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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by Ted Brosnan on November 3, 2004, at 14:58:25
How does stimulants like d-amphetamine or methylphenidate (ritalin) affects your SA? Does it make you paranoid, more anxious or more confident and pro social?!
Thanks for input!
Ted.
Posted by Laree on November 3, 2004, at 16:16:47
In reply to Stimulants and Social Anxiety?, posted by Ted Brosnan on November 3, 2004, at 14:58:25
I think it depends on the stimulant and one's personal reaction(s) to it. Ritalin made me feel incredibly anxious, but Adderall doesn't give me anxiety. When I take the Adderall I am usually more pro-social. I have had some slight social anxiety for years, even before I started taking Adderall for ADHD.
> How does stimulants like d-amphetamine or methylphenidate (ritalin) affects your SA? Does it make you paranoid, more anxious or more confident and pro social?!
>
> Thanks for input!
> Ted.
Posted by thinkfast on November 4, 2004, at 5:52:18
In reply to Stimulants and Social Anxiety?, posted by Ted Brosnan on November 3, 2004, at 14:58:25
There could be no better social anxiety drug than those you listed..for me anyway. They relieve my anxiety almost completely.
Posted by TheOutsider on November 4, 2004, at 6:19:11
In reply to Re: Stimulants and Social Anxiety?, posted by thinkfast on November 4, 2004, at 5:52:18
I find that different stimulents effect my social anxiety in different ways.
Caffein makes me more socialy anxious.
Dexedrine on the other hand is pro social, at least in the right dose, to much makes me paraniod
Posted by dove on November 4, 2004, at 10:12:24
In reply to Re: Stimulants and Social Anxiety?, posted by TheOutsider on November 4, 2004, at 6:19:11
I think it depends on if you're taking it chronically, or once in a while. When I would run out ($$ issues) and only take it 3 or 4 times a month, it was slightly pro-social. However, when taken everyday, it makes me very blah towards people, easily over-startled, and nearly anti-social (along with residual anxiety).
Higher amounts increase these effects, and small doses seem to be desirable. If I have to do a social function I take less the day before and the day of the event.
(I've taken Ritalin and am currently on Adderall)
dove
Posted by Eljakeo25 on November 4, 2004, at 10:47:30
In reply to Stimulants and Social Anxiety?, posted by Ted Brosnan on November 3, 2004, at 14:58:25
I guess it depends on how your ADHD is "wired" They say Social anxiety often exists with ADHD as both disorders may be in the broad range of a Dopamine Hypofunction Disorder. Adderall relaxes me in front of my peers, thus feeling more friendly and pro-social. Also clinical social anxiety may stem from imbalances with serotonin and GABA. Non of the anti depressants never worked for me, however I take Klonopin, which I believe it is the "gold standard" for long term treatment of SA. I have been on it for a a couple years and it still works, and I take it along with the adderall, and I am very pro social in classroom discusions and not tense around long groups of people, however I still suffer from the psychological aspect of SA, something where the medications don't seem to help much with and that is actually getting my self out there to get involved with groups or oganizations so I can meet people. I am an extravert. You can be an extravert and have social anxiety at the same time, that whats makes SA really frustrating!
Posted by J. Backer on November 4, 2004, at 11:07:29
In reply to Re: Stimulants and Social Anxiety?, posted by Eljakeo25 on November 4, 2004, at 10:47:30
my experiances with SAD and stimulants seem very similar to others. On ritalin i become more shy and anxious,but on dexadrine i become pro-social and calm/relaxed. if i take too much dexadrine i become pranoid and when i crash i do get some rebound anxiety but its not bad.
peace J
Posted by jclint on November 4, 2004, at 18:36:08
In reply to Re: Stimulants and Social Anxiety?, posted by Eljakeo25 on November 4, 2004, at 10:47:30
>I am an extravert. You can be an extravert and have social anxiety at the same time, that whats makes SA really frustrating!
I feel that one dude! Its sod's law aint it?
Interested to hear about the use of stimulants, I'll mention them at my next doc appointment.
Posted by thinkfast on November 5, 2004, at 10:01:42
In reply to Re: Stimulants and Social Anxiety?, posted by jclint on November 4, 2004, at 18:36:08
I thought I would add Adderal and Ritalin both help with my SA, but as with others, Caffeine & diet pills make me anxious. The Ritalin worked better than the Adderall because that stuff made me feel way to speedy. Ritalin doesn't seem have the same effect.
Posted by jboud24 on November 5, 2004, at 14:10:54
In reply to Stimulants and Social Anxiety?, posted by Ted Brosnan on November 3, 2004, at 14:58:25
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
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
>
Posted by zeugma on November 6, 2004, at 6:51:54
In reply to Re: Stimulants and Social Anxiety? » jboud24, posted by Iansf on November 5, 2004, at 19:30:27
> 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
>
John,did you ever ask him for a reason for never prescribing benzodiazepines? It sounds irrational on his part.
I, myself, had to jump through hoops to get my pdoc to precribe clonazepam. However, when my social anxiety was a topic during my first year of treatment, he would mention benzodiazepines as an option, but told me SSRI's were generally used first. But there is a difference between saying there is an option one is reluctant to use, and categorically saying NEVER.
I suppose he has never treated any patient with narcolepsy or ADHD, either, since he also refuses to prescribe stimulants. Interesting that someone can undergo psychiatric training without having heard of these disorders.
For what it's worth, Ritalin makes me more anxious, not less. Provigil is a stim that is actually anxiolytic- but I doubt he has heard of that drug, as it is FDA-approved for narcolepsy and apparently he knows nothing of that disorder.
Is it possible to speak to a representative of your health provider and file a complaint against him? It sounds like you have grounds to do so.
-z
> > 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
> >
>
>
Posted by banga on November 6, 2004, at 11:53:36
In reply to Re: Stimulants and Social Anxiety? » Iansf, posted by zeugma on November 6, 2004, at 6:51:54
Can anyone comment on how Provigil affected anxiety?
Posted by shefast on November 7, 2004, at 10:51:06
In reply to Re: Stimulants and Social Anxiety? » jboud24, posted by Iansf on November 5, 2004, at 19:30:27
> 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
john - have you tried your regular physician? they can prescribe these things, too!and i'd file a grievance against him as well.
Posted by Iansf on November 7, 2004, at 13:00:54
In reply to Re: Stimulants and Social Anxiety?, posted by shefast on November 7, 2004, at 10:51:06
> > 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
>
>
> john - have you tried your regular physician? they can prescribe these things, too!
>
> and i'd file a grievance against him as well.
I have filed a grievance, but since he's the only psychiatrist in their system I think they're unlikely to act. My GP refuses to prescribe psychiatric meds. My former GP was very knowledgeable and open in this area, but she is not in my current plan. I considered shifting GPs, but I can't get beyond the administrative staff of the ones I called so couldn't find out if he or she would prescribe psych meds. Plus I like my current GP as a physician and don't want to risk ending up with one I don't like.
Posted by Laree on November 9, 2004, at 20:16:56
In reply to Re: Stimulants and Social Anxiety? » shefast, posted by Iansf on November 7, 2004, at 13:00:54
Just a thought, but maybe your pdoc has run into some problems in the past rx'ing controlled meds like benzos and stimulants. Maybe some of his patients have become addicted in the past, or it could be that he has suffered from addiction(s) as well. This happened to me once when I asked a specialist about Vicodin for severe back pain (I had been on it for a while at the time from a former dr., anyway) and he kind of flipped out...Later I found out that he had been in a rehab center for his own (drug) addiction(s).
It is possible your pdoc might be under some scrutiny from a higher authority and may be trying to "keep everything clean" (like his record)...if you get my drift...
I could be WAY off-base here, but it is just something that crossed my mind. At any rate, he sounds very close-minded. You might want to think about shelling out the extra $ for a different pdoc or switching plans if at all possible. Good luck!
Best,
L.
> > > 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
> >
> >
> > john - have you tried your regular physician? they can prescribe these things, too!
> >
> > and i'd file a grievance against him as well.
>
>
> I have filed a grievance, but since he's the only psychiatrist in their system I think they're unlikely to act. My GP refuses to prescribe psychiatric meds. My former GP was very knowledgeable and open in this area, but she is not in my current plan. I considered shifting GPs, but I can't get beyond the administrative staff of the ones I called so couldn't find out if he or she would prescribe psych meds. Plus I like my current GP as a physician and don't want to risk ending up with one I don't like.
Posted by geno on November 11, 2004, at 8:25:47
In reply to Re: Stimulants and Social Anxiety?, posted by J. Backer on November 4, 2004, at 11:07:29
Good posts all. I have to jump in here, because this is a very important subject iv researched, and seems to be different for everyone, but its in my opinion a little bit of every neurotransmitter, but not alot of one nor too little of another. Ya complicating.
ALthough for me, for instance, GHB,which was about the best social dishinibitor ever, like alcohol x 10, but there are about 10 different pharmocolgy facts on it. I probably know the correct factor, and yet, then from alcohol to g, to opiates, which basically all incorperate dopamine from the Nucleaus accumbens.
Naturally, i always thought it was seratonin drugs which would make me social, but no. But lack of seratonin, is negative. So a combonation of meds for extreme social phobia, like an SSRI, plus Adderall Dexedrine, and Klonopin, I find are the best for this. BUT , IT WILL not be like ILLICIT drugs such as opiates G, alcohol. I used to think that way, and try to mix this and that, ending up overstimulated or too tired, etc.
I would have to say, as posted by one of the above, GABA and Seratonin are involved, but Dopamine release from the N A. would be suffice.
Opiate receptor agonists are another one, which is why alot of people use opiates and are addicted. Plus they release that Dopamine "reward center" and some serotonin. Meth is a big one, due to the release of so much Dopamine and serotonin. But even Adderall, the effects wear off, and the ADD effects remain, but you dont keep feeling like that, unless you keep increasing the dose.
But iv tried Zoloft, for 1 yr, by itself, with not much luck. Klonopin by itself makes me down and tired. Adderall, is probably or I should Say Ritalin ADDerall DEX, are very good social inhibitors, although ritalin for some is not, with some klnopin or xanax to ease any anxiety , but not alot where you block the effects. After that, maybe MAO's but i never took them, but heard they do great for SP. Then Schedule I drugs are schedule I because of addiction, and someone feeling social, happy and euphoric, is gonna abuse it, more soe, so If they came out with a drug next year, which made you "feel Great" social and what not, it would be banned or scheduled very High like 1 or 2. Its seems like that anyway.geno
Posted by rina on August 26, 2007, at 16:25:03
In reply to Re: Stimulants and Social Anxiety?, posted by geno on November 11, 2004, at 8:25:47
geno, i ran across an old response to this post and i was curious about something you said in it about a drug combo. my adderall is giving me daytime sleepiness with no mental alertness at all so my doc is thinking of adding dexedrine to the mix. do you think this is a good combo for ADD?
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