Social Anxiety Support

JimiPePPeroni · 11-04-2009, 08:07 AM

... at least that's how it has been for my case. I am no longer the "worry-wart" I once was, and I must say this is a tremendous improvement: not over-thinking and obsessing, especially socially. However, I am struggling to keep on my "game face", that is my expression is just so flat that something's telling me that it either must be replaced by something different, or conjuncted along with something else. Now I completely understand why I wasn't satisfied with Zoloft when it was prescribed to me in 2004. So here are my options:

-Replace Lexapro with a different "anti-obsessive" medicine that is NOT an SSRI, such as Remeron or Anafranil.

-Consider working on DA neurotransmitters perhaps with L-Tyrosine, or low dose Sulpiride (stimulants & even Wellbutrin unfortunately are out of the question, for they had caused worsening of symptoms).

-Perhaps consider TCA's (like Anafranil as mentioned above) as I have learned these are quite helpful for treating anxiety, though I'm not sure about whether or not all of them alleviate over-focused symptoms.

-Nardil, though I hadn't had much success with Manerix.

-A dopamine blocker... actually on second thought, no. Abilify & Zyprexa were enough to convince me that the Antipsychotics just don't work for me.

-Other medicines worth trying: Agomelatine, Lamictal, Mianserin, Stablon, and maybe Guanfacine.

-Plus any other suggestions would help out a lot, thanks in advance.

jim_morrison · 11-04-2009, 09:52 AM

Quote:

Originally Posted by JimiPePPeroni

.So here are my options:

-Replace Lexapro with a different "anti-obsessive" medicine that is NOT an SSRI, such as Remeron or Anafranil.

Remeron hasn't done jack for my OCD, I don't think it's generally very effective for that.

BearFan · 11-04-2009, 11:50 AM

True, I had the same problem with Lexapro myself. Good for GAD, but it just didn't give me the 'punch' I was looking for (ie increased sociability/motivation) by itself. Generally people say if you can tolerate Wellbutrin, it's a good add on.

MavenMI6Agent009 · 11-04-2009, 11:56 AM

how long does lexapro take effect.

Vini Vidi Vici · 11-04-2009, 12:05 PM

agomelatine is awesome...it helped me a ton with social anxiety. it stinks that to gain real benefits you have 2 take it 2 or 3 times a day cuz the half life is so short. but its awesome and it decreases depression alot also. if u can afford it or u live in europe id highly recommend it. as far as TCAs go...anafranil as a ton of side effects, way more than SSRIs. it causes really bad confusion....i think amytryptiline is one of the best TCAs...especially for anxiety. Nardil is definetly going to be alot more effective than Manerix...manerix has quite weak serotonergic/dopaminergic action. It just doesnt inhibit MAO very strongly. Nardil has gotta be a least 5-10 times stronger, and it also raises GABA so it automatically will stomp manerix into the dust for anxiety. Mianserin is really similiar to amytryptiline, and also very similiar to Mirtazapine. It has potent 5ht2c antagonist action like amytriptyline, which contributes significantly to making it an exceptional anxiety-killing agent. However they don't help that much with OCD...im not sure if Overfocusing is similar to OCD. I don't think Stablon is worth it, u have to take it 3 times a day and tolerance can develop. It did work quite well for depression/anxiety at first, but it made the Overfocusing/OCD alot worse for me. L-tyrosine causes anxiety similar to wellbutrin and stimulants....it has only a weak dopaminergic action. It has alot stronger Adrenergic activity, which is why it increases anxiety so effectively like stims. Remeron stinks...it does nothing for my OCD, nearly nothing for depression. It only helps with anxiety and it will make you sleep... a very long time. Guanfacine should be great for anxiety. I took clonidine, which works nearly the same way. But it will not give you more motivation. It will make you flatter and tired.

JimiPePPeroni · 11-04-2009, 12:07 PM

Quote:

Remeron hasn't done jack for my OCD, I don't think it's generally very effective for that.

Well... as long as it regains my emotions, then it'd be alright with me. Is Remeron safe alongside an SSRI?

Right now, it just feels far from possible to take a crack at this, that is unless I give the rest of my options a try. btw, thanks for the input on Agomelatine 'Vini Vidi Vici', as well as everything else. Ago. is definitely one that I am highly considering trying next.

jim_morrison · 11-04-2009, 07:24 PM

Quote:

Originally Posted by Vini Vidi Vici

Remeron stinks...it does nothing for my OCD, nearly nothing for depression. It only helps with anxiety and it will make you sleep... a very long time.

Thats a pretty dead on perfect explanation in my experience, plus it makes you eat alot. For some people it may work great though, so give it a try if you like.

Btw why does amitriptyline get mentioned so often these days compared to the other TCA's? Is it more effective? I thought that it had more potent anticholinergic effects that most of the others, so I would have guessed the side effect profile would be bad.

ecotec83 · 11-04-2009, 09:54 PM

Quote:

Originally Posted by MavenMI6Agent009

how long does lexapro take effect.

For me i felt a difference within 2 days but i also seem to be sensitive to meds.

Remeron does make you sleep well. The last time i took one of those i had to stop in the middle of making diner as my muscles turned to mush, i had to go lay down. It was like someone hit me with a tranquilizer dart.

Dangerous · 11-04-2009, 10:50 PM

Ah amprtip.. I think it's mentioned alot or prescribed a lot is because it's just one of those "Names" that come to mind when doctor, or people think TCA. Also it like a panacea for every problem in the world, my mom got it for chronic pain, my dad got it for headaches, (they both took it a couple of time and flushed it) if you say you have fibromyalgia it's you will get it. Low doses they will give you it for stomach problems like IBS and CVS. But, as with most TCA's I would say it's anticholinergic effect ARE way too much at least for me. I think it's one of the most sedating, and memory screwing TCA.

If you have OCD like they said I have, you will get Anafranil.. I don't know why they think I have ocd, probably because some docs still don't think SSA disorder is a real disorder so they have to label you with something. But that is nothing to fool with either, be prepared for the worst dry mouth possible.

If I was going down the TCA route I would say why not go all the way if you have major depression. Impramine. It's a TCA and also a tertiary amine, so that means you get the "shot gun" effect like a MAOI without killing the enzyme. Serotonin, Norepinephrine, Dopamine and god who knows what else. It's considered the gold standard for major depression of antidepressants behind SSRI's which are pretty much the standard just because. (just because they are safer than the rest). God only knows why I was never prescribed this med and everything else..maybe because I could be a dash of bipolar and it makes bipolars manic, and euphoric (which would be nice) who knows.

Me personally I would take Nortriptyline because it has the least side effect profile, and is not as sedating.

But last time I had a TCA I threw it in a dumpster because I knew of someone who used them to commit suicide, I don't trust myself with anything that is commonly used for suicide. That's the only reason I don't own a gun, even though I want one bad.

OH BTW Im on remeron lol what wrong with that, i mean why don't people like it? I know it's causes a lot of weight gain..but I am on addy so I actually lost weight since I been on the combo, and my stomach problem are gone so far.

jim_morrison · 11-04-2009, 11:21 PM

Theres nothing inherently wrong with remeron, I can only speak for myself though and say that with remeron being one of, if not the most potent antihistamines on the planet, plus having 30 odd hr half life, effectively, it ends up feeling like your walking around with a cloud over your head 24/7. Don't get me wrong I have pretty bad insomnia and remeron does fix that, but as someone already mentioned, you tend to sleep way longer hours than usual when you take it, it's not like one of these short acting sleep aids which are out of your system by the time you wake up. But if your on adderall, it may counteract that and the combo might be really good, everyone just has to try it for themselves and see how it makes them inidvidually feel.

millenniumman75 · 11-05-2009, 08:51 AM

How long have you been taking Lexapro?

JimiPePPeroni · 11-06-2009, 10:29 AM

Quote:

Originally Posted by MavenMI6Agent009

how long does lexapro take effect.
For me i felt a difference within 2 days but i also seem to be sensitive to meds.

Yep, that basically is, and was the same case with me, as I felt it's effects within (only) a few days.

Quote:

How long have you been taking Lexapro?

For about 3 weeks now.

JimiPePPeroni · 11-09-2009, 05:40 PM

btw, thank you for all the (medical) input, it really helps me a ton, giving me a better sense of the mechanisms of action, for I can compare to what already has been “crossed off the list”. to keep this thread alive & going, I mostly just want to post my current attitude towards the drugs considered:

Remeron-Honestly, I'm now thinking it may be safe to ignore. I mean, do I honestly want feel MORE tired than I already am? hell, I already sleep way too much, lol. Though, if I ever did come down to it, through desperation, and I found it to work well & effectively, perhaps I may consider adding something in to reduce the fatigue issue.

TCA’s-I now am wondering whether or not I should begin straying way from the idea of TCA use. Their effect(s) on NA should already have been foretold as a warning sign, as of late I have realized how most drugs & even supplements, including Strattera, L-Tyrosine, and especially Effexor (XR) (omg, Effexor would literally, and I’m not kidding, literally cause my expression to look angry as hell, i. e. >:o( … almost the complete opposite of Lexapro) amplified agitation, and emotional instability, perhaps due to NA overload. Perhaps just one, and only one “test-dose” would convince me whether it is safe to continue on with treatment.

Nardil-Now that I have learned about it's effects on GABA, thanks to 'Vini Vidi Vici', I may no longer consider it. Working my GABA receptors has never done me any good.

Lamictal-May be worth a try, that is unless it potentiates GABA, like the other anticonvulsants.

Guanfacine-May ditch the idea, since I already have tried Clonidine (for SAD), which btw VVV mentioned was very similar to Guan., and was very unimpressed.

Agomelatine-My #1 pick, though I'm still struggling to fully understand the meaning of " norepinephrine dopamine disinhibitor/NDDI". And because of it being an agonist @ melatonin receptors, I'm wondering whether or not it could cause fatigue issues, similar to Remeron...

veryalone · 11-09-2009, 05:45 PM

It took several weeks for me to feel the affects of Lexapro, but when it took affect boy did it change my life in a positive way. I suddenly have a girlfriend after not having one for 20 years and experienced many other firsts...

. I have been thriving in a very competitive and difficult school and overall my anxiety has diminished quite a bit. For the first couple of weeks I was doubting that it would make any difference, but I stuck with it and look at me now!

11-04-2009, 08:07 AM	#1 (permalink)
JimiPePPeroni Status: SAS Member Join Date: Aug 2009 Location: Michigan Gender: Male Posts: 31	Lexapro is good, but it's not enough... ... at least that's how it has been for my case. I am no longer the "worry-wart" I once was, and I must say this is a tremendous improvement: not over-thinking and obsessing, especially socially. However, I am struggling to keep on my "game face", that is my expression is just so flat that something's telling me that it either must be replaced by something different, or conjuncted along with something else. Now I completely understand why I wasn't satisfied with Zoloft when it was prescribed to me in 2004. So here are my options: -Replace Lexapro with a different "anti-obsessive" medicine that is NOT an SSRI, such as Remeron or Anafranil. -Consider working on DA neurotransmitters perhaps with L-Tyrosine, or low dose Sulpiride (stimulants & even Wellbutrin unfortunately are out of the question, for they had caused worsening of symptoms). -Perhaps consider TCA's (like Anafranil as mentioned above) as I have learned these are quite helpful for treating anxiety, though I'm not sure about whether or not all of them alleviate over-focused symptoms. -Nardil, though I hadn't had much success with Manerix. -A dopamine blocker... actually on second thought, no. Abilify & Zyprexa were enough to convince me that the Antipsychotics just don't work for me. -Other medicines worth trying: Agomelatine, Lamictal, Mianserin, Stablon, and maybe Guanfacine. -Plus any other suggestions would help out a lot, thanks in advance.

11-04-2009, 11:56 AM	#4 (permalink)
MavenMI6Agent009 Status: Cook Join Date: Aug 2004 Location: EL Crapo, Tx Gender: Male Posts: 13,657	how long does lexapro take effect. __________________ "The friend who can be silent with us in a moment of despair or confusion, who can stay with us in an hour of grief and bereavement, who can tolerate not knowing, not curing, not healing and face with us the reality of our powerlessness, that is a friend who cares." (Henri Nouwen) -------------------------------------------------------

11-04-2009, 12:05 PM	#5 (permalink)
Vini Vidi Vici Status: altruistic philanthropist Join Date: Jul 2009 Location: Minnesota Gender: Male Age: 18 Posts: 289	agomelatine is awesome...it helped me a ton with social anxiety. it stinks that to gain real benefits you have 2 take it 2 or 3 times a day cuz the half life is so short. but its awesome and it decreases depression alot also. if u can afford it or u live in europe id highly recommend it. as far as TCAs go...anafranil as a ton of side effects, way more than SSRIs. it causes really bad confusion....i think amytryptiline is one of the best TCAs...especially for anxiety. Nardil is definetly going to be alot more effective than Manerix...manerix has quite weak serotonergic/dopaminergic action. It just doesnt inhibit MAO very strongly. Nardil has gotta be a least 5-10 times stronger, and it also raises GABA so it automatically will stomp manerix into the dust for anxiety. Mianserin is really similiar to amytryptiline, and also very similiar to Mirtazapine. It has potent 5ht2c antagonist action like amytriptyline, which contributes significantly to making it an exceptional anxiety-killing agent. However they don't help that much with OCD...im not sure if Overfocusing is similar to OCD. I don't think Stablon is worth it, u have to take it 3 times a day and tolerance can develop. It did work quite well for depression/anxiety at first, but it made the Overfocusing/OCD alot worse for me. L-tyrosine causes anxiety similar to wellbutrin and stimulants....it has only a weak dopaminergic action. It has alot stronger Adrenergic activity, which is why it increases anxiety so effectively like stims. Remeron stinks...it does nothing for my OCD, nearly nothing for depression. It only helps with anxiety and it will make you sleep... a very long time. Guanfacine should be great for anxiety. I took clonidine, which works nearly the same way. But it will not give you more motivation. It will make you flatter and tired. __________________ Please don't take or trust any medical advice from me...Consult a perffessional. meds taken for extended period of time: zyprexa, zoloft, risperdal, klonopin, temazepam, xanax, agomelatine, ambien, adderall, metadate, EMSAM, selegiline, paxil, lexapro, wellbutrin, seroquel, trazodone, clonidine, tramadol, remeron, vyvanse, concerta, Lunesta, Parnate. Current Meds: Parnate 30 mg, Diagnoses- Major Depression, OCD, Social Anxiety, GAD

11-04-2009, 10:50 PM	#9 (permalink)
Dangerous Status: SAS Member Join Date: Oct 2009 Posts: 40	Ah amprtip.. I think it's mentioned alot or prescribed a lot is because it's just one of those "Names" that come to mind when doctor, or people think TCA. Also it like a panacea for every problem in the world, my mom got it for chronic pain, my dad got it for headaches, (they both took it a couple of time and flushed it) if you say you have fibromyalgia it's you will get it. Low doses they will give you it for stomach problems like IBS and CVS. But, as with most TCA's I would say it's anticholinergic effect ARE way too much at least for me. I think it's one of the most sedating, and memory screwing TCA. If you have OCD like they said I have, you will get Anafranil.. I don't know why they think I have ocd, probably because some docs still don't think SSA disorder is a real disorder so they have to label you with something. But that is nothing to fool with either, be prepared for the worst dry mouth possible. If I was going down the TCA route I would say why not go all the way if you have major depression. Impramine. It's a TCA and also a tertiary amine, so that means you get the "shot gun" effect like a MAOI without killing the enzyme. Serotonin, Norepinephrine, Dopamine and god who knows what else. It's considered the gold standard for major depression of antidepressants behind SSRI's which are pretty much the standard just because. (just because they are safer than the rest). God only knows why I was never prescribed this med and everything else..maybe because I could be a dash of bipolar and it makes bipolars manic, and euphoric (which would be nice) who knows. Me personally I would take Nortriptyline because it has the least side effect profile, and is not as sedating. But last time I had a TCA I threw it in a dumpster because I knew of someone who used them to commit suicide, I don't trust myself with anything that is commonly used for suicide. That's the only reason I don't own a gun, even though I want one bad. OH BTW Im on remeron lol what wrong with that, i mean why don't people like it? I know it's causes a lot of weight gain..but I am on addy so I actually lost weight since I been on the combo, and my stomach problem are gone so far. __________________ WARNING: With a name like Dangerous why would you ever take medical advice from me?

11-04-2009, 11:21 PM	#10 (permalink)
jim_morrison Status: SAS Member Join Date: Aug 2008 Location: Australia Gender: Male Age: 23 Posts: 1,030	Theres nothing inherently wrong with remeron, I can only speak for myself though and say that with remeron being one of, if not the most potent antihistamines on the planet, plus having 30 odd hr half life, effectively, it ends up feeling like your walking around with a cloud over your head 24/7. Don't get me wrong I have pretty bad insomnia and remeron does fix that, but as someone already mentioned, you tend to sleep way longer hours than usual when you take it, it's not like one of these short acting sleep aids which are out of your system by the time you wake up. But if your on adderall, it may counteract that and the combo might be really good, everyone just has to try it for themselves and see how it makes them inidvidually feel. __________________ Warning: I am not a trained medical professional. Any information provided by me is based on my own personal experiences and research and is not intended to be used as professional medical advice. Please contact a medical professional before taking any action that may be discussed on this board.

11-04-2009, 11:50 AM	#3 (permalink)
BearFan Status: SAS Member Join Date: Mar 2008 Posts: 26	True, I had the same problem with Lexapro myself. Good for GAD, but it just didn't give me the 'punch' I was looking for (ie increased sociability/motivation) by itself. Generally people say if you can tolerate Wellbutrin, it's a good add on.

11-05-2009, 08:51 AM	#11 (permalink)
millenniumman75 Status: Super Moderator Join Date: Feb 2005 Location: Dayton-Cincinnati, OH Gender: Male Age: 34 Posts: 38,682	How long have you been taking Lexapro? __________________ millenniumman75 You are a success story waiting to happen! Live and let live VACUUMS more than a Hoover.... Live and HELP live is better!

11-09-2009, 05:40 PM	#13 (permalink)
JimiPePPeroni Status: SAS Member Join Date: Aug 2009 Location: Michigan Gender: Male Posts: 31	btw, thank you for all the (medical) input, it really helps me a ton, giving me a better sense of the mechanisms of action, for I can compare to what already has been “crossed off the list”. to keep this thread alive & going, I mostly just want to post my current attitude towards the drugs considered: Remeron-Honestly, I'm now thinking it may be safe to ignore. I mean, do I honestly want feel MORE tired than I already am? hell, I already sleep way too much, lol. Though, if I ever did come down to it, through desperation, and I found it to work well & effectively, perhaps I may consider adding something in to reduce the fatigue issue. TCA’s-I now am wondering whether or not I should begin straying way from the idea of TCA use. Their effect(s) on NA should already have been foretold as a warning sign, as of late I have realized how most drugs & even supplements, including Strattera, L-Tyrosine, and especially Effexor (XR) (omg, Effexor would literally, and I’m not kidding, literally cause my expression to look angry as hell, i. e. >:o( … almost the complete opposite of Lexapro) amplified agitation, and emotional instability, perhaps due to NA overload. Perhaps just one, and only one “test-dose” would convince me whether it is safe to continue on with treatment. Nardil-Now that I have learned about it's effects on GABA, thanks to 'Vini Vidi Vici', I may no longer consider it. Working my GABA receptors has never done me any good. Lamictal-May be worth a try, that is unless it potentiates GABA, like the other anticonvulsants. Guanfacine-May ditch the idea, since I already have tried Clonidine (for SAD), which btw VVV mentioned was very similar to Guan., and was very unimpressed. Agomelatine-My #1 pick, though I'm still struggling to fully understand the meaning of " norepinephrine dopamine disinhibitor/NDDI". And because of it being an agonist @ melatonin receptors, I'm wondering whether or not it could cause fatigue issues, similar to Remeron...

11-09-2009, 05:45 PM	#14 (permalink)
veryalone Status: SAS Member Join Date: Aug 2009 Posts: 36	It took several weeks for me to feel the affects of Lexapro, but when it took affect boy did it change my life in a positive way. I suddenly have a girlfriend after not having one for 20 years and experienced many other firsts... . I have been thriving in a very competitive and difficult school and overall my anxiety has diminished quite a bit. For the first couple of weeks I was doubting that it would make any difference, but I stuck with it and look at me now!