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Discussion Starter · #1 ·
I've been on Klonopin(aka Rivotril aka clonazepam) for 5 years now. This drug is absolutely amazing for my social phobia and AvPD, almost like magic. I can down this drug and go out and do all the things I've always wanted.

Before Klonopin, I could barely leave the house and spent most of my time alone. I only used the telephone when I had to, and avoided everything in life.

In the last five years while on Klonopin:
  • I've visited countries all over the world.
  • I've met and had numerous relationships with the opposite sex, including meeting and marrying my current wife.
  • I moved from the U.S. to Europe (country withheld to maintain my complete anonymity).
  • I launched a semi-successful business due to my ability to meet and talk to clients(however the business success was short-lived :()
  • I've met complete strangers on Facebook who live near me, then met them at a pub just to have a beer. (I even invited THEM)
  • I regularly initiate polite conversations with complete strangers.
  • And there are plenty of other "pro-social" things that I've done while on the drug. Too many to list here.
Now there WAS a bit of effort in learning to navigate this "new social world" and forcing myself to face a bit of residual fear. But mostly, ALL of this stuff was made possible by Klonopin.

Now here's the bad part...(Come on, this is SocialAnxietySupport. You knew there was going to be a bad part :p)

  • I am completely and totally addicted to this stuff(can you blame me?)
  • My dose tolerance to the drug has gone through the roof. I now need 4mg a day just to stay calm when I'm indoors, to overcome my generalized anxiety. If I want to go out and do something, that dose goes up to a whopping, ridiculous 8 to 10mg to conquer my social phobia!

    I sometimes try a lower dose, while carrying an "emergency pill" or two with me, but I usually end up needing to pop the emergency pill under my tongue to deal with my anxiety.
  • When I don't have enough Klonopin in my system, it's very hard to get to sleep and I never get a good nights rest(light sleep, frequent waking, etc.).
  • My memory which used to be perfect(I remembered things down to the minutest detail) is now complete and utter crap.

    I sometimes re-watch movies I've already seen in the theater when they come out on DVD. Not for the joy of re-watching, but because I can't remember half of it because I was buzzed on 8mg of Klonopin at the theater. However, memory loss is a known side effect of the drug, so this may only be temporary. I don't have the problem as bad if I watch a movie while on a low dose or none at all.
  • Overall mental fogginess. I get confused very easily, lose my train of thought, etc. I've read on some sites that this might be permanent.
*The WORST one is- I believe that the Klonopin has made my anxiety worse than before when I'm not taking it or not taking enough! I've read on some sites that this might be permanent :(. I read somewhere that Klonopin may permanently damage some receptor sites in the brain that lessen the effect of adrenaline.

So here's the big question: What do I do now?

Do I just taper off the drug, then quit and climb back into my shell of never leaving the house?

Do I try some kind of therapy and just hope for results?

Do I just keep taking it and try to reduce the dose?

Do I do the hokey-pokey and turn myself around? :p

Anyway, if anyone was nice enough to read my book length post, I would appreciate any thoughts, comments, or advice.

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This is the reason I haven't tried a benzo yet, and probably never will.
 

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Well, at least you got a taste of the good life for a short while. Klonopin has been great to me but I try to keep my usage very sparse, no more than twice a week. I think this is the best way to keep using it long-term, and I still have to go out in public every once in awhile without any drugs and try to become resistant to the anxiety and awkwardness on my own. I know this means completely **** all to your situation, but I don't think I'll ever be benzo free either. I mostly take it because it helps with my tinnitus (constant ringing in the ears).

I've never had to taper from a benzo before so I'm not familiar with the process but I know it takes a long time, and that's what I'd do in your situation if the side effects of constant use were starting to cripple me. And then continue to take klonopin maybe twice a week, a barbituate once a week (don't know much about this, but I saw Medline post something about it once), and maybe gabapentin once or twice a week in combination with some kind of therapy. I don't like stimulants myself but some people here have had good success with them in combination with self-control and memantine. I'd imagine you have a pretty difficult and painful road ahead of you tapering from such a high dosage, but again I don't really know.
 

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I had a somewhat similar experience on Xanax (Alprazolam). I took it for 3 years, became tolerant and dependent, and finally went off ~a couple of months ago.

If you going to taper off Clonazepam, then you must get a working combo because I simply relapsed a many months ago when I tapered off Alprazolam and there wasn't any effective regimen. That said, I suggested 30 mg Memantine + Amphetamine with periodic breaks.

Also, work with your Pdoc on a slow taper or Diazepam substitution, don't go cold turkey, feel free to ask any question.
I concur with these suggestions. I would still add another drug to combat your SA/GAD besides just amph, memantine and benzos. Have you tried the SSRI's, SNRI's or MAOI's yet? They are a more longer term solution than benzos.
 

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Discussion Starter · #7 ·
Thanks for all the great advice guys. Sorry it took me so long to answer back, but I actually had to "research" some of the drugs/treatments mentioned before I could cobble together a (somewhat)intelligent reply.

That said, I suggested 30 mg Memantine + Amphetamine with periodic breaks.
Guide 4 Dummies- After reading through many of the posts here at SAS, it seems that the Memantine + Amphetamine combo is usually effective for people who have problems being social even when their anxiety is reduced. For example, I believe Crazymed reported that benzos do absolutely nothing for him, but the mem + amph combo worked wonders because it gave him the energy and drive to "get out there" socially. Another user(can't remember the screen name right now) reported that his SA was mostly caused by the fact that he couldn't motivate himself to be social, but not so much by a fear of social activities. He was also helped by the mem + amph combo.

Although I'm certainly no "social butterfly", I really don't have a problem socializing when I'm relaxed, such as after taking Klonopin. This makes me think that an amphetamine combo might not be right for me, especially since even a cup of coffee gives me the jitters. I would be afraid that an amphetamine would just make me feel MUCH more nervous.

Isn't the memantine just used to prevent tolerance to the amphetamine? Or is there some benefit in taking memantine alone?

This is the reason I haven't tried a benzo yet, and probably never will.
Well, don't let my story scare you off of them entirely. My problem was that I started using them too frequently. As Under17 noted, Klonopin is GREAT for situational anxiety where you just need something to pull you through, for example: job interviews, speeches, big social events, airplane flights, etc etc

Klonopin has been great to me but I try to keep my usage very sparse, no more than twice a week. I think this is the best way to keep using it long-term, and I still have to go out in public every once in awhile without any drugs and try to become resistant to the anxiety and awkwardness on my own.
[SNIP]
And then continue to take klonopin maybe twice a week, a barbituate once a week (don't know much about this, but I saw Medline post something about it once), and maybe gabapentin once or twice a week in combination with some kind of therapy. I don't like stimulants myself but some people here have had good success with them in combination with self-control and memantine.
Yeah, I think the "no more than twice a week" rule is a good one. I started using it daily because... well, it just worked amazingly well. Plus I have GAD and AvPD too, so it helped with those conditions. But daily use just leads to greater and greater tolerance.

I don't like the idea of stimulants either. Anything that makes me feel "speedy" always seems to make my anxiety worse. Then again, I've never tried an amphetamine, so maybe the feeling is different than I imagine.(I imagine it feeling like I just drank 3 gallons of espresso :teeth)

I just have no idea how to cope with my GAD and AvPD without the Klonopin. I'm thinking maybe some meditation for the GAD and trying to force myself to try some CBT and exposure therapy for the AvPD? Do you (or does anyone else reading this) think this sounds like a good plan?

Go on a different med. Have you tried any others besides benzo's for your SP?
I think I've literally tried every SSRI except Prozac. Paxil was the only one I tried that didn't make my anxiety worse.

Paxil made me feel a bit better, but I'm not sure it was enough to justify the side effects: "weird" feeling in my head all the time, constant yawn reflex, teeth grinding, some mild sexual side effects, etc. When I was on Paxil, my mom did tell me that I "seemed less angry", but that could have just been her wishful thinking. I sometimes wonder if my "slight improvement" on Paxil might have just been a placebo effect. After all, I knew I had a drug in my system that might help my SA, so I could have simply been trying to be a bit more social to somehow convince myself that it was helping more than it was.

I've never tried an MAOI.

Anyway, I would appreciate any other thoughts or suggestions you guys might have. You all really seem to know your stuff when it comes to SA meds! :)

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Careful on the meds

Hey man,

I think meds are great for getting yourself out there and building positive experiences and social skills that a lot of social-phobes have never had the opportunity to work on before. But, looking at meds as a complete "solution" to fix a chemical imbalance might be the wrong mentality. No doubt most all of us on this forum have something screwed up with our neurotransmitters, but the fact is that psychiatry may not be sufficiently equipped to deal with this disorder with chemicals alone.

I respond really, extremely well to meds like Klonopin and Paxil, but I worry greatly about poop-out, withdrawal, dependance, and most importantly long-term side effects. For this reason, I view long-term med usage as a last resort. I think it's good for us to be on meds for a prolonged period of several years to build up a social skillset and to understand and experience normal, satisfying social interaction. Then, once we have had a healthy social life, I think it should become easier to achieve that without meds. Even if we're never going to be politicians or lawyers, we can still lead happy and satisfying lives and carve out a place for ourselves.

I love klonopin - but taking a dependency on it is risky because of tolerance, withdrawal, and the risk of long-term side effects. I had amazing results with Klonopin for the 2-3 years I was on it (off and on) and was able to do things I had never been able to before, meet new people, interact without anxiety, and basically just enjoy life. It pretty much turned me into a social animal, which I loved every second of.

Right now I'm med free (except for the occasional beta-blocker, and a beer or two when I go out but everybody does that) and am doing okay. I'm pretty stressed out and have fairly high levels of anxiety, but I'm doing almost all the things I was doing while on meds (although I have no GF now and don't have nearly as active and successful of a social life). I've been completely sober for several months now (was on Paxil + Klonopin before). Life is pretty tough and I have to deal with anxieties and tension that I know other people don't ever experience, and it sucks. But at the same time, the fact that I am still living my life is rewarding, and I've been able to concentrate on my career, physical fitness, hobbies, etc.

I would still be on meds now if I felt there were no long-term dangers. But, you encounter all these horror stories on forums, and the sheer quantity of them is intimidating. I've started to experience some memory problems and verbal recall from taking Paxil & Klonopin, which is unacceptable and unsustainable for my demanding engineering job, so I've been forced to cut out the meds. Now, I'm much more confident I can lead a happy life sober than I was 6 months ago when I cut out the meds.

Anyway, I think the most important thing is to be resilient. When trying to overcome something like social anxiety or depression, there will be setbacks. You have to cherish the minor victories and not let the setbacks take you all the way back down. When you fall, get up. Every day is a new day to fight the good fight anew, you know.
 

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Discussion Starter · #9 ·
I respond really, extremely well to meds like Klonopin and Paxil, but I worry greatly about poop-out, withdrawal, dependance, and most importantly long-term side effects. For this reason, I view long-term med usage as a last resort.
I dunno. I have mixed feelings about the idea of being on a drug(or several) for my whole life. On the one hand, being permanently dependent on a drug is not "normal" or "natural".

On the other hand, I believe that some of us are just born with chemical imbalances in our brains that are not "normal" or "natural" either. I can remember being a nervous kid from age 6 and showing a few signs of SP even before I developed a "full-blown" case of social anxiety at age 12. Anxiety disorders also run in my family. So I definitely think I was born with an abnormal genetic tendency for anxiety problems.

I mean you wouldn't tell a schizophrenic that he should "just learn to deal" with his problems without medication, so I'm not sure that anyone should tell a social phobic that either...
 

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Schmoe, I think I agree with you in general. But like I mentioned in my post, medicating for social anxiety seems unsustainable. It's generally accepted that being on a benzo chronically for many years is going to cause cerebral damage (sorry to burst any bubbles). It's becoming more accepted, at least by some, that being on an antidepressant for a long period of time can cause lasting damage as well (memory impairment, sexual SEs). It will be interesting to see what 50 years of Prozac use can do to a body.

I'm 24, and despite nearly intolerable social anxiety that is really painful and that I have to deal with on a day-to-day basis and that I know can be successfully alleviated by medication, I'm trying to go without meds at this point. I worry both about poop-out and long-term effects of meds.

Luckily, SA can be mitigated, at least to an extent, by lifestyle factors. Eating and sleeping well, getting daily exercise, avoiding stressors, using meds PRN, building self-confidence, and adapting one's lifestyle can go a long way.

But I have mixed feelings as well. I crave the successful and fulfilling social life that I know I could have if I were on meds, to the extent that I've had it and experienced it previously. For now I have to settle for a smaller circle of friends and a less ambitious social charter. It does suck because, at least for me, fulfilling interaction with others is key to happiness and SA hadicaps one from achieving that. I don't know, it's tough man.
 

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Discussion Starter · #11 ·
Dopaminergics directly helps social anxiety when taken at right doses. Welsey's lack of response to benzo is an anomaly on his side, he has to take a psychostimulant + benzo in order to feel the effects of benzo.
[SNIP]
I think Wesley's reply would be more useful since he tried Amphetamine first hand.
So is it generally accepted knowledge here on the board that amphetamines don't cause increased nervousness and paranoia in social phobics? Like I mentioned before, I always just assumed that(despite the dopaminergic effect) taking an amphetamine would feel like downing 10 gallons of coffee.

I wish Wesley would drop into the thread. NOt only does he have firt-hand experience with amphetamine, I think he's either tried or studied almost every possible treatment for SA. So, are ya out there Crayzymed??? Weigh in :D
 

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Discussion Starter · #12 ·
It's generally accepted that being on a benzo chronically for many years is going to cause cerebral damage (sorry to burst any bubbles). It's becoming more accepted, at least by some, that being on an antidepressant for a long period of time can cause lasting damage as well (memory impairment, sexual SEs). It will be interesting to see what 50 years of Prozac use can do to a body.
[SNIP]
But I have mixed feelings as well. I crave the successful and fulfilling social life that I know I could have if I were on meds, to the extent that I've had it and experienced it previously. For now I have to settle for a smaller circle of friends and a less ambitious social charter. It does suck because, at least for me, fulfilling interaction with others is key to happiness and SA hadicaps one from achieving that. I don't know, it's tough man.
Yeah I realize that being on a benzo "chronically" can cause some neural receptor damage. As I mentioned in my first post, I think I'm experiencing some permanent memory loss and increased anxiety because of my extended use of Klonopin. And before Klonopin, I was on the maximum dose of Paxil for about a year and a half, and I believe that as a result I now have bouts of depression. The start of the depression could have just been a coincidence, but I never had what I would term as depression before taking Paxil, and the depressive episodes started immediately after stopping Paxil.

As you mentioned, it's definitely tough to stop after you've had success with a medication regimen. My life was almost "normal" for 5 years, now I'm back down in the pits of SA as I slowly reduce my daily dosage of Klonopin.

It's SO hard to stay on this reduced dosage and every day I think "F*** this, maybe I should just stay on Klonopin and be happier. If my brain receptors get damaged, so be it. At least I wouldn't be miserable for another few years." So far, I'm still toughing it out and just trying to find SOME better way.
 

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Stimulants and tranquilizers are complete opposites. The reason why people who suffer from SA respond to one and not the other is due to the type of SA one has. For those like you, SA is a more straightforward anxiety disorder and tranquilizers work by providing a calming sensation, allowing you to be yourself without being excessively worried or nervous. For me, anxiety is secondary to my personality; I become anxious when in social situations because I'm very introverted and don't feel any urge to speak and socialize with people -- my disposition is to seclude myself from others and do my own thing, even though I want my mind to seek social engagement. So stimulants work for people with this type of SA because they boost the chemicals in your brain responsible for energy, motivation, alertness, and pursuit of rewarding and pleasurable stimuli. These same chemicals are released when one is anxious, which is why they can increase anxiety especially for those who have the former type of SA.

You have an anxiety disorder, so stay away from amphetamines and drugs that increase norepinephrine, they'll only exacerbate your SA. The best thing to do at this point is stay at the dose of clonazepam you are at right now and every week or two lower it 1mg/day average until you feel minor withdrawal symptoms. Then stick with that dose until those withdrawal symptoms fade. Then once you're comfortable you can continue to slowly lower the dose and repeat the cycle. You can also try other meds like MAOIs for the social phobia (Nardil would suit you much better than Parnate) during or after the clonazepam taper.
 

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Discussion Starter · #14 ·
For those like you, SA is a more straightforward anxiety disorder and tranquilizers work by providing a calming sensation, allowing you to be yourself without being excessively worried or nervous. For me, anxiety is secondary to my personality; I become anxious when in social situations because I'm very introverted and don't feel any urge to speak and socialize with people -- my disposition is to seclude myself from others and do my own thing, even though I want my mind to seek social engagement. So stimulants work for people with this type of SA because they boost the chemicals in your brain responsible for energy, motivation, alertness, and pursuit of rewarding and pleasurable stimuli. These same chemicals are released when one is anxious, which is why they can increase anxiety especially for those who have the former type of SA.

You have an anxiety disorder, so stay away from amphetamines and drugs that increase norepinephrine, they'll only exacerbate your SA.
[SNIP]
You can also try other meds like MAOIs for the social phobia (Nardil would suit you much better than Parnate) during or after the clonazepam taper.
Yeah, the thing about the "two different types of SA" was exactly the same conclusion that I came to after reading through a ton of posts on the board, but you expressed it much better than I did in my earlier post.

I think it would be pretty much impossible for me to get a doctor in this country to prescribe an MAOI, though I'd love to try one. Doctors here just want to either send you to therapy or hand you an SSRI script :(. And there's a 6 month waiting list to see a shrink, ANY shrink.

I could probably get Parnate through...um... my own means, but not Nardil. However, I too have read in posts that Nardil works much better for SA. HAs anyone found Parnate helpful?

Trial and error is the way to go.
So true. Unfortunately, I'm having to do that trial and error method on my own and by paying exhorbitant prices and getting my hands on what meds I can.

I'm considering maybe trying Propranolol to lower my physical anxiety symtoms, mix in some CBT to help with the mental anxiety, and then maybe add some D-Cycloserine to try to make the Propranolol-induced calm state "last" even without the drug. Does that sound any good at all? Or does anyone see any obvious problems there?
 

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Thank you House for repeating what I just said. :)
Repeating what you said just means I agree with you. If only one person said that advice then maybe the OP may not think that is common consensus of the rest of the forum.
 

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Discussion Starter · #16 ·
Repeating what you said just means I agree with you. If only one person said that advice then maybe the OP may not think that is common consensus of the rest of the forum.
For what it's worth- I didn't think that you were repeating what he said. Sure you also asked if I had tried other medications, but you also gave a list of some to try. For example, I had completely forgotten about SNRIs until you brought them up. I don't think I've read many success stories or positive reviews about SNRIs in relation to SA, but I still appreciated the suggestion, and who knows if nothing else works, I may give Effexor a go.
 

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So is it generally accepted knowledge here on the board that amphetamines don't cause increased nervousness and paranoia in social phobics? Like I mentioned before, I always just assumed that(despite the dopaminergic effect) taking an amphetamine would feel like downing 10 gallons of coffee.

I wish Wesley would drop into the thread. NOt only does he have firt-hand experience with amphetamine, I think he's either tried or studied almost every possible treatment for SA. So, are ya out there Crayzymed??? Weigh in :D
My brain is weird, GHB, alcohol, Benzo's, opiates etc all dont work for my social anxiety, GHB "works" eg it induced euphoria but my SA stays there, without amphetamine i'm completely immume to benzo's or opiates, can take like 40mg xanax or 60mg oxycodone and pretty much notice nothing, yet when i take them on a stimulant they do work.

Your saying that klonopin was your miracle cure, so i would say a gabaergic stays the best treatment for your case and i wouldnt bother with amphetamine's.

I would say 40mg memantine would be worth a try, there are study's showing that nmda antagonist prevent tolerance to the sedative effects but not to the anxiolytic effects, so i would cast some doubt, however i know that 2 people (one of them guide4dummies) noticed some reversal of tolerance to the anxiolytic and sedative effects of the benzo's they were on.

Here's guide4dummie's post on another forum:
First of all, thanks graatch for pointing out those things. I'll explain in details.

I took Alprazolam for 3 years, then went through accidental cold-turkey withdrawal because the local pharmacies weren't carrying any (happens where I live occasionally, sucky country/city). I experienced severe withdrawal symptoms including paranoia and transient psychosis but soon I got again on Alprazolam and thankfully didn't have a seizure. During that period I was completely tolerant to 2 mg Alprazolam's both sedative and anxiolytic effects.

Since I started taking memantine, the tolerance was reversed somewhat and 1 mg was anxiolytic and practical enough for social anxiety disorder. 2 mg was very effective sedative. Tolerance didn't develop any further from this point on.
But again, show some doubt as one study showed no tolerance prevention in the rats to the anxiolytic effects, possible explanation is that some NMDA antagonists can behave differendly due to differend binding profile's in the NMDA complex, those anecdotal reports make it promosing, to early to draw conclusions, but worth a try i gues.
 

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I've been on Klonopin(aka Rivotril aka clonazepam) for 5 years now. This drug is absolutely amazing for my social phobia and AvPD, almost like magic. I can down this drug and go out and do all the things I've always wanted.
Looks like alcohol has some similar benefits without the bad part (except can't drive )
 

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Discussion Starter · #19 ·
Looks like alcohol has some similar benefits without the bad part (except can't drive )
Similar, but MUCH different. You can dose up on Klonopin and walk around without staggering, slurring, etc. Basically, Klonopin is like being sh*tfaced drunk but with maybe 1/15 the motor and cognitive impairments. Besides, alcohol is HARD on your body.
 

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Similar, but MUCH different. You can dose up on Klonopin and walk around without staggering, slurring, etc. Basically, Klonopin is like being sh*tfaced drunk but with maybe 1/15 the motor and cognitive impairments. Besides, alcohol is HARD on your body.
Alcohol IS hard on the body. I don't get how people can get sh*t faced on a regular basis.

The problem with benzos tho (from what i've read) is they are super addictive. They have severe withdrawal symptoms, and if used too much they lose their effects and you need more and more just to feel "normal"

I also think that if you use a benzo to do things like socialize, your mind will associate that you NEED a benzo to be that social guy. And that causes a psychological addiction too.

It's like how people use alcohol as a crutch to socialize. And when they are sober, they can't do sh*t. That's kinda sad because they are the same person!!!!! Their mind has just associated that they are awesome when drunk, and lame when sober. Bad association.

I think facing fears can produce a natural high, and it's better in the longrun.

Cheers,
 
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