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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Tepiaca on January 2, 2004, at 0:24:19
I cant understand this ! , its unbelieveable how a 50 years old medicine -NARDIL- is still the best treatment in the market to combat SP.
what are they doing ??? there are no new medicines for SP on the market . Paxil is a completely fake , its useless.
They should invest more money to obtain more medicines to help this and all the anxiety problems. Anxiety is one of the most common problems in human's brain
The best treatment today for many people is NARDIL ,and what do they do? they change the medicine's ingredients and now nardil has lost his power in a high percentage . I dont understand them ! I really dont!
The only purpose of that people , is money $$$$
and they dont really care about helping people who is passing for a though moment
, that is the only truth
The principal managers of all the pharmacies industries should be people like you and me. Someone who have passed through all this in his life ,someone who have felt all the cruelty world of depression anxiety , psichosis and all differents kinds of mental diseases. but not them!!anyway I know that is something
hard to gethave you heard if there is any new medicine near??
Posted by Kon on January 2, 2004, at 7:50:53
In reply to how can a 50 years old medicine be the best for SP, posted by Tepiaca on January 2, 2004, at 0:24:19
> its unbelieveable how a 50 years old medicine -NARDIL- is still the best treatment in the market to combat SP.
I think this is debatable. While there is no question that Nardil is one of the more effective drugs for SP, the drug which has demonstrated the largest improvement score in SP is not Nardil (Phenelzine) but a benzo (particularly clonazepam). Two different meta-analysis came to this conclusion (see Federoff and Taylor, 2001) and the most recent review in November of this year (Blanco, 2003).
Even as a group the benzos tended to score higher (but not significantly) than both the SSRIs and MAOIs such as Nardil . This was the case for both self-reported and therapist reported measures of anxiety reduction. From the Blanco (2003) review:
"Our analysis found that clonazepam, based on a single study, had the largest mean effect size of all medications. The effect sizes of SSRIs and phenelzine were similar to each other and numerically (but not statistically) smaller than those of clonazepam."
Wrt Nardil:
"Until relatively recently, phenelzine was considered the gold standard in the treatment of SAD. However, results from the meta-analyses suggest that its efficacy is not superior to that of the SSRIs or clonazepam, although it has never been directly compared to those medications."
Summary of results the Blanco (2003)review:
Effect size based on Liebowitz Social Anxiety scale (higher the number the > the reduction in anxiety):
Benzos-1.54
Nardil-1.02
SSRIs-0.65
Effect size based on Clinical Global Impression Scale:Benzos-16.61
Nardil-5.53
SSRIs-4.1The Federoff (2001) had similar results with benzos tending to be somewhat better than SSRIs ad MAOIs.
Posted by btnd on January 2, 2004, at 18:36:20
In reply to Is Nardil really the best for SP?, posted by Kon on January 2, 2004, at 7:50:53
Although studies show that Klonopin is slightly better for social anxiety/phobia than Nardil - I agree with the statement that it's hard to believe that after 50 years we only have 2 choices when it comes to treatment of SA/SP. Sad...
Posted by scott-d-o on January 2, 2004, at 22:26:57
In reply to I agree - 50 years and no new meds for SP/SA » Kon, posted by btnd on January 2, 2004, at 18:36:20
A combination of 50mg/d of sulpiride and 1mg/d of clonazepam works well for me. I believe sulpiride was invented about 25 years ago so I guess that's a little bit better ;-)
What's pathetic is we don't have shit for dopaminergic meds in the USA and I believe dopamine plays quite a significant role in social phobia. You can thank the FDA for this deficiency, not only in the states but worldwide.
Posted by scott-d-o on January 2, 2004, at 22:28:47
In reply to Re: I agree - 50 years and no new meds for SP/SA, posted by scott-d-o on January 2, 2004, at 22:26:57
I apologize ahead of time, this is how it should read:
What's pathetic is we don't have sh*t for dopaminergic meds in the USA and I believe dopamine plays quite a significant role in social phobia.
I don't mean to offend ;-)
Posted by whitecat on January 3, 2004, at 9:45:12
In reply to Re: I agree - 50 years and no new meds for SP/SA, posted by scott-d-o on January 2, 2004, at 22:28:47
My doc prescribed me Mobemide (I think it's and Moclobemide are the same) for my SP. I asked her for Nardil, but she said: "We already do not prescribe this antique", and that Nardil is very problematic drag. So I think I won't be able to reach Nardil in this country.. I didn't begin with Mobemide yet, but I read here it's rather week med against SP. We'll see..
This is the end of the thread.
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