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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by maddog on June 27, 2004, at 19:05:07
Hi Everyone,
I am looking for some advice on drug therapy for general anxiety and social anxiety.
I have been on and off Paxil for 3 years and I take Klonopin on a as needed basis (essentially, before important meetings and presentations). Klonopin works very well. Paxil is OK but the disadvantages (lethargy, sexual, etc.) outweigh the advantages.
I have a prescription for Nardil and I have discontinued Paxil for 4 weeks now. So I am set to go. I have the following questions which I hope some of you have experience dealing with.
1) Does Nardil offer therapeutic advantages over Klonopin? Which of these two drugs is more effective for anxiety and/or social anxiety?
2) How do these two drugs compare in terms of tolerance, dependency, withdrawal?
3) Does the effective dosage of Klonopin lower when using Nardil? Is Klonopin even needed?
Although Klonopin works well for me, it does not offer around the clock relief from anxiety, unless I take Klonopin around the clock -- which I would prefer not to do. It seems that Nardil would provide this but I am concerned that it will be less effective and have more severe side effects.
Any advice is appreciated!
Thanks,
maddog
Posted by anxiety_free on June 27, 2004, at 21:51:51
In reply to Nardil vs. Klonopin, posted by maddog on June 27, 2004, at 19:05:07
> Hi Everyone,
>
> I am looking for some advice on drug therapy for general anxiety and social anxiety.
>
> I have been on and off Paxil for 3 years and I take Klonopin on a as needed basis (essentially, before important meetings and presentations). Klonopin works very well. Paxil is OK but the disadvantages (lethargy, sexual, etc.) outweigh the advantages.
>
> I have a prescription for Nardil and I have discontinued Paxil for 4 weeks now. So I am set to go. I have the following questions which I hope some of you have experience dealing with.
>
> 1) Does Nardil offer therapeutic advantages over Klonopin? Which of these two drugs is more effective for anxiety and/or social anxiety?
>
> 2) How do these two drugs compare in terms of tolerance, dependency, withdrawal?
>
> 3) Does the effective dosage of Klonopin lower when using Nardil? Is Klonopin even needed?
>
> Although Klonopin works well for me, it does not offer around the clock relief from anxiety, unless I take Klonopin around the clock -- which I would prefer not to do. It seems that Nardil would provide this but I am concerned that it will be less effective and have more severe side effects.
>
> Any advice is appreciated!
>
> Thanks,
> maddogHey! Personally, I'd go with a new anti-depressant besides Nardil (SSRI, Tricyclic, whatever) and Klonopin. Unlike Xanax or other short-acting benzos, Klonopin doesn't require constant pill-popping; for continuous control of anxiety you should only have to take 2 or 3 doses (usually 2). Given the dietary restrictions involved with MAOIs, I'd give something else a whirl first. As far as I know, anti-depressants can help anxiety a lot, but nothing beats a straight up sedative/tranquilizer like Klonopin. One common way to address anxiety is to use a new anti-depressant with Klonopin, then discontinue the Klonopin and see how the anti-depressant does on its own. A lot of docs keep patients on Klonopin long-term because there's less of a risk of dose escalation, tolerance, and other problems than with some other benzos. If that's not your style, you could try a different anti-depressant (Tofranil, for instance, is good for anxiety) with an as-needed benzo and perhaps a beta-blocker, also for as-needed use. Another option would be BuSpar, which is good for anxiety, but not as good as a benzo. Augmenting your anti-depressant of choice with a mood-stabilizer (Depakote is good for anxiety) or anti-psychotic (low-doses of some seem to help with anxiety) might work well, too. Good luck!
Posted by Questionmark on June 29, 2004, at 0:48:31
In reply to Nardil vs. Klonopin, posted by maddog on June 27, 2004, at 19:05:07
> Hi Everyone,
>
> I am looking for some advice on drug therapy for general anxiety and social anxiety.
>
> I have been on and off Paxil for 3 years and I take Klonopin on a as needed basis (essentially, before important meetings and presentations). Klonopin works very well. Paxil is OK but the disadvantages (lethargy, sexual, etc.) outweigh the advantages.
>
> I have a prescription for Nardil and I have discontinued Paxil for 4 weeks now. So I am set to go. I have the following questions which I hope some of you have experience dealing with.
>
> 1) Does Nardil offer therapeutic advantages over Klonopin? Which of these two drugs is more effective for anxiety and/or social anxiety?
>
> 2) How do these two drugs compare in terms of tolerance, dependency, withdrawal?
>
> 3) Does the effective dosage of Klonopin lower when using Nardil? Is Klonopin even needed?
>
> Although Klonopin works well for me, it does not offer around the clock relief from anxiety, unless I take Klonopin around the clock -- which I would prefer not to do. It seems that Nardil would provide this but I am concerned that it will be less effective and have more severe side effects.
>
> Any advice is appreciated!
>
> Thanks,
> maddog
1)In my personal experience and opinion, Nardil is significantly better for anxiety (at least/especially social anxiety) than Klonopin. Klonopin can keep anxiety at bay a good deal, but it makes one (me, at least) not feel like socializing that much more-- maybe even less so sometimes. But Nardil, on the other hand, takes so much anxiety away AND basically MAKES one (me) socialize more (it makes one more "prosocial"). It's like i just automatically talk to people more.2)i don't know, because i wasn't on Klonopin consistently for that long a period of time and i've never had to quit Nardil yet. But i would definitely guess that Nardil would be even harder to withdrawal from than Klonopin would be. As far as tolerance and dependence, i couldn't tell you.
3)A) Almost definitely. (B)It is certainly forseeable that for a lot of people, Klonopin would not be needed (or worth it) for extra anxiety relief if taking Nardil.
*Nardil would almost definitely have more side effects (& more severe) than Klonopin. You would get round-the-clock relief from Nardil, however. And the Nardil would very likely be more effective as well.
Posted by maddog on June 29, 2004, at 4:53:08
In reply to Re: Nardil vs. Klonopin » maddog, posted by Questionmark on June 29, 2004, at 0:48:31
Wow, this is exactly the kind of articulate information that I need. thanks very very much.
maddog
> > Hi Everyone,
> >
> > I am looking for some advice on drug therapy for general anxiety and social anxiety.
> >
> > I have been on and off Paxil for 3 years and I take Klonopin on a as needed basis (essentially, before important meetings and presentations). Klonopin works very well. Paxil is OK but the disadvantages (lethargy, sexual, etc.) outweigh the advantages.
> >
> > I have a prescription for Nardil and I have discontinued Paxil for 4 weeks now. So I am set to go. I have the following questions which I hope some of you have experience dealing with.
> >
> > 1) Does Nardil offer therapeutic advantages over Klonopin? Which of these two drugs is more effective for anxiety and/or social anxiety?
> >
> > 2) How do these two drugs compare in terms of tolerance, dependency, withdrawal?
> >
> > 3) Does the effective dosage of Klonopin lower when using Nardil? Is Klonopin even needed?
> >
> > Although Klonopin works well for me, it does not offer around the clock relief from anxiety, unless I take Klonopin around the clock -- which I would prefer not to do. It seems that Nardil would provide this but I am concerned that it will be less effective and have more severe side effects.
> >
> > Any advice is appreciated!
> >
> > Thanks,
> > maddog
>
>
> 1)In my personal experience and opinion, Nardil is significantly better for anxiety (at least/especially social anxiety) than Klonopin. Klonopin can keep anxiety at bay a good deal, but it makes one (me, at least) not feel like socializing that much more-- maybe even less so sometimes. But Nardil, on the other hand, takes so much anxiety away AND basically MAKES one (me) socialize more (it makes one more "prosocial"). It's like i just automatically talk to people more.
>
> 2)i don't know, because i wasn't on Klonopin consistently for that long a period of time and i've never had to quit Nardil yet. But i would definitely guess that Nardil would be even harder to withdrawal from than Klonopin would be. As far as tolerance and dependence, i couldn't tell you.
>
> 3)A) Almost definitely. (B)It is certainly forseeable that for a lot of people, Klonopin would not be needed (or worth it) for extra anxiety relief if taking Nardil.
>
> *Nardil would almost definitely have more side effects (& more severe) than Klonopin. You would get round-the-clock relief from Nardil, however. And the Nardil would very likely be more effective as well.
Posted by Questionmark on June 29, 2004, at 9:52:31
In reply to Re: Nardil vs. Klonopin » Questionmark, posted by maddog on June 29, 2004, at 4:53:08
Posted by JayDee on June 29, 2004, at 19:51:01
In reply to Re: Nardil vs. Klonopin » maddog, posted by Questionmark on June 29, 2004, at 0:48:31
> 1)In my personal experience and opinion, Nardil is significantly better for anxiety (at least/especially social anxiety) than Klonopin. Klonopin can keep anxiety at bay a good deal, but it makes one (me, at least) not feel like socializing that much more-- maybe even less so sometimes. But Nardil, on the other hand, takes so much anxiety away AND basically MAKES one (me) socialize more (it makes one more "prosocial"). It's like i just automatically talk to people more.
>
> 2)i don't know, because i wasn't on Klonopin consistently for that long a period of time and i've never had to quit Nardil yet. But i would definitely guess that Nardil would be even harder to withdrawal from than Klonopin would be. As far as tolerance and dependence, i couldn't tell you.
>
> 3)A) Almost definitely. (B)It is certainly forseeable that for a lot of people, Klonopin would not be needed (or worth it) for extra anxiety relief if taking Nardil.
>
> *Nardil would almost definitely have more side effects (& more severe) than Klonopin. You would get round-the-clock relief from Nardil, however. And the Nardil would very likely be more effective as well.
Ive heard that it takes a good amount larger dose to take care of social anxiety vs depression with Nardil... what dosage are you using, Questionmark?
also were you on Nardil before the forumulation change in late 03, did you notice a difference?Jon
Posted by Questionmark on June 30, 2004, at 10:21:06
In reply to Re: Nardil vs. Klonopin, posted by JayDee on June 29, 2004, at 19:51:01
> > 1)In my personal experience and opinion, Nardil is significantly better for anxiety (at least/especially social anxiety) than Klonopin. Klonopin can keep anxiety at bay a good deal, but it makes one (me, at least) not feel like socializing that much more-- maybe even less so sometimes. But Nardil, on the other hand, takes so much anxiety away AND basically MAKES one (me) socialize more (it makes one more "prosocial"). It's like i just automatically talk to people more.
> >
> > 2)i don't know, because i wasn't on Klonopin consistently for that long a period of time and i've never had to quit Nardil yet. But i would definitely guess that Nardil would be even harder to withdrawal from than Klonopin would be. As far as tolerance and dependence, i couldn't tell you.
> >
> > 3)A) Almost definitely. (B)It is certainly forseeable that for a lot of people, Klonopin would not be needed (or worth it) for extra anxiety relief if taking Nardil.
> >
> > *Nardil would almost definitely have more side effects (& more severe) than Klonopin. You would get round-the-clock relief from Nardil, however. And the Nardil would very likely be more effective as well.
>
>
> Ive heard that it takes a good amount larger dose to take care of social anxiety vs depression with Nardil... what dosage are you using, Questionmark?
> also were you on Nardil before the forumulation change in late 03, did you notice a difference?
>
> Jon
i've heard the same-- just on here i think. i'm not sure how true it is though. It probably depends on the person. i am on 60mg Nardil right now. i was never on the "old" Nardil formulation before.
But anyway, i'd have to say that it's about the same for me. It is relatively just as effective for social anxiety as it is for depression. In fact, it's probably slightly more effective at relieving my low to moderate-level social anxiety than it is in relieving any of my depression. i think. But it's probably more effective at relieving my more severe depression (at higher doses) than it is my more severe social anxiety-- if that makes sense. You know what, forget about these last several sentences. It is relatively effective for depression as it is for social anxiety-- for me at least.
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