Best medication/treatment for treatment restistant acne? - Social Anxiety Forum
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post #1 of 67 (permalink) Old 03-13-2007, 02:10 PM Thread Starter
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Best medication/treatment for treatment restistant acne?


What is best medication/treatment for treatment resistant acne? Any ideas. List them all and tell me which you think is the best or has worked for you.


Heres a few I come up with, not sure how good they work tho as ive never tried them.

Accutane
Proactive
Murad
Neutrogena




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post #2 of 67 (permalink) Old 03-13-2007, 02:30 PM
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I use clindamycin phosphate 1% gel (an antibiotic) on my face during the day and Retin A Micro 0.1% gel at night for my acne. Retin A Micro is topical Accutane, pretty much, so it works similarly. If you have really bad acne, Accutane and/or tetracycline (another antibiotic) would probably be worth considering being as they're the go-to oral meds for severe/treatment-resistant acne, but Accutane comes with a series of unpleasant side effects (and I think your psych will have to write a note of your mental health standing to whichever dermatologist or doctor you might get an rx for Accutane from because Accutane has been linked to depression/suicide, or so I've read).

I've tried all sorts of prescription sulfur-based emollients plus antibiotic wipes/pledgets, not to mention just about every antibiotic there is for acne.

Oh, and I hope I don't have to mention that I exhausted all the over-the-counter acne treatments (Clearasil, Neutrogena, Clean and Clear, Biore.... AHHHHHHHHH ), even Proactiv. None of them worked. Some of them may have helped my face's oilyness or whatever for a short period of time, but nothing OTC works like the rx stuff I use now.

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post #3 of 67 (permalink) Old 03-13-2007, 04:03 PM Thread Starter
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re: Best medication/treatment for treatment restistant acne?


Thanks korey

Is your current treatment working well? Do you get side effects with your topical accutane?




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post #4 of 67 (permalink) Old 03-13-2007, 04:22 PM
 
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re: Best medication/treatment for treatment restistant acne?


from personal experience:

RX: if you have mild/moderate acne and you're considering oral antibiotics i would recommend minocycline. if you want a cream i would say benzaclin. as for severe acne, retin-a, and all the other topical retinoids work well, as does accutane (or so most people claim, however i would be uneasy considering the risk for depression/suicidical thoughts).

OTC: vitamins, vitamins, vitamins. Vitamin A will heal scars and fade red marks; vitamin C and E work in combination to promote healthy skin; zinc works as a natural antioxidant that fights off bacteria; omega-3 is an essential fatty acid; evening primrose oil relieves redness and is also an efa. Also, i have tried this in the past, but it is a hassle...vitamin b5. it works, but it is annoying to pop 10mg of b5 per day, when they come in .5mg (thats 20 pills a day of just b5). NOTE: be weary when using a multivitamin since it may contain iodine, which can easily cause inflammation of the skin and lead to even worst acne.

MY REGIMEN: i have tried so many rx acne medications and only one thing has worked for me, and that is a combination of natural products with rx. for me it is as follows: wash face 2x daily with Basis Cleansing Bar for Sensitive Skin (Dove Bar for sensitive skin....both very good cleansers). Apply benzaclin at night to areas that are acne prone or use as on-the-spot if you want (depends how sensitive your skin is and how severe the acne is). then, make sure to take Vitamin A, E, C, Zinc, Evening Primrose Oil, and Omega-3 (if you want doses, etc...simply ask and i will post). this has worked wonders for me and this is coming from someone who has tried (i'll try to remember everything): proactiv, murad, acne.org regimen, minocycline, tazorac, differin, neutrogena on the spot, doxycycline, and probably many others.

very long post, but acne ruined my life when i had it, and i am so happy to be clear so i had to share my success story in full detail.
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post #5 of 67 (permalink) Old 03-13-2007, 04:42 PM
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If you have bad acne, then take accutane. I'm on it right now, its been 4 months and I'm almost completely free of lesions. However I still have all these annoying left over red marks, so it still looks bad. The only other things that helped for me was benzaclin and tazorac for a while, but not nearly as good as accutane. I don't see the point in wasting time using a million different remedies when accutane works every time. If the acne isn't that bad, then any kind of benzyol peroxide should work if you apply it twice a day.

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post #6 of 67 (permalink) Old 03-13-2007, 04:58 PM Thread Starter
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Re: re: Best medication/treatment for treatment restistant a


Quote:
Originally Posted by LDG 124
from personal experience:

RX: if you have mild/moderate acne and you're considering oral antibiotics i would recommend minocycline. if you want a cream i would say benzaclin. as for severe acne, retin-a, and all the other topical retinoids work well, as does accutane (or so most people claim, however i would be uneasy considering the risk for depression/suicidical thoughts).

OTC: vitamins, vitamins, vitamins. Vitamin A will heal scars and fade red marks; vitamin C and E work in combination to promote healthy skin; zinc works as a natural antioxidant that fights off bacteria; omega-3 is an essential fatty acid; evening primrose oil relieves redness and is also an efa. Also, i have tried this in the past, but it is a hassle...vitamin b5. it works, but it is annoying to pop 10mg of b5 per day, when they come in .5mg (thats 20 pills a day of just b5). NOTE: be weary when using a multivitamin since it may contain iodine, which can easily cause inflammation of the skin and lead to even worst acne.

MY REGIMEN: i have tried so many rx acne medications and only one thing has worked for me, and that is a combination of natural products with rx. for me it is as follows: wash face 2x daily with Basis Cleansing Bar for Sensitive Skin (Dove Bar for sensitive skin....both very good cleansers). Apply benzaclin at night to areas that are acne prone or use as on-the-spot if you want (depends how sensitive your skin is and how severe the acne is). then, make sure to take Vitamin A, E, C, Zinc, Evening Primrose Oil, and Omega-3 (if you want doses, etc...simply ask and i will post). this has worked wonders for me and this is coming from someone who has tried (i'll try to remember everything): proactiv, murad, acne.org regimen, minocycline, tazorac, differin, neutrogena on the spot, doxycycline, and probably many others.

very long post, but acne ruined my life when i had it, and i am so happy to be clear so i had to share my success story in full detail.
your regimen sounds very promising, please post the dosages




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post #7 of 67 (permalink) Old 03-13-2007, 05:29 PM
 
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Re: re: Best medication/treatment for treatment restistant a


Quote:
Originally Posted by Noca
your regimen sounds very promising, please post the dosages
Vitamin A = 10,000 IU (one at night)
E = Natural E 400 IU (one at night)
C = Ester-C 500mg (one at night)
Zinc = 50mg (one at night)
Evening Primrose Oil = 1300mg (one in the morning, one at night)
Omega-3 = 400mg EPA + 200mg DHA (get the Premium Omega Mega Potency; it is more expensive, but very efficient. take one in the morning and one at night, or just one at night if you find it to be more economical)

All of these vitamins can be purchased at your local GNC.
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post #8 of 67 (permalink) Old 03-13-2007, 05:43 PM
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Re: re: Best medication/treatment for treatment restistant a


Quote:
Originally Posted by Noca
Thanks korey

Is your current treatment working well? Do you get side effects with your topical accutane?
My current treatment is working well, although I've been wanting to bomb my entire body's skin with a cycle of Accutane ever since I read about it. Facial acne is one thing, but shoulder acne/"bacne" is another monster, one that can't be easily treated with topicals. Too bad Accutane would cost me between $300 and $500 a month (even as generic). Damn retinoids and their high cost.

Retinoids are derived from vitamin A (aka retinoic acid), which is probably why vitamin A has the skin treatment qualities that it does. In fact, there is some website that sells bottles of highly concentrated vitamin A for topical treatment of skin problems (mainly acne). When I say highly concentrated, I mean 25,000 IU per drop, which is pretty high for those who are familiar with the IU system in vitamin dosages/measurements.

I've tried supplements, but none of them ever worked that great for me. I remember that a vitamin A supplement I took made my facial skin less oily for a few days, but that was all. I take a sublingual vitamin B complex supplement occasionally because I've read that the B vitamins (particularly B12) can help metabolism => increase medication absorption, and give energy to boot .

I didn't have much of a life to ruin, but acne definitely tested that fact when I started breaking out badly back in high school. My mom finally let me see a dermatologist near the end of my junior year of high school, but I didn't come across RAM until the summer before my senior year.

As for side effects, think "sunburn." Retinoids like RAM, Tazorac, and Differin all work by increasing the rate at which your skin sheds its cells, which stops your pores from clogging, which really does stop zit formation at the source. But like I said, there is a sunburn that you get on your face for a couple of weeks once you first start treatment. Your skin peels and gets red and shiny for a while. It's a little painful, but that's because it's bringing all the crap at the base of your skin to the surface and then getting rid of it. It also speeds up healing (perk of being a vitamin A derivative), so when a zit does form, it can be gone within a day or so rather than a week to a month as mine used to last.

Since the point of retinoid treatment is to keep your pores unclogged, it's best to use cleansing and moisturizing products that specifically say "noncomedogenic" on the label. I used to use Purpose Gentle Daily Cleanser and its corresponding daily moisturizer/sunblock, but then I found this Eucerin Redness Relief skin calming system that actually worked a lot better (but is a lot more expensive). It's tinted light green, so it actually neutralizes the red color from acne/hyperpigmentation. I love that stuff. I need to go get some more from Walgreens.

Oh, and while antibiotics can be useful, they shouldn't be used long-term. I was on minocycline for almost a year and found that it was starting to kill the good bacteria in my digestive system, so I had to stop taking it. Doxycycline gave me terrible stomach cramps. I was never brave enough to try tetracycline being as it was the "strongest" of that type of antibiotic. I'm also apparently allergic to sulfa-based antibiotics because I tried Bactrim DS for my acne once, and it was during Hurricane Katrina. I had a rash all over the place (and I mean all over the place) and no A/C or running water. That was an unpleasant experience...

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post #9 of 67 (permalink) Old 03-14-2007, 08:27 AM
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re: Best medication/treatment for treatment restistant acne?


Accutane (isotretinoin), period.

I have been on them all. Wrt antibiotics, I've tried all the anti-acne types: -myacin, tetracycline, and bactrim/sulfa classes, as well as intranasal and high-potency antibiotics. I have tried all topical retinoids; the strongest topical retinoid is Tazorac. No topical is as effective as Accutane, however. I've tried anti-inflammatories, azelaic acid, so on and so forth... I can't even remember them all.

I was recently on Tazorac, Benzaclin, and high-dose minocycline (as well as intermittent cephalaxin Rx's). And fish oil and specific doses of vitamin E and B and C and zinc and other stuff. This was the most effective combination I'd been on, yet it was crap. I continued to have nodulocystic acne. I tried every OTC remedy as well... in fact, continue to take several OTC remedies (for other purposes), but for acne they do nothing.

I started Accutane therapy last Saturday. There was *literally* nothing left to try.

Medication-related posts are for brainstorming purposes only. Talk to your doctor.

My meds: Parnate, Lamictal, Wellbutrin, trazodone
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post #10 of 67 (permalink) Old 03-14-2007, 01:57 PM
 
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re: Best medication/treatment for treatment restistant acne?


everyone is posting raves and recommendations about accutane. however, people need to understand that not everyone's skin needs accutane. accutane is last resort and is used for acne that does not respond to other treatments or extremely severe cystic acne. a dermatologist will never start out on accutane unless they feel the acne is that severe that no other treatment will work. there are many other treatments that work as good as accutane (sometimes even better). for someone with mild/moderate acne...accutane is not the most sensible answer. your treatment really depends on the severity of your acne; accutane is not for everyone.
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post #11 of 67 (permalink) Old 03-14-2007, 03:11 PM
 
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Re: re: Best medication/treatment for treatment restistant a


I've been on Accutane twice and still have crummy skin. After the second round failed to show lasting improvements, I just stopped seeing my dermatologist because at that point I'd already been with her for 6 years.
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post #12 of 67 (permalink) Old 03-14-2007, 06:48 PM
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Re: re: Best medication/treatment for treatment restistant a


Quote:
Originally Posted by LDG 124
everyone is posting raves and recommendations about accutane. however, people need to understand that not everyone's skin needs accutane. accutane is last resort and is used for acne that does not respond to other treatments or extremely severe cystic acne. a dermatologist will never start out on accutane unless they feel the acne is that severe that no other treatment will work. there are many other treatments that work as good as accutane (sometimes even better). for someone with mild/moderate acne...accutane is not the most sensible answer. your treatment really depends on the severity of your acne; accutane is not for everyone.
I understand where you are coming from. For those with mild to moderate acne, many of the other treatments can work (though usually half-assed). But if you are looking for the BEST treatment for acne, accutane easily wins. Accutane is really looked upon as this super serious and dangerous drug. But, its side effects are not really any different from other acne medications. Basically what you get is dry skin, specifically dry lips. Other acne treatments like benzoyl peroxide and topical retinoids dry out and irritate your skin a lot worse than accutane will. Unless you plan on getting pregnant, accutane isn't any more dangerous than an ssri.

I tried going through a regimen of different cremes, washes, vitamins and moisturizers, and it was ok, but it was way too much of a hassle without any strong results. People like me who are resistant to these treatments, I recommend accutane to because it works for me and everyone else I know.

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post #13 of 67 (permalink) Old 03-14-2007, 08:22 PM
 
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re: Best medication/treatment for treatment restistant acne?


"best medication/treatment for treatment resistant acne"?

if this is the case, then accutane. but make sure your acne really is "treatment resistant" and that you haven't just tried a couple of otc's.

has anyone here actually tried accutane? what was your skin like before the tane? after? side effects?
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post #14 of 67 (permalink) Old 03-15-2007, 03:35 PM
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re: Best medication/treatment for treatment restistant acne?


I took my daughter to the doctor yesterday and for acne she has put her on Duac . Firstly she must wash her face with fragrance-free cleanser such as Neutrogena or Cetaphil then put on this gel.
This stuff has Clindamycin/Benzoyl peroxide in it - it's on prescription here.
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post #15 of 67 (permalink) Old 03-15-2007, 04:10 PM
 
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Re: re: Best medication/treatment for treatment restistant a


Quote:
Originally Posted by lilly
I took my daughter to the doctor yesterday and for acne she has put her on Duac . Firstly she must wash her face with fragrance-free cleanser such as Neutrogena or Cetaphil then put on this gel.
This stuff has Clindamycin/Benzoyl peroxide in it - it's on prescription here.
Duac never worked that well for me as benzaclyn (same basic ingredients)
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post #16 of 67 (permalink) Old 03-15-2007, 07:51 PM
 
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Re: re: Best medication/treatment for treatment restistant a


[quote=drive-to-the-hoop]
Quote:
Originally Posted by "LDG 124":8e5b2
everyone is posting raves and recommendations about accutane. however, people need to understand that not everyone's skin needs accutane. accutane is last resort and is used for acne that does not respond to other treatments or extremely severe cystic acne. a dermatologist will never start out on accutane unless they feel the acne is that severe that no other treatment will work. there are many other treatments that work as good as accutane (sometimes even better). for someone with mild/moderate acne...accutane is not the most sensible answer. your treatment really depends on the severity of your acne; accutane is not for everyone.
I understand where you are coming from. For those with mild to moderate acne, many of the other treatments can work (though usually half-assed). But if you are looking for the BEST treatment for acne, accutane easily wins. Accutane is really looked upon as this super serious and dangerous drug. But, its side effects are not really any different from other acne medications. Basically what you get is dry skin, specifically dry lips. Other acne treatments like benzoyl peroxide and topical retinoids dry out and irritate your skin a lot worse than accutane will. Unless you plan on getting pregnant, accutane isn't any more dangerous than an ssri.
[/quote:8e5b2]

That's incorrect. They consider it serious because it is serious. Yeah, nobody should get pregnant on it, but evidently it does happen or else they wouldn't make girls/women jump through hoops just to get and stay on the medication. And do you think the monthly blood tests are just for show? They have to monitor your liver functions (and other things) and there's the mandatory monthly pregnancy test for women that's also run during that time. We can't forget the mental effects that Accutane has, which are common and significant. It makes your skin extremely sensitive, not just dry. It tears and burns much more easily and risks scarring. There are other very serious side effects that I can testify to not just being on paper because I've experienced them myself (i.e. brain swelling).
Comparing it to an SSRI is extremely false and misleading for those that don't know much or anything about Accutane. The side effects are much different than other acne medications because most are only topical (so they can only speak to the dryness and not what goes on inside the body).

Also, for mild to moderate acne, many medications and OTC products aren't half-assed. I know plenty of people who have seen great success on a number of products whereas I'm still struggling after so many years. Accutane is only the best treatment for persistent and serious acne.
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post #17 of 67 (permalink) Old 03-16-2007, 03:39 AM
 
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Re: re: Best medication/treatment for treatment restistant a


Quote:
Originally Posted by archaic
That's incorrect. They consider it serious because it is serious. Yeah, nobody should get pregnant on it, but evidently it does happen or else they wouldn't make girls/women jump through hoops just to get and stay on the medication. And do you think the monthly blood tests are just for show? They have to monitor your liver functions (and other things) and there's the mandatory monthly pregnancy test for women that's also run during that time. We can't forget the mental effects that Accutane has, which are common and significant. It makes your skin extremely sensitive, not just dry. It tears and burns much more easily and risks scarring. There are other very serious side effects that I can testify to not just being on paper because I've experienced them myself (i.e. brain swelling).
Comparing it to an SSRI is extremely false and misleading for those that don't know much or anything about Accutane. The side effects are much different than other acne medications because most are only topical (so they can only speak to the dryness and not what goes on inside the body). Also, for mild to moderate acne, many medications and OTC products aren't half-assed. I know plenty of people who have seen great success on a number of products whereas I'm still struggling after so many years. Accutane is only the best treatment for persistent and serious acne.


and although many people are skeptical about the suicide rate factor, it is not made up information. there are many stats proving this.
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post #18 of 67 (permalink) Old 03-16-2007, 07:23 AM
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re: Best medication/treatment for treatment restistant acne?


Accutane is the heavy duty artillery in the acne-fighting arsenal. I was on it for five months and it basically cured the moderately severe acne I had, though the side effects were bad. Now that's all over but I'm left with those annoying red marks and icepick acne scars that don't seem to be getting any better. I don't know if there's any way to get rid of them.


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post #19 of 67 (permalink) Old 03-16-2007, 06:25 PM
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Re: re: Best medication/treatment for treatment restistant a


Quote:
Originally Posted by archaic
That's incorrect. They consider it serious because it is serious. Yeah, nobody should get pregnant on it, but evidently it does happen or else they wouldn't make girls/women jump through hoops just to get and stay on the medication. And do you think the monthly blood tests are just for show? They have to monitor your liver functions (and other things) and there's the mandatory monthly pregnancy test for women that's also run during that time. We can't forget the mental effects that Accutane has, which are common and significant. It makes your skin extremely sensitive, not just dry. It tears and burns much more easily and risks scarring. There are other very serious side effects that I can testify to not just being on paper because I've experienced them myself (i.e. brain swelling).
Comparing it to an SSRI is extremely false and misleading for those that don't know much or anything about Accutane. The side effects are much different than other acne medications because most are only topical (so they can only speak to the dryness and not what goes on inside the body).

Also, for mild to moderate acne, many medications and OTC products aren't half-assed. I know plenty of people who have seen great success on a number of products whereas I'm still struggling after so many years. Accutane is only the best treatment for persistent and serious acne.
Wow. Sounds like you had a really tough time. I've never known anyone to get brain swelling from accutane. Your right that I shouldn't have compared it to an ssri, which is a totally different drug. However, from what I've heard from my doctors, the side effects are mostly dose dependent. I've worked very slowly up from 10-40mg over a course of 4 months, and never had worse side-effects than dry lips or headaches. Although it worked much slower than starting at a high dose, its still as effective in the slighter-longer run. Perhaps moving slowly up the dosage chain is the key to minimizing side effects?

The worse side-effect I've ever heard from someone I knew was a raise in blood-cholesterol levels. Yes, this is why blood-tests are important. He cut down on his cholesterol intake and fatty foods, and he was fine. For most of those with severe acne, there really isn't any medication that is going to work better for you than accutane. I'm sorry if I'm biased, but this drug saved my life and many other lives I know.

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post #20 of 67 (permalink) Old 03-16-2007, 07:28 PM
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re: Best medication/treatment for treatment restistant acne?


Quote:
The worse side-effect I've ever heard from someone I knew was a raise in blood-cholesterol levels. Yes, this is why blood-tests are important.
Yep. In fact, at the conclusion of my Accutane course the dermatologist wanted me to take another blood test because my cholesterol levels (the 'bad' cholesterol, or LDL) were too high. I never did end up doing that though. That was almost five years ago though so I assume I'm fine now


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