re: MOST EFFECTIVE MED FOR SOCIAL PHOBIA!, posted by JohnL on June 5, 2000, at 5:24:01
> Having said that, the best 100% effective medication I've ever taken for social phobia symptoms is Adrafinil. You can mailorder it for about $30 from overseas. I've tried EVERYTHING except Nardil or Parnate. Adrafinil is far superior to anything else normally prescribed for social phobial.
John,
Have you been diagnosed as suffering from social-phobia as opposed to simply experiencing anxiety in social situations?Can you describe what you experience during an episode of social-phobia?
- Scott
Posted by Lynne on June 17, 2000, at 0:32:06
In reply to Re: Most Effective Med for Social Phobia!, posted by SLS on June 5, 2000, at 10:50:28
I took 300mg today of Adrafinil and didn't feel anything.I will take 600mgs tomarrow. Do I take both tablets at the same time? How will I know when I have the right doseage?Does this drug build up in your body? Or is it day to day like with Dexedrine.
Thanks,Lynne
>
>
>
>
>
Posted by Dwight on June 17, 2000, at 5:26:38
In reply to Doesage of Adrafinil (JohnL or AndrewB), posted by Lynne on June 17, 2000, at 0:32:06
TO John, Andrew, Tina,
I also have been taking 300mg of adrafini and haven't noticed anything. When I took 600mg with Adderal at the same time, I noticed I was cursing aloud more than usual, e.g., when spilling water, when my cat knocked over a plant, etc. I have not noticed much of anything with 50mg of amisulpride either. If I go up to 100 will it's mechanism of action shift over dopamine enhancement to dopamine suppression? When does that shift take place? or does it? I thought someone said, the dosage was paradoxical like that.
Thanks Dwight.
> I took 300mg today of Adrafinil and didn't feel anything.I will take 600mgs tomarrow. Do I take both tablets at the same time? How will I know when I have the right doseage?Does this drug build up in your body? Or is it day to day like with Dexedrine.
>
> Thanks,Lynne
> >
> >
> >
> >
> >
Posted by AndrewB on June 17, 2000, at 7:59:23
In reply to Re: Dosage of Adrafinil (JohnL or AndrewB), posted by Dwight on June 17, 2000, at 5:26:38
Don't expect to see anything at all with adrafinil for the first two weeks. If after three weeks nothing happens, take your dosage up to 600. Dosage may go as high as 1200.
Give amisulpride 6 days at 50mg. If nothing, take dosage up to 100. Dosage may go as high as 200mg.
Keep us posted. I am tracking responses to amisulpride and adrafinil.
Andrew B
Posted by Lynne on June 17, 2000, at 9:09:42
In reply to Re: Dosage of Adrafinil (JohnL or AndrewB), posted by AndrewB on June 17, 2000, at 7:59:23
AndrewB,
I have a question for you. I am taking 40mg Prozac for 1 month and I can't see that it does anything much except make me sleepy. It has helped with obsessive thoughts. I am trying the Adrafinil now. Should I continue with the Prozac?
Can you recommend anything for sleep that doesn't make me have memory problems. I have been taking Tamazepan, but it makes me forgetful. Sonata didn't do anything for me.Thanks! I get more help from reading this board than any doctor I've been to.
Lynne
Posted by Dwight on June 17, 2000, at 9:34:41
In reply to Re: Dosage of Adrafinil (JohnL or AndrewB) » AndrewB, posted by Lynne on June 17, 2000, at 9:09:42
I read a post here earlier this morning about St.Johns Wort--I believe it was either JohnL or AndrewB--, saying that it was important to get a high enough dose, i.e., 2700mg/day. That's a lot! On the bottle I have it recommends only 150mg twice a day (but it also contains reishi mushroom, avena sativa and lavender). Anyway, a few hours ago I took 1000mg. Wow, what a difference! I'd taken SJW on numerous occassions in the past and had never felt much of anything. Why do the recommend such miniscule doses? This time I really felt something--a warm, kind of bouncy feeling, hard to describe, but pleasant. I'm wondering though if this might be due, not only to the increase in dose, but also to some sort of synergistic interaction with the adrafinil or amisulpride. I mention this because I remember JohnL saying that SJW worked better with these meds.
Posted by SLS on June 17, 2000, at 9:55:11
In reply to St. JohnsWort (high dose!) +adrafinil+ amisulpride, posted by Dwight on June 17, 2000, at 9:34:41
Hi Dwight.
> I read a post here earlier this morning about St.Johns Wort--I believe it was either JohnL or AndrewB--, saying that it was important to get a high enough dose, i.e., 2700mg/day. That's a lot! On the bottle I have it recommends only 150mg twice a day (but it also contains reishi mushroom, avena sativa and lavender). Anyway, a few hours ago I took 1000mg. Wow, what a difference! I'd taken SJW on numerous occassions in the past and had never felt much of anything. Why do the recommend such miniscule doses? This time I really felt something--a warm, kind of bouncy feeling, hard to describe, but pleasant. I'm wondering though if this might be due, not only to the increase in dose, but also to some sort of synergistic interaction with the adrafinil or amisulpride. I mention this because I remember JohnL saying that SJW worked better with these meds.
This is great. It must feel great. I hope you continue to feel great. Please send me any extra brain-juice via UPS.How would you describe the nature and severity of your depression?
What other drugs and dosages are you taking?
If you were to maintain a 1000mg - 2000mg daily dosage, how much would it cost?
Thanks.
- Scott
Posted by AndrewB on June 17, 2000, at 12:07:27
In reply to Re: Dosage of Adrafinil (JohnL or AndrewB) » AndrewB, posted by Lynne on June 17, 2000, at 9:09:42
Lynne and Dwight,
Give Prozac 6 weeks before you give up on it.
I don't really pay too much attention to what works with sleep but I have read good things here about both rememeron (sp?) and zyprexa for sleep. Or maybe take your prozac before you go to bed? Are you both sleepy and can't get to sleep?
Some studies may have used as much as 2,700mg of SJW but that is really high. John L uses 900mg of St. Johns (or did) and I use 1200mg. It is a matter of personal experimentation. I would start out at 900 and see if anything happens after 2 weeks. Sometimes too much SJW can cause a little agitation but that seems to be about it.
Dwight you are adding on meds and supplements so quickly it is impossible to tell what is doing what. You are supposed to add on only one drug at a time so you can tell what helps and what hurts. You might want to stay away from those kitchen sink herbal supplements for mood that have a bit of everything in them. If you want to try SJW, buy a bottle that contains SJW exclusively and in a standardized formula (.3% hypericin, 4% hyperforin)
Posted by michael on June 17, 2000, at 12:28:20
In reply to Doesage of Adrafinil (JohnL or AndrewB), posted by Lynne on June 17, 2000, at 0:32:06
The package insert says 2 to 4 tablets per day, taken in the morning and at noon (i.e. 300mg am & 300mg pm OR 600mg am & 300mg pm, etc.)
Btw - don't forget that you need to have your liver enzymes checked if you're taking it for "extended periods" (e.g. more than a couple months?)
> I took 300mg today of Adrafinil and didn't feel anything.I will take 600mgs tomarrow. Do I take both tablets at the same time? How will I know when I have the right doseage?Does this drug build up in your body? Or is it day to day like with Dexedrine.
>
> Thanks,Lynne
> >
> >
> >
> >
> >
Posted by JohnL on June 17, 2000, at 17:52:50
In reply to Doesage of Adrafinil (JohnL or AndrewB), posted by Lynne on June 17, 2000, at 0:32:06
Quite a discussion going on here. Pretty cool. I couldn't resist jumping in, since I'm pleasantly familiar with all the topics being discussed here.
Anyone trying Adrafinil should not expect anything for at least two weeks. Four is better, six even better. Contrary to my usual belief pattern, Adrafinil really does require time. It has an accumulating effect. The messy analogy I made in another post is that it's like throwing handfuls of spaghetti at the wall. Some of it will stick, some of it will fall to the floor. Keep throwing until the whole wall is covered. That really takes at least two weeks in my experience. Longer is better. (in case you're wondering, no, I've never thrown spaghetti at the wall :-))
Concerning Amisulpride, sources of information vary a little bit. But basically I think the turnaround pivot point is in the 250mg to 300mg range. That's where its mechanism reverses. I don't know though, based on symptoms and side effects Andrew talked about a while ago, I think I experienced that pivot mechanism at 100mg. Who knows.
Concerning SJW, 2700mg does seem like a lot. I mean, it was used in clinical trials at that dose with few side effects. But at that dose I get agitation sortof side effects. My optimum dose is the 1200mg range, though recently I've only been taking 300mg once every other day. That doesn't seem like much, but I do notice in a negative way when I stop taking it.
One observation I've made with SJW is that it seems to have a lot more ooomph when combined with something else, like Prozac, Adrafinil, Amisulpride, or whatever (but NOT Paxil! stay away from that combo). SJW seems to me to have a nice synergy with other things. But not all other things. Definitely not Paxil. If used as monotherapy, I really do think the recommended dose is way too low. One study indicated 300mg of SJW is roughly the same as 10mg of a tricyclic. Based on that, 5 to 8 pills a day seems to be in the right ballpark. And as was mentioned, brands that have minimum %hyperforin are good ones. Like 3%, 4%, 5%. There's even a new brand called New Chapter that has 10%hyperforin designed to be dosed once daily. I personally don't like the brands that have other ingredients mixed in, because then it's hard to tell what's doing what.
For me anyway, Adrafinil with a little SJW ended my very prolonged multiyear anhedonic melancholic depression. I had one more trick up my sleeve to try in place of Adrafinil, and it's working great. But, that's another post for another day...
JohnL
Posted by SLS on June 18, 2000, at 19:46:54
In reply to Re: Doesage of Adrafinil - all, posted by JohnL on June 17, 2000, at 17:52:50
Hi John.
Thanks for such a comprehensive post.
I was wondering what the problem is with combining St. John's Wort with Paxil?
Also, when the comparisons are made between SJW and tricyclics, is there any particular mechanism being referred to, such as reuptake inhibition?
Thanks.
- Scott
Posted by rick_number1001@yahoo.com on August 25, 2001, at 12:02:17
In reply to Re: MOST EFFECTIVE MED FOR SOCIAL PHOBIA! , posted by Lynne on June 8, 2000, at 0:03:12
I think the research (and experts agree) that Nardil
is more effective than Paxil for Social Phobia.
(My experience too by a longshot).With both antidepressants a higher dose is required
for more severe cases.Unfortunately both of these drugs produce significant
sexual side effects at the high doses.
(ie; Paxil 30-50mg and Nardil 90mg)
In my case over comparable dose ranges Nardil had
LESS side effects than Paxil, Zoloft, and Celexa.
Only Prozac had fewer. (Luvox was a bad experience).Though I never went over 30 Paxil, I experienced
as much negative sexual side effects at that dose
than I did at the usual max dose of Nardil, 90mg90mg Nardil was VERY effective for me - 2 years
straight taken all by itself.I can claim nothing close for an SSRI.
Also, Nardil (poop out) is due to doctors not
knowing about it. Nardil dose needs to escalate
1 tablet every 1-3 weeks (when the good effects
start to diminish). As with a benzodiazepine,
dose escalation stops at the "therapeutic dose
level". Usually this is 60-90mg.I HIGHLY recommend Nardil if other meds are not
satisfactory to you.
Also, John Marshall's book "Social Phobia" is
EXCELLENT. He runs U. of Wisc. Psychiatric clinic.Good luck - I hope you give it a try and report
back!!!Craig (rick_number1001@yahoo.com to be anonymous)
http://www.socialfear.com
> > > DOES ANYONE KNOW IF NARDIL IS MORE EFFECTIVE AGAINST
> > > SOCIAL PHOBIA THAN PAXIL?! I KNOW EVERYONE REACTS
> > > DIFFERENTLY TO MEDICATIONS, BUT WHAT SEEMS TO USUALLY
> > > BE THE MOST EFFECTIVE MED FOR SOCIAL PHOBIA?!
> > > ANY INPUT WOULD BE GREATLY APPRECIATED!!
> > >
> > > THANX,
> > > Z
> >
> > Disclaimer: We do all respond differently, depending on what chemistry is at fault causing the social phobia.
> >
> > Having said that, the best 100% effective medication I've ever taken for social phobia symptoms is Adrafinil. You can mailorder it for about $30 from overseas. I've tried EVERYTHING except Nardil or Parnate. Adrafinil is far superior to anything else normally prescribed for social phobial.
> >
> > Here is a little info I found on it. Notice how it says passive people become more outgoing and talkative. I can personally attest to that as being true. I've always been the shy guy in the corner, all my life. Not any more. I'm perfectly comfortable in any group of people. What's the secret? Adrafinil.
> >
> >
> > ADRAFINIL (Olmifon)
> >
> > Rapidly restores vigilance and alertness in older people and the physically and mentally tired. Has a powerful
> > antidepressant action far superior to that of fluoxetine (Prozac) and clomipramine (Anafranil) and is without any serious
> > side effects. Adrafinil restores your powers of concentration, memory and intellectual function. When administered to
> > older people who have lost interest in life, adrafinil makes them want to take part in life again and they find that they
> > have renewed energy and vigor. Adrafinil may be correctly described as an anti-aging drug because it directly combats
> > degeneration in the part of the brain that allows you to take pleasure in life. Elderly people very often have disturbed
> > sleep patterns and take many naps during the day. Adrafinil restores a youthful sleep/wake cycle of full alertness in the
> > daytime and deep restorative sleep at night. After several weeks of treatment with Adrafinil daytime sleepiness
> > disappears, interest in intellectual activity is restored and depression lifts. It is very important to note that this improved
> > quality of alertness is NOT accompanied with mental excitation and insomnia as occurs with amphetamine or caffeine.
> > The correct dosage is 300 to 600 mg per day. The dosage can be adjusted according to response. Remember it takes
> > three weeks for all the effects of Adrafinil to become apparent. Do not use Adrafinil if you have any type of kidney or liver
> > problem or if you suffer from epilepsy.
> >
> >
> > ADRAFINIL: What is; (a.k.a. Olmifon) (Description & information below)
> > NOTE:not to be confused with "Anafranil (a.k.a. clomipramine)" the Antidepressant.
> >
> > Adrafinil provides alertness in most without the feeling often felt with stimulants that usually are prescribed for a person with
> > narcolepsy. Such as amphetamines etc. Also the possibility of tolerance is low with its continued use. There is however a
> > need for certain Liver function tests
> > on a regular basis with its continued use. Normally the same types of required testing as with the medication " cylert " which is
> > commonly prescribed in the USA. It is also used in certain parts europe as a "antidepressant". It is the combination of
> > Adrafinil's releasing stimulantive arousal effect(s), and its antidepressant effects that some doctors in europe recommend
> > Adrafinil over its newer form of Modafinil. There have been studies done in the United States "measuring depression in
> > individuals with sleep disorders",. In one study it was suggested that the
> > "rate of narcolepsy and depression is estimated to be between 30-52%".
> >
> > ADRAFINIL
> >
> >
> > Adrafinil: Alertness Without Stimulation
> >
> > Adrafinil is the prototype of a new class of smart drug - the eugeroics (ie, "good arousal") - designed to promote vigilance
> > and alertness. Developed by the French pharmaceutical company Lafon Laboratories, adrafinil (brand name, Olmifon) has
> > been approved in many European countries for treating narcolepsy, a condition characterized by excessive daytime sleepiness
> > and other unusual symptoms.
> >
> > Non-narcoleptic users generally find that adrafinil gives them increased energy and reduces fatigue, while improving cognitive
> > function, mental focus, concentration, and memory. It has been reported that quiet people who take adrafinil become more
> > talkative, reserved people become more open, and passive people become more active.
> >
> > Of course, many stimulant drugs, ranging from caffeine to methamphetamine, are known to produce similar alerting/energizing
> > effects. Adrafinil has been described by some users as a "kinder, gentler" stimulant, because it provides these benefits but
> > usually with much less of the anxiety, agitation, insomnia, associated with conventional stimulants.
> >
> > Adrafinil's effects are more subtle than those of the stimulants you may be used to, building over a period of days to months.
> > They appear to be based on its ability to selectively stimulate 1-adrenergic receptors in the brain.2 These receptors normally
> > respond to norepinephrine (noradrenaline), a neurotransmitter linked to alertness, learning, and memory. This is in contrast to
> > conventional stimulants, which stimulate a broader spectrum of brain receptors, including those involving dopamine. Its more
> > focused activity profile may account for adrafinil's relative lack of adverse side effects.
> >
> > Dosing
> >
> > The standard dose is 2 to 4 300-mg tablets per day for improving cognitive function, although some people may find lower
> > doses produce a desirable degree of improvement. Higher doses have been used to treat narcolepsy.
>
>
> What doseage did you start out with?
>
> did you take it all at one time? How long before you noticed the effects?
>
> Thanks, Lynne
Posted by Joe Schmoe on August 26, 2001, at 9:15:39
In reply to Re: MOST EFFECTIVE MED FOR SOCIAL PHOBIA! » Lynne, posted by rick_number1001@yahoo.com on August 25, 2001, at 12:02:17
It sounds like the problems Nardil causes are in the body while the benefits are in the brain.
The scientists need to develop some way to make a MAOI that only works in the brain and is not utilized by the rest of the body. Maybe some second pill that you take an hour later that destroys the MAOI, but that cannot cross the blood-brain barrier.
Posted by Mitch on August 26, 2001, at 17:48:57
In reply to Re: MOST EFFECTIVE MED FOR SOCIAL PHOBIA!, posted by Joe Schmoe on August 26, 2001, at 9:15:39
> It sounds like the problems Nardil causes are in the body while the benefits are in the brain.
>
> The scientists need to develop some way to make a MAOI that only works in the brain and is not utilized by the rest of the body. Maybe some second pill that you take an hour later that destroys the MAOI, but that cannot cross the blood-brain barrier.
There are transdermal patches of phenelzine, and I believe tranylcypromine (parnate), that are supposed to be in clinical studies right now. I would really want to try an MAOI, but my doc says NO. The patches are supposed to be a way of bypassing the gut so you don't have the diet restrictions, but still would have to be cautious about drug interactions. Does anybody know what the status of these patches is??
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