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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 Annie on April 29, 2000, at 10:59:41
I've been reading through all the notes on this site, thanks for all the insight into Effexor XR etc. I just started taking Effexor XR for Social Anxiety, and wondered if anyone else has had this prescribed for this or only for depression? I was taking Buspar for 6 weeks, up to 40 mg/day and felt awfully sick, with little reduction in anxiety.
Posted by DC on April 29, 2000, at 21:13:14
In reply to Effexor XR Social Anxiety, posted by Annie on April 29, 2000, at 10:59:41
Annie,
I'll be interested to hear how effexor works for you since social anxiety is my main problem as well. Currently I take a combo of adderal, neurontin, and klonipan. You might ask about the neurontin--that one seemed to make a big difference right away. The main drug for social phobia is Nardil--I took it off an on for three years. But it caused horrible insomnia--corrected by high dose trazodone--and weight gain (30lbs). On my current combo I am getting similar results in terms of social confidence, have lost 25 lbs, and have more energy and mental quickness. Downside is that I have sometimes have a nagging feeling of urgency and don't feel "happy." None of ssri's helped me very much. Try the neurontin.
> I've been reading through all the notes on this site, thanks for all the insight into Effexor XR etc. I just started taking Effexor XR for Social Anxiety, and wondered if anyone else has had this prescribed for this or only for depression? I was taking Buspar for 6 weeks, up to 40 mg/day and felt awfully sick, with little reduction in anxiety.
Posted by Annie on May 1, 2000, at 23:25:14
In reply to Re: Effexor XR Social Anxiety, posted by DC on April 29, 2000, at 21:13:14
> Hey DC, thanks for the reply, I've had a hell of a time trying to post my messages and have repeated myself at least 3 times! Hopefully this gets to you. Will keep you posted re Effexor XR, my biggest issue with the social anxiety is that I blush like a lunatic, and it's driving me nuts. What have your symptoms been like? I wonder why my Dr. hasn't suggested the meds you are taking.
Posted by Rick on May 3, 2000, at 18:30:32
In reply to Re: Effexor XR Social Anxiety, posted by Annie on May 1, 2000, at 23:25:14
> > Hey DC, thanks for the reply, I've had a hell of a time trying to post my messages and have repeated myself at least 3 times! Hopefully this gets to you. Will keep you posted re Effexor XR, my biggest issue with the social anxiety is that I blush like a lunatic, and it's driving me nuts. What have your symptoms been like? I wonder why my Dr. hasn't suggested the meds you are taking.
Annie, these days the first medications usually tried for social anxiety are the SSRI antidepressants (especially Paxil, but also Zoloft, Prozac, Celexa, and Luvox). Some people do very well on them, although many suffer side effects (including initially WORSE anxiety) Many, if not all, of these side effects tend to resolve or become less bothersome within the first few weeks. Also, for some people, they can take eight weeks or more to begin working (if at all). The response to a given med vary greatly by person.
The antidepressant Effexor doesn't seem to be as commonly prescribed for Social Phobia. However,
Medline has a few smaller-scale studies on Effexor that showed a great deal of success in treating social phobia, especially among people who didn't respond to SSRI's. Also, I believe the manufacturer is undertaking larger-scale tests of effectiveness based on this evidence. Effexor acts partially through the same mechanism as the SSRI's (essentially making serotonin more "available" to the brain), but it also has some different properties.The reason the MAOI antidepressant Nardil is avoided by most pdocs, despite its great success in treating Social Phobia, is that it carries the risk of dangerous or even fatal hypertensive crises if certain common foods or medications (including common decongestants) are ingested concurrently.
While I've dabbled with some other meds, Klonopin is absolutely the mainstay of my treatment. It does so much for me. In placebo-controlled studies, it showed a higher response rate (over 75%) than any other medication has to-date. The trick
Posted by Rick on May 3, 2000, at 18:54:55
In reply to Re: Effexor XR Social Anxiety, posted by Rick on May 3, 2000, at 18:30:32
OK, I have NO idea why the bottom portion of my post disappeared, but let's try again. I'll start with the Klonopin info:
While I've dabbled with some other meds, Klonopin is absolutely the mainstay of my treatment. It does so much for me. In placebo-controlled studies, it showed a higher response rate (over 75%) than any other medication has to-date. The tricky part is finding just the right dosage for you -- not too high (can cause anti-productive sedation) and not too low. For me 1.5-2.0 mg/day does the trick. And it begins to work very quickly. The first few weeks or two Klonopin made me drowsy, but then my body adjusted. It has no adverse effects for me -- just some unanticipated GOOD ones (e.g., caused my chronic facial pain to disappear). That's not to say no one has adverse effects...again, everyone's body chemistry is different. Klonopin is a benzo (type of tranquilizer), and many doctors and patients are "benzophobic" and worried about withdrawal or even addiction problems if benzos are to be used for longer than a few weeks. Studies have found that such problems are the exception to the rule, and that for most people benzos are very safe and non-addictive.
Finally, while I don't know much about it, I have heard of an operation (is it clled ETS?) that is specifically directed at decreasing blushing.
Hope some of this helps.
Good Luck,
Rick
Posted by Annie on May 3, 2000, at 22:44:20
In reply to Re: Effexor XR Social Anxiety, posted by Rick on May 3, 2000, at 18:30:32
Rick, thanks for all the info. I will try the Effexor XR for a few months and see what happens. I hope it helps with the blushing.
Posted by Annie on May 3, 2000, at 22:48:40
In reply to Re: Effexor XR Soc. Anx.-REST of post, posted by Rick on May 3, 2000, at 18:54:55
> Rick, now I see the rest of the first message. What were your symptoms with Social Anxiety? Have you used EDMR or EMDR(can't remember the correct sp?) with your Dr. for treatment? I just did the other day, and it was a really interesting experience, supposed to be a great help for Social Anxiety.
OK, I have NO idea why the bottom portion of my post disappeared, but let's try again. I'll start with the Klonopin info:
>
> While I've dabbled with some other meds, Klonopin is absolutely the mainstay of my treatment. It does so much for me. In placebo-controlled studies, it showed a higher response rate (over 75%) than any other medication has to-date. The tricky part is finding just the right dosage for you -- not too high (can cause anti-productive sedation) and not too low. For me 1.5-2.0 mg/day does the trick. And it begins to work very quickly. The first few weeks or two Klonopin made me drowsy, but then my body adjusted. It has no adverse effects for me -- just some unanticipated GOOD ones (e.g., caused my chronic facial pain to disappear). That's not to say no one has adverse effects...again, everyone's body chemistry is different. Klonopin is a benzo (type of tranquilizer), and many doctors and patients are "benzophobic" and worried about withdrawal or even addiction problems if benzos are to be used for longer than a few weeks. Studies have found that such problems are the exception to the rule, and that for most people benzos are very safe and non-addictive.
>
> Finally, while I don't know much about it, I have heard of an operation (is it clled ETS?) that is specifically directed at decreasing blushing.
>
> Hope some of this helps.
>
> Good Luck,
> Rick
>
Posted by DC on May 4, 2000, at 0:59:57
In reply to Re: Effexor XR Soc. Anx.-REST of post, posted by Annie on May 3, 2000, at 22:48:40
Annie, I really feel for you. I know of one person with social phobia and depression who was helped tremendously by effexor. In general,though, Nardil seems to be the most effective drug. Are you willing to put up with the side effects? Neurontin seems quite useful--why not add it to the effexor? THe other drugs I've heard to be useful are mostly from overseas: notably, amisulpride, adrafinil, and edronax/reboxetine. SSRIs sometimes work. I had a good response from prozac once, but have not been able to duplicate it.
Posted by Annie on May 4, 2000, at 22:37:33
In reply to Re: Social anxiety, posted by DC on May 4, 2000, at 0:59:57
> Hey DC, I've been on the Effexor XR for one week now, and just went to 75mg. You know, I think, THINK, I actually feel better. I am feeling a little manic perhaps (and enjoying it), not shrinking away from challenging situations, and blushing has decreased in # of incidents anyway (don't know about severity). So thanks for the message, I will keep you posted. Did you read my other message about EDMR or EMDR? The rapid eye movement therapy? Really a neat experience! Can't wait to go back and do more. Re Nardil, don't need to gain one pound, so will wait to see how Effexor works before changing meds again. I am so hypersensitive to everything, I am nervous to take any combination of anything. One problem could be is that I am seeing only my family Dr. for meds, and a psychologist for therapy. No pyschiatrist yet. Any advice along these lines?
Annie, I really feel for you. I know of one person with social phobia and depression who was helped tremendously by effexor. In general,though, Nardil seems to be the most effective drug. Are you willing to put up with the side effects? Neurontin seems quite useful--why not add it to the effexor? THe other drugs I've heard to be useful are mostly from overseas: notably, amisulpride, adrafinil, and edronax/reboxetine. SSRIs sometimes work. I had a good response from prozac once, but have not been able to duplicate it.
Posted by Rick on May 6, 2000, at 0:26:54
In reply to Re: Social anxiety, posted by Annie on May 4, 2000, at 22:37:33
Annie -
Glad to hear the Effexor may be doing the trick for you. I have copies of the full studies I referred to earlier, and in the larger one women showed even better response than men. (The same was true in the Neurontin study, but there women showed a greater PLACEBO effect as well. The Effexor study was open, i.e., no placebo, so it might have shown the same pattern.)
PLEASE keep us apprised on your progresswith Effexor.
I've never heard of the eye thing. Sounds interesting. Can you elaborate?
The symptom that has been most troubling in my social anxiety (because it's the most outwardly noticeable) is a tremulous voice. It's especially bad in some situations such as being the center of attention, giving a presentation, or making certain kinds of phone calls. But now it's about 70% under control with the Klonopin.
By the way, I tried Nardil just when I was embarking on my first really big diet...and to my surprise losing weight was EASIER than I thought. But I know a lot of people really balloon up on Nardil.
Rick
> > Hey DC, I've been on the Effexor XR for one week now, and just went to 75mg. You know, I think, THINK, I actually feel better. I am feeling a little manic perhaps (and enjoying it), not shrinking away from challenging situations, and blushing has decreased in # of incidents anyway (don't know about severity). So thanks for the message, I will keep you posted. Did you read my other message about EDMR or EMDR? The rapid eye movement therapy? Really a neat experience! Can't wait to go back and do more. Re Nardil, don't need to gain one pound, so will wait to see how Effexor works before changing meds again. I am so hypersensitive to everything, I am nervous to take any combination of anything. One problem could be is that I am seeing only my family Dr. for meds, and a psychologist for therapy. No pyschiatrist yet. Any advice along these lines?
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> Annie, I really feel for you. I know of one person with
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