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New mum to summer rose
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For SA the only SSRI that worked (make that anti depressant that worked) for me and my family members who had SA was Paxil. Nothing else seems to tackle SA like paxil for some reason even though it comes with alot of nasty side effects that non ssri medications and stimulants will not give you, it does work better for me than a benzo for social anxiety. TCAs do not do anything for SA personally and SNRI meds like effexor have not proved useful either :/
possibly you might find a stimulant like dexedrine or ritalin helps but it just made me manic depressive.
Aside from paxil, the only other social stimulant for me was lorazepam (Ativan) and high doses of diazepam as clonazepam or klonopin as its known just tires you out, its not a social booster.
Yeah if you can put up with the side effects and take a small amount then paxil is the best for SA
 

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New mum to summer rose
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Side effects on paxil were not that bad actually, considering I went up to 60mg which is bordering on serotonin overload.
They were as follows in the first four weeks

Dry mouth (very minimal compared to the other pills I have been prescribed)
Stomach upsets (if you miss a dose or forget to take one that day)
Headaches (last about a week)
Nausea (The worst side effect by far but it did go)
Lost appetite (lasts a month or two)
Sleepiness and sleeping in more often (not such a bad thing)

Over all the side effects were not fun but tolerable and for some reason my sex drive was HIGH on these compared to effexor, nortiptyline and clonzepam but fluoxetine was even better for increasing libido and having little to no side effects aside from massive weight gain, which in a bulimic person like myself is BAD.

Over all paxil are something I am reconsidering going back on, so is my P-doc as they do the best job for SA and OCD and the lack of motivation I feel on effexor is very debilitating, i mean on paxil i could work part time, on effexor I cannot even do three hours in a job. I cannot sleep or leave the house without intense effort and withdrawals from effexor are the worst, make sure you say no to these, do yourself a favor :) Stick with the lower dose SSRI meds that have less withdrawal side effects even paxil is less severe if you switch to fluoxetine than effexor.
 

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New mum to summer rose
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I've taken fluoxetine, which is in theory the most interesting atypical SSRI. It worked wonderfully with some augmentations (yohimbine, fluanxol) for 2-3 months. Now it's hardly noticeable. I think SSRI needs some augmentation to hasten/enhance/improve the effect.
Yes true :)
SSRI meds on their own do not seem to work on all aspects so its good when its augmented with something out of the SSRI class like an NDRI type of drug thats moderately safe to use with it.
some people find mirtazapine good others like wellbutrin :D
personally i would have wellbutrin over mirtazapnine because of the horrific weight gain on mirtazapine and zombie like sedation :)
 

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Paxil is good on 10mg dose. I think it is the best "safe" drug for SA. Best of all the drugs is lorazepam but it has strong addictive potential.
 

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The Power Of Nature
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SSRI's are not much better then placebo with lexapro being a bit better and having the least side effects, they are effective in addition to another med tough.
Many are being overdosed, one can get beneficial effects from 2,5mg of lexapro.
 

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for SA are SSRI's the best option to start off with?
SSRI's are usually the "front-line" treatment most doctors like to start with when treating an anxiety disorder. They are not necessarily the best or most effective option, but are perhaps among the safer drugs to start out with. There's also a wide range available with different profiles to suit different conditions and people. Some people find some SSRI's effective for anxiety, particularly if there is depression or low mood as well.

I tried loads of SSRI's myself and found the side effects to be intolerable such that I wasn't able to even take them long enough to see if they worked. That is a major drawback with SSRI's, the side effects and the fact they normally take 4-6 weeks before they begin to work.
 

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for SA are SSRI's the best option to start off with?
it doesnt matter if its the most effective its what you will be prescribed, most likely, first.

everyone has an opinion my dr has said hes seen a huge amount of success with zoloft. it has not worked for me but it has basically cured dysthimia (mild depression) so i am continuing to take it
 

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SSRI's are usually the "front-line" treatment most doctors like to start with when treating an anxiety disorder. They are not necessarily the best or most effective option, but are perhaps among the safer drugs to start out with. There's also a wide range available with different profiles to suit different conditions and people. Some people find some SSRI's effective for anxiety, particularly if there is depression or low mood as well.

I tried loads of SSRI's myself and found the side effects to be intolerable such that I wasn't able to even take them long enough to see if they worked. That is a major drawback with SSRI's, the side effects and the fact they normally take 4-6 weeks before they begin to work.
have u tried going up slowly? i had this problem and i started on 12.5mg of zoloft for 3 weeks ,then moving up by 12.5mg every 3 weeks until hitting the effective dose i had almost no side effects doing it this way.

the typical starting dose for zoloft is 25mg for 1 week then 50mg for 4-6 weeks, so as you can see it was quite a gradual ramp-up
 

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SSRI is probably the best thing to try first.

In reality many people need more than just an SSRI. It can help some but usually nothing close to benzos.

Klonopin, xanax, ativan.....these are the meds that work good on anxiety. They also get you high and are considered abuseable and dangerous by some.
 

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New mum to summer rose
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:)

Paxil is good on 10mg dose. I think it is the best "safe" drug for SA. Best of all the drugs is lorazepam but it has strong addictive potential.
This ^^ :ditto ^___^
Paxil combined with low dose lorazepam (under 2.5mg) is social gold.

Then again lorazepam is highly addictive and short lasting and very easy to want more of like most benzos but this one seems to offer the kick that diazepam and klonopin did not do for me but that's personal opinion as a lot of people find klonopin very effective but I am yet to hear about its positive social effects.

Stimulants help a lot of people on here with very bad SA
Mine was never bad enough except as a teen so I found paxil and a bit of lorazepam effective and now I do not need benzos but definitely start with something low dose and possibly try lexapro first or fluoxetine so if they do not help your SA then the withdrawals and tapering onto paxil wont be so hard as if you were to do it the other way around (from paxil slowly onto fluoxetine or lexapro)
say no to celexa though, its just a weaker version of lexapro and i am yet to see it work for anyone I know on it, my husband included, he would benefit from Paxil but there is a 67% chance of ED on it so he is really wary of it :s
 

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crazymed said:
SSRI's are not much better then placebo
I have experiences with sertraline and paroxetine. Sertraline is good only at starting(stimulating effect) but paroxetine is good for social anxiety, generalised anxiety, premature ejaculation :D and for emotional problems. I'm not so emotional agressive(also self-agressive) when taking paroxetine, I'm more self confident and I don't think too much on stupid things(GAD). So I really have many reasons to take it. It just simply reverse my neurotic personality.

But while I consider paroxetine a good med, also good for SA I must say it is not good enough for SA. I would not go to work being only on paroxetine and this is the problem.

Arisa1536 said:
Then again lorazepam is highly addictive and short lasting and very easy to want more of like most benzos but this one seems to offer the kick that diazepam and klonopin did not do for me
For me clonazepam works but I need at least 1,5-2mg. 3-4mg is good dose for me.
 

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For SA the only SSRI that worked (make that anti depressant that worked) for me and my family members who had SA was Paxil. Nothing else seems to tackle SA like paxil for some reason even though it comes with alot of nasty side effects that non ssri medications and stimulants will not give you, it does work better for me than a benzo for social anxiety. TCAs do not do anything for SA personally and SNRI meds like effexor have not proved useful either :/
possibly you might find a stimulant like dexedrine or ritalin helps but it just made me manic depressive.
Aside from paxil, the only other social stimulant for me was lorazepam (Ativan) and high doses of diazepam as clonazepam or klonopin as its known just tires you out, its not a social booster.
Yeah if you can put up with the side effects and take a small amount then paxil is the best for SA
Paxil was the first med I was ever prescribed for SA when it was still a relatively new drug around 1999-2000. I know what you mean about the side effects, they were horrendous for me. I literally felt like I had been poisoned and was dying. Couldn't stand it after 2 weeks and had to quit. I took 20mg and these are the side effects I felt:

- Strong Metallic taste in throat and mouth
- A weird sensation in throat like I needed to keep swallowing
- Nausea and sick feeling in stomach
- Extreme lethargy and no energy
- Weakness in limbs and muscular pains
- Constant dull headache
- Flu-like feeling of general ill-ease and shaky/weak feeling
- Complete lack of appetite
- Wanting to sleep all the time
- Low mood and lack of motivation to do anything
- Anxiety and increased fear, feeling shaky inside
- Erectile dysfunction and inability to reach orgasm

I very rarely get major side effects like this from drugs and normally tolerate them well, but this drug is the only one which more or less gave me the full list. I wonder if that is because it was a sign it was effective or just totally not suitable for me.

I'm interested what dose you took, what side effects you experienced, and how you coped? Do you think Paxil is as effective a drug as Nardil? Did it totally obliterate your SA and turn you into an outgoing person?

I remember at the time Paxil was licensed in the UK specifically for social phobia there was a lot media attention and they were hyping it as the "shyness pill that turns shy people into social butterflies" so I had high hopes for it and was disappointed when the side effects were so severe.

I've since learned there is an XR (extended release) version and I wondered if that had has fewer side effects, or whether going on a very low dose and building up gradually might work.
 

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Paxil was the first med I was ever prescribed for SA when it was still a relatively new drug around 1999-2000. I know what you mean about the side effects, they were horrendous for me. I literally felt like I had been poisoned and was dying. Couldn't stand it after 2 weeks and had to quit. I took 20mg and these are the side effects I felt:

- Strong Metallic taste in throat and mouth
- A weird sensation in throat like I needed to keep swallowing
- Nausea and sick feeling in stomach
- Extreme lethargy and no energy
- Weakness in limbs and muscular pains
- Constant dull headache
- Flu-like feeling of general ill-ease and shaky/weak feeling
- Complete lack of appetite
- Wanting to sleep all the time
- Low mood and lack of motivation to do anything
- Anxiety and increased fear, feeling shaky inside
- Erectile dysfunction and inability to reach orgasm
I experienced most of those but that is something you have to expect and be prepared for if you plan on taking an SSRI. Your doctor should have warned you. Most if not all go away eventually as they did for me. The one that I think is most likely not to go away completely is orgasm problems. Things like this are different for everyone but the one thing you need to know is that you have to be able to give these medications a chance if you want any shot at them working.

For me the side effects were so bad I ended up in the emergency room but I held on and now Paxil works SUPER for me.

I would, however, make sure you have not caused serotonin syndrome which can be immensely dangerous. I've heard that it is possible to cause it taking just one SSRI but I have no proof of that, it usually happens when people take something else that increases serotonin. I personally feel like I was close to that point when I first started Paxil. I don't want to give you the impression there is no risk. Just be careful and monitor your symptoms and don't take something else you are not sure is ok.
 

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Side effects on paxil were not that bad actually, considering I went up to 60mg which is bordering on serotonin overload.
They were as follows in the first four weeks

Dry mouth (very minimal compared to the other pills I have been prescribed)
Stomach upsets (if you miss a dose or forget to take one that day)
Headaches (last about a week)
Nausea (The worst side effect by far but it did go)
Lost appetite (lasts a month or two)
Sleepiness and sleeping in more often (not such a bad thing)

Over all the side effects were not fun but tolerable and for some reason my sex drive was HIGH on these compared to effexor, nortiptyline and clonzepam but fluoxetine was even better for increasing libido and having little to no side effects aside from massive weight gain, which in a bulimic person like myself is BAD.

Over all paxil are something I am reconsidering going back on, so is my P-doc as they do the best job for SA and OCD and the lack of motivation I feel on effexor is very debilitating, i mean on paxil i could work part time, on effexor I cannot even do three hours in a job. I cannot sleep or leave the house without intense effort and withdrawals from effexor are the worst, make sure you say no to these, do yourself a favor :) Stick with the lower dose SSRI meds that have less withdrawal side effects even paxil is less severe if you switch to fluoxetine than effexor.
Both Paxil and Prozac raised your libido?
 
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