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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by AndrewB on June 11, 2000, at 7:15:54
Dwight,
How to treat social phobia. I have 4 drug suggestions. Remember do only one drug trial at a time so you can be sure what is doing what! By the way, if this seems like a lot of medicines, remember that studies indicate that social anxiety may involve dysregulation of multiple receptor systems (GABA, certain serotonin receptors, D2-D3, and possibly [I haven’t seen a study for this] alpha andrenergic). The side effects should be minimal and all these med.s are relatively inexpensive.
1) Switch out the neurontin for klonopin. I’ve taken the neurontin. The memory loss is unacceptable . I would think that as a writer you find this side effect troublesome. I have seen two posters on this board say that low dose klonopin lacks cognitive and other side effects when combined with an arousal agent. The latest such post is from Rick. See the post entitled ‘Social Phobia Cocktail, Wow!’ In addition, I remember that one clinic, the Anxiety Network I think, rated klonopin as their #1 social anxiety medicine. They didn’t think much of SSRIs. The one study done on it as a social anxiety med showed it to have, if I remember right, around an 80% effective rate. At low doses, addiction is not a real issue, but withdrawal still needs to be tapered and slow.
2) Try adrafinil again but before you do try Naphazoline to determine if you respond will respond to adrafinil. For more info. on Naph., see my post entitled ‘For those interested in Adrafinil or Reboxetine’. Remember that adrafinil requires a liver test.
3) Try your amisulpride. Give it a 15 day trial. If you are like me you will see improvement in less than a week, but some people take longer. It should make you more open, more social, and make you feel less threatened by others. Dwight, where did you order your amisulpride from? Others who would like more info. on amisulpride can email me at andrewb@seanet.com for an information piece I have put together.
4) Start taking 5 mg. selegiline per day. I don’t know if this will help much but you can give it a try. I believe that the right form of dopaminergic enhancement will increase confidence and boldness (too much will induce mania). I’m currently experimenting with finding such a dopaminergic enhancer. Until I do, deprenyl will have to do.
Below are answers to your other questions.
Amisulpride does not cause weight gain in men. I am told that it is an insignificant problem in women too, but I would like that verified. It does not cause constipation or memory problems. Expect no side effects in men except for sedation. I do not know how common sedation is (for others it has a subtle arousing effect), but I suggest, if sedation occurs without an antidepressant effect, to cut the dosage down.
You can take amisulpride with adderal. Anthony is taking it with ritalin, so it seems to be okay. Adderal and amisulpride both stimulate the striatal D2 receptors. Is this a bad thing or a good thing. I can’t say but personally I have not experienced any (other than transitory) side effects from strong striatal and limbic system D2-D3 stimulation. Overstimulation of other dopamine receptors or receptors in other parts of parts of the brain is more problematic for me.
Adrafinil needs 2 to 3 weeks at its effective dosage to kick in. You can gauge nothing of its effect in a few days. Anything you experience during the first few days on it is in all likelihood transitory. Does adrafinil cause weight gain? No.
Adrafinil does not affect dopamine at all. It does however affect norepinephrine as does adderal. This means that either adrafinil’s or adderal’s dosage would need to be adjusted downward when both are taken together.
In general, I wouldn’t let weight gain be the deciding factor on whether or not you use adderal and how much you use. I understand that weight gain is very important to you but there are other options out there for weight control. I suggest you check out 7-Keto DHEA. A study has shown that at doses of 200mg./day people lose weight on it. Unlike normal DHEA, it has no side effects. I take it myself. The most economical form is the 100mg. capsules.
Does Adderal help you with your ADD and your thinking? What are the symptoms of inattentive ADD. I am interested to know. Does adderal cause any anxiety.
Let me know how it goes,
AndrewB
Posted by Dwight on June 12, 2000, at 22:11:03
In reply to Dwight: social anxiety meds, posted by AndrewB on June 11, 2000, at 7:15:54
Andrew,Thanks for all the tips. What you said makes sense. I'll go to the health food store and get some of 7 keto DHEA. I used to take the regular form of DHEA and although it didn't reduce appetite I noticed a definite improvement in muscle tone. I'll give the adrafinil another shot for a longer time period. I didn't know it could take so long to take effect. You have some good tips here. One question: what's the dosage for adrafinil? I'll keep you posted.
Thanks
Dwight
> Dwight,
>
> How to treat social phobia. I have 4 drug suggestions. Remember do only one drug trial at a time so you can be sure what is doing what! By the way, if this seems like a lot of medicines, remember that studies indicate that social anxiety may involve dysregulation of multiple receptor systems (GABA, certain serotonin receptors, D2-D3, and possibly [I haven’t seen a study for this] alpha andrenergic). The side effects should be minimal and all these med.s are relatively inexpensive.
>
> 1) Switch out the neurontin for klonopin. I’ve taken the neurontin. The memory loss is unacceptable . I would think that as a writer you find this side effect troublesome. I have seen two posters on this board say that low dose klonopin lacks cognitive and other side effects when combined with an arousal agent. The latest such post is from Rick. See the post entitled ‘Social Phobia Cocktail, Wow!’ In addition, I remember that one clinic, the Anxiety Network I think, rated klonopin as their #1 social anxiety medicine. They didn’t think much of SSRIs. The one study done on it as a social anxiety med showed it to have, if I remember right, around an 80% effective rate. At low doses, addiction is not a real issue, but withdrawal still needs to be tapered and slow.
>
> 2) Try adrafinil again but before you do try Naphazoline to determine if you respond will respond to adrafinil. For more info. on Naph., see my post entitled ‘For those interested in Adrafinil or Reboxetine’. Remember that adrafinil requires a liver test.
>
> 3) Try your amisulpride. Give it a 15 day trial. If you are like me you will see improvement in less than a week, but some people take longer. It should make you more open, more social, and make you feel less threatened by others. Dwight, where did you order your amisulpride from? Others who would like more info. on amisulpride can email me at andrewb@seanet.com for an information piece I have put together.
>
> 4) Start taking 5 mg. selegiline per day. I don’t know if this will help much but you can give it a try. I believe that the right form of dopaminergic enhancement will increase confidence and boldness (too much will induce mania). I’m currently experimenting with finding such a dopaminergic enhancer. Until I do, deprenyl will have to do.
>
> Below are answers to your other questions.
>
> Amisulpride does not cause weight gain in men. I am told that it is an insignificant problem in women too, but I would like that verified. It does not cause constipation or memory problems. Expect no side effects in men except for sedation. I do not know how common sedation is (for others it has a subtle arousing effect), but I suggest, if sedation occurs without an antidepressant effect, to cut the dosage down.
>
> You can take amisulpride with adderal. Anthony is taking it with ritalin, so it seems to be okay. Adderal and amisulpride both stimulate the striatal D2 receptors. Is this a bad thing or a good thing. I can’t say but personally I have not experienced any (other than transitory) side effects from strong striatal and limbic system D2-D3 stimulation. Overstimulation of other dopamine receptors or receptors in other parts of parts of the brain is more problematic for me.
>
> Adrafinil needs 2 to 3 weeks at its effective dosage to kick in. You can gauge nothing of its effect in a few days. Anything you experience during the first few days on it is in all likelihood transitory. Does adrafinil cause weight gain? No.
>
> Adrafinil does not affect dopamine at all. It does however affect norepinephrine as does adderal. This means that either adrafinil’s or adderal’s dosage would need to be adjusted downward when both are taken together.
>
> In general, I wouldn’t let weight gain be the deciding factor on whether or not you use adderal and how much you use. I understand that weight gain is very important to you but there are other options out there for weight control. I suggest you check out 7-Keto DHEA. A study has shown that at doses of 200mg./day people lose weight on it. Unlike normal DHEA, it has no side effects. I take it myself. The most economical form is the 100mg. capsules.
>
> Does Adderal help you with your ADD and your thinking? What are the symptoms of inattentive ADD. I am interested to know. Does adderal cause any anxiety.
>
> Let me know how it goes,
>
> AndrewB
Posted by Maniz on October 31, 2000, at 19:51:23
In reply to Andrew: social anxiety meds » AndrewB, posted by Dwight on June 12, 2000, at 22:11:03
Wow AndrewB! This is VERY interesting...
I respond very well to naphazoline. I feel it clears my head.
I read your previous post.
I tried naphazoline as a nose descongestant. I did not try the eye drops. I think nasal aplication is much more easy (and should be cheaper, 15$ is too much for a 3$ product).
Unfortunately, there are cautions (from the packet insert):
*use ONE drop into each nostril every 4 hours
*use only for 4 or 5 days
*use can aggravate nasal congestionI would suggest using the eye drops into the nose if you can´t find nose drops.
I was thinking in trying naphazoline via oral, diluting in water or even under the tongue to prevent the congestion side effect. What do you think?.
One thing that intrigues me is how some stimulants can have a good effect on anxious people (like DMAE for some). Maybe having anxiety for long periods depletes transmitters or affect receptors?
Would ephedrine from the herb ephedra or Ma Huan have a similar effect to naphazoline?.
Maybe ephedra or naphazoline are safer (and way much cheaper) alternatives to Adrafinil.
Another alternative could be amino acids like l-phenilalanine or l-tyrosine (or better the acetyl form) as they are NE precursors (counting on NE being an adrenergic).
I will very much value any comment.
Thanks
> 2) Try adrafinil again but before you do try Naphazoline to determine if you respond will respond to adrafinil. For more info. on Naph., see my post entitled ‘For those interested in Adrafinil or Reboxetine’. Remember that adrafinil requires a liver test.
Posted by AndrewB on November 1, 2000, at 1:17:42
In reply to naphazoline AndrewBRe: Andrew: social anxiety meds, posted by Maniz on October 31, 2000, at 19:51:23
Naphazoline can create a good arousal effect in some people.
Rebound nasal congestion is a concern with nasal drops.
Eye drops are therefore less problematic.
Price may not be a problem. S.D. posted on 6-15 with the heading 'BauschLomb All Clear AR has Naph. .03% for $4'.
Sublingual administration may or may not be effective. Can liquid preperations be absorbed effectively sublingually? Let me know if you try this mode though. Oral ingestion I wouldn't bother with.
Note that Naphazoline can be effective because it is an Alpha 1 agonist. Therefore it works on a very specific part of the andrenergic (NE) system. General upregulation of NE activity may not have the same beneficial effects.
Specifically, ephedra should not be used as an arousal agent because, due to its mode of action, it rapidly causes tolerance and depletion of NE.
Many people will expereince tolerance to the effects fo Naphazoline overtime. Some don't though and Dr. Goldstein has indicated that in such cases it can be used on an ongoing basis as an arousal agent.
Tyrosine is ususually ineffective. Though it is converted to dopamine and NE, the body usually has sufficient quantities of this amino acid. A rate limiting step of converting the tyrosine to the neurotransmitters usually prevents supplemental tyrosine from raising NE and dopamine levels.
L-phenylalanine can be an arousal agent in some. Some will expereince anxiety, agitation or other neg. side effects with it. Some evidence indicates that phenylalanine is not effective for long-term use.
A positive response to Naphazoline may indicate a positive response to the NE reuptake inhibitor reboxetine.
Some people experience less anxiety on some NE meds, most notably clonidine. Naphazoline and Rebox are unlikely to reduce anxiety.
AndrewB
Posted by Maniz on November 3, 2000, at 16:21:20
In reply to Re: naphazoline AndrewBRe: Andrew: social anxiety meds, posted by AndrewB on November 1, 2000, at 1:17:42
Hi,
I tried the naphazoline under the tongue (two drops).
I think it works. It is subtle so it is a bit subjective, but after trying it the second time I found I was doing things, especially like putting order in my home.
Side effect, possibly a bit nervous like feeling blood pumps, sory I can not tell more precicely.
I do not know what could be the problem with sublingual administration. Rebound congestion?.
Regarding eye or nasal drops, the Merk site mentions the possibility of the same side effects for both.
I searched for oral administration of naphazoline and could not find much.
Another drug mentioned as a an alpha 1 agonist is phenylephrine which is administered orally for the same casses as naphazoline.
> Naphazoline can create a good arousal effect in some people.
>
> Rebound nasal congestion is a concern with nasal drops.
>
> Eye drops are therefore less problematic.
>
> Price may not be a problem. S.D. posted on 6-15 with the heading 'BauschLomb All Clear AR has Naph. .03% for $4'.
>
> Sublingual administration may or may not be effective. Can liquid preperations be absorbed effectively sublingually? Let me know if you try this mode though. Oral ingestion I wouldn't bother with.
>
> Note that Naphazoline can be effective because it is an Alpha 1 agonist. Therefore it works on a very specific part of the andrenergic (NE) system. General upregulation of NE activity may not have the same beneficial effects.
>
> Specifically, ephedra should not be used as an arousal agent because, due to its mode of action, it rapidly causes tolerance and depletion of NE.
>
> Many people will expereince tolerance to the effects fo Naphazoline overtime. Some don't though and Dr. Goldstein has indicated that in such cases it can be used on an ongoing basis as an arousal agent.
>
> Tyrosine is ususually ineffective. Though it is converted to dopamine and NE, the body usually has sufficient quantities of this amino acid. A rate limiting step of converting the tyrosine to the neurotransmitters usually prevents supplemental tyrosine from raising NE and dopamine levels.
>
> L-phenylalanine can be an arousal agent in some. Some will expereince anxiety, agitation or other neg. side effects with it. Some evidence indicates that phenylalanine is not effective for long-term use.
>
> A positive response to Naphazoline may indicate a positive response to the NE reuptake inhibitor reboxetine.
>
> Some people experience less anxiety on some NE meds, most notably clonidine. Naphazoline and Rebox are unlikely to reduce anxiety.
>
> AndrewB
This is the end of the thread.
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