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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Sarah S on March 18, 2003, at 15:02:11
Hello all, I'm new to this board and I'd like to thank everyone in advance for any replies I may get.
Anyway, I have anxiety/depression and social phobia. My social phobia used to be extreme--I went through middle school and part of high school completely terrified of people, unable to say more than a few sentences to anyone. I would sweat and tremble at the mere thought of having to interact with people, although I desperately wished that I could have friends and a normal life. I hated myself.
At the end of high school and my first year of college, my SP lessened--I guess I just matured or something--but because I didn't get any sort of treatment it never completely went away, and I remained quiet and lonely.
Due to certain circumstances, I was finally forced to get treatment, and with therapy and Wellbutrin and Ativan I've improved a lot. However, I still have a lot of problems--I can talk to people if they come to my dorm room or whatever (even though I'm still really reserved), but I'm completely unable to initiate social contact. It's like there's an evil inner force preventing me from going to other people's dorm rooms or calling them or reaching out to them in any way. As a result I still have not made a lot of friends, which makes me hate myself and believe that I'm socially dysfunctional, unpleasant, doomed to be alone forever, etc. Because of this I have crying spells and sometimes I still cut myself. I've also developed nausea which makes it hard to eat, and I think this is psychological.
Whew. . .sorry for giving so much background. Here's the question: should I just continue with cognitive therapy and my current medications, and hope that things eventually get better? Or should I take a risk and go off Wellbutrin in order to switch to Nardil? I'm afraid that in the period when I'm off Wellbutrin but the Nardil hasn't kicked in yet, that I will get more depressed, and I don't know what I could do about that. I also don't know if Nardil is only for severe SP or if it would help people like me, who are partially recovered from SP but are still not "normal."
So what do you think? Could Nardil be the answer? Any thoughts on this would be greatly appreciated.
p.s.I already know about the dietary restrictions and the weight gain and that doesn't bother me.
Posted by daizy on March 18, 2003, at 15:13:11
In reply to am I a candidate for Nardil?, posted by Sarah S on March 18, 2003, at 15:02:11
> Hello all, I'm new to this board and I'd like to thank everyone in advance for any replies I may get.
>
> Anyway, I have anxiety/depression and social phobia. My social phobia used to be extreme--I went through middle school and part of high school completely terrified of people, unable to say more than a few sentences to anyone. I would sweat and tremble at the mere thought of having to interact with people, although I desperately wished that I could have friends and a normal life. I hated myself.
>
> At the end of high school and my first year of college, my SP lessened--I guess I just matured or something--but because I didn't get any sort of treatment it never completely went away, and I remained quiet and lonely.
>
> Due to certain circumstances, I was finally forced to get treatment, and with therapy and Wellbutrin and Ativan I've improved a lot. However, I still have a lot of problems--I can talk to people if they come to my dorm room or whatever (even though I'm still really reserved), but I'm completely unable to initiate social contact. It's like there's an evil inner force preventing me from going to other people's dorm rooms or calling them or reaching out to them in any way. As a result I still have not made a lot of friends, which makes me hate myself and believe that I'm socially dysfunctional, unpleasant, doomed to be alone forever, etc. Because of this I have crying spells and sometimes I still cut myself. I've also developed nausea which makes it hard to eat, and I think this is psychological.
>
> Whew. . .sorry for giving so much background. Here's the question: should I just continue with cognitive therapy and my current medications, and hope that things eventually get better? Or should I take a risk and go off Wellbutrin in order to switch to Nardil? I'm afraid that in the period when I'm off Wellbutrin but the Nardil hasn't kicked in yet, that I will get more depressed, and I don't know what I could do about that. I also don't know if Nardil is only for severe SP or if it would help people like me, who are partially recovered from SP but are still not "normal."
>
> So what do you think? Could Nardil be the answer? Any thoughts on this would be greatly appreciated.
>
> p.s.I already know about the dietary restrictions and the weight gain and that doesn't bother me.Have you tried a benzo? That might help for the time you kick the W, untill you start the Nardil.. It seems to be the drug of choice at the Mo, wish I could get some!
Posted by Questionmark on March 18, 2003, at 16:17:43
In reply to am I a candidate for Nardil?, posted by Sarah S on March 18, 2003, at 15:02:11
Hi. i'm so sorry. What a curse SP is. Such a curse.
Personally, i think if you're going to be on any meds Nardil would probably be your best bet-- since you definitely seem unsatisfied with your current state. Hopefully getting off the Wellbutrin wouldn't make you feel too much worse. If you do go off and feel really bad at times, have a little caffeine (tea or whatever) to pick you up a bit maybe (but of course not too much once you've started the Nardil). Caffeine's a much better AntiD than Wellbutrin anyway, in my opinion. Also if you do go off Wellb and start feeling really bad, try to just keep reminding yourself that within a few days or weeks you'll probably feel much better than you have in who-knows-how-long.
Also taper down the Ativan as you start the Nardil regimen. Fortunately Nardil has GABA-ergic properties as well, so you probably won't need to continue the Ativan.
" I also don't know if Nardil is only for severe SP or if it would help people like me, who are partially recovered from SP but are still not 'normal.'" -- Maybe you'll just need a lower dose. If it's severe enough to want it then it's probably severe enough to try it, right? i dunno. i've never been on Nardil but from everything i've read and heard it truly seems like the best "cure" for people with your (and my) kind of problems. i'm trying to be med-free now, just cuz i'm so freaking sick of them and all the extra crap involved with them (side effects, difficulty determining my identity, long-term or permanent changes [?], and eventual possible withdrawal). But if this last ditch, natural and healthy approach effort doesn't work, i'm giving myself over to Nardil. Anyway, sorry for all that...
i wish you the best.
Posted by Sarah S on March 18, 2003, at 20:00:35
In reply to Re: am I a candidate for Nardil?, posted by Questionmark on March 18, 2003, at 16:17:43
Thanks for replying guys. . .it means a lot to me since none of my friends or family can really help me with questions like these.
Well, I'm no stranger to the benzos. . .I've used Klonopin in the past and I'm currently on Ativan. Ativan has been great, in fact I think it's more responsible for my improvement than Wellbutrin, since I started WellB before I started Ativan, and WellB by itself made me feel anxious and jumpy.
If it would be possible to use some sort of benzo for the first four weeks or so on Nardil--you know, before it's started working--then I think I'd be fine. Does anyone know if that would be a bad interaction? Also, Xanax sounds like it could be a temporary stand-alone med since it apparently has both anti-anxiety and antidepressant qualities, but isn't Xanax hard to quit when you decide not to use it anymore?Thanks for the caffeine idea, but caffeine makes me anxious :( I'm thinking of trying a natural sedative/antidepressant in the interim, like kava.
Posted by ace on March 18, 2003, at 22:59:04
In reply to benzos ok on Nardil?, posted by Sarah S on March 18, 2003, at 20:00:35
Posted by utopizen on March 19, 2003, at 1:47:16
In reply to benzos ok on Nardil?, posted by Sarah S on March 18, 2003, at 20:00:35
Sarah,
I've had SP all my life. I first made an appt. with a psychopharmacologist when I was 18. I thought I had a mild case of shyness or something, and mostly was prompted to do something about it after seeing the Paxil ads and having hope it would do something.
Well at the end of my first interview, my pdoc was a bit convinced I may be shy but didn't have social phobia. He was about to get up and said, "well, you have friends, right? you seem to do fine." Then I answered, "no, I have no friends." And so he stopped getting up and wrote a script for Celexa.
Well since then I've tried Wellbutrin, a high dose of Effexor, Neurontin, Gabitril, Visatril, Atarax, Abilify, Risperdal, Inderal and other meds. Klonopin worked, but he only gave me enough to go to an occassional party with. Neurontin worked, but I talked in a monotone on it and it made me depressed.
I also have ADD, so the stims like Adderall or Ritalin made me really anxious. I eventually read up on all the stims and discovered Desoxyn (methamphetamine) was available, and for a slightly higher co-pay ($25 versus $5) I can get it legally through my p-doc. He trusts me not to go over it the dose said, which is a pretty big trust given the drug's abuse history.
Desoxyn didn't decrease my anxiety, but it didn't make me jittery and more anxious like the others-- I can barely tell it's in me except that I can focus and can read and write easily. Nice thing about ADD is that in treating myself I end up better than well almost-- never writer's block on Desoxyn, that's for sure. And the palpations (heart pounding) are much more benign.
If anything, because it's softer on my heart, I'd consider it "safer" than regular amphetamines like Adderall or Dexedrine. I would not take it if you have an addictive personality, since taking high doses does make you super happy (I did this twice just because I'm curious on how medicines affect me, but never had the desire to repeat it).
My doc wants me to see his colleague now that it's been a year and a half and he says after I had a consult with his colleague a few months ago, I seem to have more faith in him. He's admitted he's not as experienced in treating social anxiety as his colleague because his collague focuses a lot on it and researches it so much. They're both top psychopharmacologists in Boston, just the one I'm seeing now doesn't have too much knowledge in social anxiety beyond the typical pdoc. This other pdoc suggested Nardil, but I reminded him of the problem with it and stims, and he seemed to do a "oh yeah, you're right" and backed away... I don't feel comfortable with methamphetamine and Nardil anyway, but I'll keep it open as a possibility.
Klonopin does work, better than well for sure, for me. Friends of mine at parties can't get over how outgoing and smooth I am around girls without any alcohol, talking in a way their "normal" mental state doesn't have them do. I'll probably go on Klonopin long-term while trying out extremely low doses of antipsychotics and an antidepressant, with an MAOI in the possibility. But I don't see the need for an MAOI if my ADD requires a stim, Klonopin works effectively, and there's some chance an AD and AP might give me some long-term treatment.
I'm not sure if antipsychotics are worth my investment, because .5mg of Risperdal really knocked me out. But my doc told me I can always try another or lower the dose more, and that it takes 3 weeks to kick in. Abilify didn't make me tired, but didn't make me anxious after 2 weeks with athkasia, so I decided to stop it. I might want to try that out again with Klonopin for the anxiety and see if the anxiety goes away after a month.
In the meantime, I just started 20mg of Paxil tonight (it's the regular kind, I don't know what's so special about the CR but my doc didn't prescribe it anyway). I doubt it'll do anything, and if it does, it'll be combined with an AP and Klonopin by that time most likely so I won't even know if it has done anything. In a month or two, I'll likely be on Klonopin long-term, just in time for an internship for me.
This is the end of the thread.
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