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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by jesus on February 5, 2003, at 20:13:58
a few months ago I got put on 10mg Lexapro for anxiety and depression.. I figured that since it was an ssri it'd be effective for my social phobia (which is really debilitating when you're a college student) while tackling depression and anxiety simultaneously.. ive been on lex for about two months now and its working ok for depression and but my social phobia is still pretty bad (even having a simple conversation with somebody is frightening to me).. anways, i guess that the lexapro probably won't be the thing that's going to help with this so, instead of asking my pdoc to push my script up to 20mg im going to ask him if he'd consider putting me on a different drug.. like i said in an earilier thread, I'd really like to give benzos a try b/c I hear they can really help with this sort of thing.. is this true? are there any other drugs that anybody knows of?
Posted by michael73 on February 5, 2003, at 21:58:14
In reply to Effective meds for Social Phobia?, posted by jesus on February 5, 2003, at 20:13:58
Hi, I took Anafranil for depression and OCD. I had problems with shyness and anxiety around people. Unexpectedly, Anafranil really helped with that but that may have been due to the treatment of the OCD. Maybe something to discuss with you pdoc. Side effects that made me quit it were a nervous tension (not really anxiety but an inability to relax) and difficulty urinating which sucked because paruresis was one of my biggest anxiety issues. I also was on Klonopin and that may have had something to do with my better social function but I don't think as much as the Anafranil. I had a lot of trouble in college with social anxiety and so feel for you. Good luck. Michael73
Posted by viridis on February 6, 2003, at 1:46:45
In reply to Effective meds for Social Phobia?, posted by jesus on February 5, 2003, at 20:13:58
I've had great success with Klonopin. It's a benzo (so many doctors may be reluctant to prescribe it) but it has very low abuse potential and is generally much easier to get than, say, Xanax. It works extremely well for me for anxiety and panic attacks (although I don't have SP) at the same dose I started with over a year and a half ago.
It may make you sleepy and/or uncoordinated at first, but those side effects quickly disappeared for me. And, since it's a benzo, if you do take it for any length of time and decide to stop you should do so gradually.
Good luck!
Posted by Bill L on February 6, 2003, at 9:11:41
In reply to Effective meds for Social Phobia?, posted by jesus on February 5, 2003, at 20:13:58
Jesus - I take 20 mg of Lexapro and it works really well for my social phobia. I do not think that benzos are going to help in your case. Check with your doctor. I would definitely raise the dose of Lexapro before taking a benzo in your situation.
Posted by utopizen on February 6, 2003, at 17:51:39
In reply to Re: Effective meds for Social Phobia?, posted by Bill L on February 6, 2003, at 9:11:41
> Jesus - I take 20 mg of Lexapro and it works really well for my social phobia. I do not think that benzos are going to help in your case. Check with your doctor. I would definitely raise the dose of Lexapro before taking a benzo in your situation.
>>
the majority of those who take an SSRI do not benefit for their social anxiety.Klonopin benefits 70-80%, so I'd really like to think how your basing your statement... Klonopin is obviously going to help someone with such a severe case of social phobia, where you may not have had such a severe case or were just lucky to have it be related to serotonin.
Posted by viridis on February 7, 2003, at 0:11:01
In reply to Re: Effective meds for Social Phobia?, posted by utopizen on February 6, 2003, at 17:51:39
Again, I can't speak specifically to SP, but I do have lots of experience with anxiety disorders, and I agree with Utopizen. You might be one of the lucky ones who benefits from SSRIs like Lexapro, but my experience with SSRIs has been awful. I prefer to stick with safer, more reliable drugs that have a longer track record, fewer side effects, and a much higher efficacy rate for anxiety problems. Benzos fit this profile, and Klonopin is the best for many (although of course, not all).
Posted by JonW on February 7, 2003, at 9:08:59
In reply to Re: Effective meds for Social Phobia?, posted by utopizen on February 6, 2003, at 17:51:39
> the majority of those who take an SSRI do not benefit for their social anxiety.
>
> Klonopin benefits 70-80%, so I'd really like to think how your basing your statement... Klonopin is obviously going to help someone with such a severe case of social phobia, where you may not have had such a severe case or were just lucky to have it be related to serotonin.I agree that Klonopin is an effective med for social anxiety, but I think you are overgeneralizing a bit. Just because a clinical trial shows improvement in 80% doesn't mean it will benefit 80% of the general population with SP. Also, how can you say the majority who take an SSRI do not get any benefit for SP? What is this based on? Actually, there have been far more trials confirming the efficacy of SSRIs than Klonopin. Neither Klonopin nor an SSRI will necessarily be effective for someone. Everyone responds differently. It is an overgeneralization and a seemingly baseless statement to say Klonopin will work for most and the SSRIs will not work for most. There is no magic pill yet, but there is a biological and psychological component to this disorder that can both be addressed. I know I'd appreciate it if you rephrased what you said.
Jon
Posted by utopizen on February 7, 2003, at 17:43:02
In reply to Overgeneralization » utopizen, posted by JonW on February 7, 2003, at 9:08:59
>I know I'd appreciate it if you rephrased what you said.
>
> JonJon,
Most only means greater than 50%. That's what I was basing it on. I was basing it on every clinical trial I ever read that the drug companies use to brag about their meds. So if the drug co.'s thing 30% (rather than most) is something to brag about, why should I make it up?
Obviously, most people don't get remission from SSRIs on their social anxiety, and I'm getting that DIRECTLY from the most highly acclaimed psychopharmacology department in the country-- MGH/Boston.
Here's the article:
http://www.mghmadi.org/curbside/index.htmlOh, and I'd like to ask you what you're basing the "general pop" figure on if not a clinical trial--- what, a Gallop poll? How is a clinical trial LESS of an indicator for what the general pop will find?
It's not even a generalization anyway, so how could it be an over-generalization?
Posted by JonW on February 8, 2003, at 0:55:09
In reply to Re: Overgeneralization, posted by utopizen on February 7, 2003, at 17:43:02
> Jon,
>
> Most only means greater than 50%. That's what I was basing it on. I was basing it on every clinical trial I ever read that the drug companies use to brag about their meds. So if the drug co.'s thing 30% (rather than most) is something to brag about, why should I make it up?I thought you were saying that they didn't exert any *effect* for most. I didn't know you were speaking in terms of remission. In any event, most clinical trials for SSRIs have response rates of 50% and greater. Paxil has the most research. I'm unsure where you are getting the 30% figure from.
> Obviously, most people don't get remission from SSRIs on their social anxiety, and I'm getting that DIRECTLY from the most highly acclaimed psychopharmacology department in the country-- MGH/Boston.
I think remission is something that requires CBT in combination with most any med for the majority of people with severe SP. At least until they come up with the magic pill.
> Oh, and I'd like to ask you what you're basing the "general pop" figure on if not a clinical trial--- what, a Gallop poll? How is a clinical trial LESS of an indicator for what the general pop will find?
Not that long ago I read an article that said the majority of outpatients don't qualify for clinical trials, and so naturally I wonder how important that is.
> It's not even a generalization anyway, so how could it be an over-generalization?
When you said most people with SP don't get any benefit from an SSRI it's an overgeneralization, but if we are talking about remission it is not. Anyway, I didn't mean to offend you in any way. I personally felt it was an overgeneralization I thought it should be phrased differently, but it's no big deal. I just don't want someone to think SSRIs are a waste of time because they serve as the cornerstone for remission for many people.
Jon
Posted by utopizen on February 8, 2003, at 15:54:41
In reply to Re: Overgeneralization » utopizen, posted by JonW on February 8, 2003, at 0:55:09
Jon,
Um, I've seen the Effexor trial press release from MGH and Joseph Biederman- it brags like crazy how 30% found efficacy. And I don't think Paxil is higher in efficacy, but maybe I'm wrong.
But that link I gave you gives a good overview of percentages. Plus, clinical trials disqualify many just because they don't often accept comorbid conditions unless it's comorbidity that's being studied. So I think that makes it more of an indicator for people with only one condition.
This is the end of the thread.
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