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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by becksA on September 13, 2004, at 15:56:48
at my last pdoc appt., she told me to get some bloodwork done so we could possibly pursue Lithium or Lamictal, I forget which needed the bloodwork. Anyway, I'm questioning whether or not it really is bipolarity or serious social anxiety. I don't have any of the major bipolar symptoms. (Nothing comes in waves...it's just been steady, one on one social anxiety, and it's gotten extreme.) Therefore I haven't gotten any bloodwork done, and I'm going to ask the pdoc to put me on an MAOI. I'm very hesitant to get excited about any positive results however, because NOTHING has worked up until this point, and we've tried just about everything. Including heavy doses of Xanax, all the SSRI's, lately even tackling GABA. Nothing has helped. Everything has merely put a screen over the problem, rather than fixing it at the roots, and I can always feel the anxiety coming back in full force, simply because I know it's still there. Is this the right thing to do? I've read MAOI's are for people for which nothing else has worked.
Thanks
Posted by utopizen on September 13, 2004, at 17:36:28
In reply to Social Anxiety or BiPolar?, posted by becksA on September 13, 2004, at 15:56:48
Try the Lamictal or Lithium first. It may very well help your anxiety.
Have you tried an antipsychotic as well? And combining an antipsychotic with a mood stabalizer and/or SSRI often helps one another be more effective. One pill at a time approaches rarely work in the field.
But nevertheless, try the Lamictal first. You may not have bipolar, but you may respond to its antidepressant/antianxiety effects anyhow. It's worth a shot. Give it some time, and a few months down the road after exausting antipsychotics and, um, did you try Klonopin??? then MAOIs may be an option for you. But one thing at a time! =)
Posted by HappyGirl on September 13, 2004, at 17:53:18
In reply to Social Anxiety or BiPolar?, posted by becksA on September 13, 2004, at 15:56:48
Hi:
In my knowledge, when any of meds. does NOT offer any relief, like the case of yours, some of pdocs. put Lithium and other mood-stabilizers to see if there is some of Bipolar trace. Because, Anxiety is a BIG part of Bipolarity in some of Bpers. All of Bpers are NOT same symptoms, ... some have more 'high/mania,' while other are mostly depression that is often mistaken 'unipolar.'In regard to 'blood-work,' ... Lithium needs. Before and after Lithium regimen is required due to whether you are safe to take the Lithium. In my case, I did at the beginning, ... maybe two months' interval and gradually once six months, even just once a year. Even this, bloodwork also all depends on person to person, ... probably also the pdoc.'s concern over this.
H.G.
Posted by becksA on September 13, 2004, at 18:22:20
In reply to Re: Social Anxiety or BiPolar?, posted by HappyGirl on September 13, 2004, at 17:53:18
Hmmm, seems like I might as well try out the Lithium before going the MAOI route.
Posted by King Vultan on September 13, 2004, at 18:41:04
In reply to Social Anxiety or BiPolar?, posted by becksA on September 13, 2004, at 15:56:48
I have social phobia and have had good luck with both of the MAOIs, but it looks like Parnate is probably going to wind up working better in my particular case. However, I think my problem is a little atypical, as it also has some panic attack elements (particularly, runaway sweating). SSRIs had some effect but didn't really address the fundamental problem, and I didn't make real progress until I went over to drugs that work strongly on norepinephrine, such as some of the tricyclics.
As for the MAOIs, Nardil is more anxiolytic than Parnate, as it is very serotonergic and also works on GABA. Parnate is more dopaminergic, and in my particular case, seems to give me extra assertiveness and self confidence, or at least more than Nardil did. However, my general anxiety levels are relatively low for someone who also suffers from depression, but that's not to say that they aren't even lower on either of these two drugs. I don't have any experience with mood stabilizers and so lack that perspective, and I have only taken benzos for sleep.
Todd
Posted by becksA on September 13, 2004, at 19:44:10
In reply to Re: Social Anxiety or BiPolar?, posted by King Vultan on September 13, 2004, at 18:41:04
Another interesting angle. Thanks
Posted by Sad Panda on September 13, 2004, at 21:10:46
In reply to Social Anxiety or BiPolar?, posted by becksA on September 13, 2004, at 15:56:48
> at my last pdoc appt., she told me to get some bloodwork done so we could possibly pursue Lithium or Lamictal, I forget which needed the bloodwork. Anyway, I'm questioning whether or not it really is bipolarity or serious social anxiety. I don't have any of the major bipolar symptoms. (Nothing comes in waves...it's just been steady, one on one social anxiety, and it's gotten extreme.) Therefore I haven't gotten any bloodwork done, and I'm going to ask the pdoc to put me on an MAOI. I'm very hesitant to get excited about any positive results however, because NOTHING has worked up until this point, and we've tried just about everything. Including heavy doses of Xanax, all the SSRI's, lately even tackling GABA. Nothing has helped. Everything has merely put a screen over the problem, rather than fixing it at the roots, and I can always feel the anxiety coming back in full force, simply because I know it's still there. Is this the right thing to do? I've read MAOI's are for people for which nothing else has worked.
>
> Thanks
>
>I would try a 5-HT2A antagonist. The TCA Nortriptyline or an AP like Risperdal or Zyprexa would be worth trying if the GABA drugs or SSRI's don't work.
Cheers,
Paul.
Posted by theo on September 14, 2004, at 13:52:54
In reply to Social Anxiety or BiPolar?, posted by becksA on September 13, 2004, at 15:56:48
Keppra has helped me with anxiety, I would ask your doc what they think about.
Posted by CraigD on September 15, 2004, at 12:12:52
In reply to Re: Social Anxiety or BiPolar?, posted by Sad Panda on September 13, 2004, at 21:10:46
Hey all,
I'm coming at things from the opposite angle - constantly trying to treat my social anxiety while ignoring the fact my dad and sis are BP.
I've added lamictal and cut back on my Celexa and it's worked wonders for my anxiety. Give that a try first. It can't hurt (but titrate up slowly) I'd also suggest taking your dosage in the am instead of at night, as it kept me awake with disturbing dreams.
Cheers and good luck. So many of these "diagnosises" overlap and are tough to distinguish, ya know?
This is the end of the thread.
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