![[dr. bob]](/dr-bob-sm.gif)
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 mxrider on August 11, 2004, at 19:19:10
Hello all.
This is my first post. I've been lurking for a few weeks now. I have had social anxiety and atypical depression since my teen years, I guess that makes it about 20 years! I started klonopin and Paxil a few years ago on my own (online ordering, ain't it great!). Anyway, the klonopin is a life saver for SA, but the paxil cr didn't help much with depression at low dosages, and, at higher dosages I felt more anxious and generally bad. I recently started seeing a Psych...I guess that's my Pdoc?? Anyway we tried lexapro w/ the klonopin and the lex was terrible for me. I spent a month on the lex. The agitation, and insomnia were intolerable(I can usually tolerate meds pretty well). We (I:)) decided to try Remeron w/ the clonaz. Heavy sedation at first, but, I understand it passes. Love the sleep anyway. Might add Effexor later for some morning "activation" later. Anyone in a similar boat?? Looking foward to similar experience.
Posted by malthus on August 11, 2004, at 20:12:16
In reply to social phobia atypical depression, posted by mxrider on August 11, 2004, at 19:19:10
Welcome to PB!
My doctor specifically didn't want to put me on Paxil because she said it was too activating. I've been on Effexor for about four months and find that it is not activating at all for me. I too tried Seroquel but it made me so tired and groggy in the morning; I had to go off it. Now I'm on Lamictal as a mood stabilizer but the doctor is keeping me on the Effexor for depression. Hope Effexor works for you!
best, malthus
Posted by malthus on August 11, 2004, at 20:20:24
In reply to Re: social phobia atypical depression, posted by malthus on August 11, 2004, at 20:12:16
Sorry MXRider:
it was the remeron that made me groggy, not seroquel. i've tried so many meds that i get them mixed up. i have been taking klon. for years for panic and anxiety but think it has pooped out. doc is cutting me down but it takes a while to get out of the system. now i take ativan.
Posted by JahL on August 11, 2004, at 20:53:24
In reply to social phobia atypical depression, posted by mxrider on August 11, 2004, at 19:19:10
> Hello all.
Hi. Welcome to the show.
> This is my first post. I've been lurking for a few weeks now. I have had social anxiety and atypical depression since my teen years, I guess that makes it about 20 years! I started klonopin and Paxil a few years ago on my own (online ordering, ain't it great!). Anyway, the klonopin is a life saver for SA,
Atypical depression and social anxiety can go hand in hand, particularly since one of the defining features of the former is interpersonal rejection sensitivity.
It's great that the s. anxiety element of yr illness has been addressed (PS - I am the on-line king!).
> but the paxil cr didn't help much with depression at low dosages, and, at higher dosages I felt more anxious and generally bad.
The literature suggests that MAOIs are significantly more effective in terms of responsive and remission (72% as against 48% response rate in one important study; that's big!) than trycylics. Though SSRIs are nominally first line treatments for Atypical, I would imagine they they too are slightly inferior for this subtype of depression.
Of course with the MAOIs come the sometimes dangerous and unpleasant side effects, the main reason they are not first line. I have tried 3 MAOIs and my experiences tell me they deserve respect; they all exerted powerful effects upon me.
> We (I:)) decided to try Remeron w/ the clonaz. Heavy sedation at first, but, I understand it passes. Love the sleep anyway.
Remeron is sometimes prescribed purely for sedation at low doses (15mg?). It certainly helped me sleep. At higher doses NE activation (if my memory serves me correct) can eliminate these sedative qualities.
This isn't gospel - I haven't done any serious reading for a couple of years now - but it will hopefully give you something to think about.
Best of luck,
J.
Posted by jay on August 11, 2004, at 21:44:03
In reply to social phobia atypical depression, posted by mxrider on August 11, 2004, at 19:19:10
> Hello all.
>
> This is my first post. I've been lurking for a few weeks now. I have had social anxiety and atypical depression since my teen years, I guess that makes it about 20 years! I started klonopin and Paxil a few years ago on my own (online ordering, ain't it great!). Anyway, the klonopin is a life saver for SA, but the paxil cr didn't help much with depression at low dosages, and, at higher dosages I felt more anxious and generally bad. I recently started seeing a Psych...I guess that's my Pdoc?? Anyway we tried lexapro w/ the klonopin and the lex was terrible for me. I spent a month on the lex. The agitation, and insomnia were intolerable(I can usually tolerate meds pretty well). We (I:)) decided to try Remeron w/ the clonaz. Heavy sedation at first, but, I >understand it passes. Love the sleep anyway. >Might add Effexor later for some morning "activation" later. Anyone in a similar >boat?? Looking foward to similar experience.
>
>It seems to be a real trick...to find the right "brew", or "chemical mixture". I am not saying you said this...this is just an observation (I am talkative tonight :-) but for many of us, we come in with mental illness and really messed up lives. Some say treat the illness..and good life will follow. I honestly don't think that is quite true. The meds help with our sysmptoms, but if we don't deal with problems they will still get bigger and bigger, and then meds become useless under such weight.
I guess what I am saying...is that along with meds, even if we use a journal or have *someone* to talk to, you must talk about needed changes or nothing will get better.
Anyhow...sorry for the rant....it helps me too to write this stuff down. It sounds like you have a positive response with Remeron...so obviously stick with it. If you are gonna do Effexor..do it *very* slowly and start very low. A benzo like clonazepam during the day can keep the anxiety heat off of you. Sounds like you are doing good so far....best wishes..and please, let me/us know what you think (re: the above)
Best wishes,
Jay
Posted by T-rotten on August 12, 2004, at 4:10:36
In reply to social phobia atypical depression, posted by mxrider on August 11, 2004, at 19:19:10
> Hello all.
>
> This is my first post. I've been lurking for a few weeks now. I have had social anxiety and atypical depression since my teen years, I guess that makes it about 20 years! I started klonopin and Paxil a few years ago on my own (online ordering, ain't it great!). Anyway, the klonopin is a life saver for SA, but the paxil cr didn't help much with depression at low dosages, and, at higher dosages I felt more anxious and generally bad. I recently started seeing a Psych...I guess that's my Pdoc?? Anyway we tried lexapro w/ the klonopin and the lex was terrible for me. I spent a month on the lex. The agitation, and insomnia were intolerable(I can usually tolerate meds pretty well). We (I:)) decided to try Remeron w/ the clonaz. Heavy sedation at first, but, I understand it passes. Love the sleep anyway. Might add Effexor later for some morning "activation" later. Anyone in a similar boat?? Looking foward to similar experience.Well I am very similar at these points to you.
Klona is the #1 to the SP.
I already used SSRIs and Parnate and had not good results. Now Ixel(milnacipran) is showing very good work (plus some pamelor).
I'd say to you dont stay in remeron alone, and even not to stop it and go on effexor. Keep the remeron and add effexor cause this combo is very effective (I still like ixel more than venlafaxine anyway if you could get it).
Tanks.
Posted by pinky on August 12, 2004, at 6:47:55
In reply to Re: social phobia atypical depression, posted by T-rotten on August 12, 2004, at 4:10:36
How much klon are you all taking? Chew or swallow?
Posted by invisiblemanpa on August 12, 2004, at 8:33:36
In reply to Re: social phobia atypical depression, posted by pinky on August 12, 2004, at 6:47:55
Sounds like there are others out there just like me! I have been struggling with the same symptons for about 6 years and socail anxiety all of my adult life.....after trying numerous mixes I was started on Remeron...75 mg of Effexor, Ativan ..and..Temezapam for sleep...after about two weeks I felt the best that I had for years...ready to tackle the world and restart my career...I was able to interview, interact, exercise, etc...I accepted a position out of state in the hospitality industry in which I have my Masters...after two weeks of being back in chaos, facing the realism of bankruptcy...ie..not being able to rent, open a checking account, etc...plus the normal chaos of work...I could feel the darkness creeping up again and things started to shutdown..I could not focus, concentrate, very anxious..then I went out and did the old quick fix to make it go away and sat in my hotel room and binge drank and ended up in the er....now I am back, living with my Mother..faced my employer and quit and feel like worse than I did 6 months ago...I guess it will take time again to feel decent.....the darkness never goes away...the meds just push it deeper inside of us...and it is waiting for the right time to jump out again....well I will stay on the same med cocktail and pray for the best.....I can't even look at job boards now or imagine facing a new job like a did just a few weeks ago...
Posted by mxrider on August 12, 2004, at 9:45:07
In reply to Re: social phobia atypical depression, posted by invisiblemanpa on August 12, 2004, at 8:33:36
Sounds like there are a few others like me...I usually only take .5mg 2x's per day for SA, unless I have a special event or something.
Invisiblemanpa...I too have done the binge drinking thing, as you know, it just prolongs the agony. I was able to finally stop that (THE most important thing to do!) The other things will fall into place if we take it SLOW.Best of luck
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.