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.
poster:JahL
thread:376555
URL: http://www.dr-bob.org/babble/20040811/msgs/376618.html