[rtcpenguin]

I was on Zoloft (sertraline) for over 2 months, first at 50mg/day and eventually at 100mg/day. Unfortunately, I didn't benefit at all from the drug even after that period. I felt just as anxious, and suffered from some fairly severe sexual and psychological side effects (felt like a zombie). I was on Luvox CR for about 3 weeks and began to suffer some of the same side effects as Zoloft and discontinued using it.

I've been using klonopin on and off for about 2 years now, mainly when I know I'm going to do something especially nerve racking, like giving a presentation or going on a date. However, I've never used it consistently for fear of developing a tolerance to it. Also, at therapeutic doses (1.5mg) I get sort of foggy and tend to forget bits and pieces of events. I'd really like to find a permanent solution without these side effects. I don't think I'm willing to try another SSRI given the aforementioned negative experiences.

I also tried proprananol (inderal) and didn't have any luck.

There has been some discussion about mirtazapine I've read here, but I can't find many success stories. Is this a worthwhile option?

I'm especially weird because I don't really suffer from depression. If anything, its mild and its only because I lack personal relationships because I'm afraid to talk to most people.

 

[rtcpenguin]

Thanks for all the info, I really appreciate it.

I met with my psychiatrist last week and had a discussion about different options. I mentioned mirtazapine (Remeron) and he was open to the idea, although he warned it had some serious side effects (namely weight gain). He recommended I try clomipramine (Anafranil) and I went with his suggestion as I've struggled with weight in the last couple years. I took my first two 25 mg pills tonight and will report back in a couple weeks. I've got my fingers crossed for this one since it is at least not an SSRI.

 

[Medline]

TCAs have never shown to be effective for social phobia. Clomipramine might be more useful than the primary noradrenergic tricyclics, but it can have many side effects. Lyrica, SNRIs, MAOIs or if possible potent stimulants like Adderall in combination with benzos (as needed) are other options.

 

[rtcpenguin]

TCAs have never shown to be effective for social phobia. Clomipramine might be more useful than the primary noradrenergic tricyclics, but it can have many side effects. Lyrica, SNRIs, MAOIs or if possible potent stimulants like Adderall in combination with benzos (as needed) are other options.

Yeah, I'm already experiencing some pretty bad side effects 12 hours in. I feel sort of confused and tired, and most definitely can't reach orgasm which is unacceptable. I'm considering just quitting right now and going back for remeron or wellbutrin.

 

[jim_morrison]

Yeah, I'm already experiencing some pretty bad side effects 12 hours in. I feel sort of confused and tired, and most definitely can't reach orgasm which is unacceptable. I'm considering just quitting right now and going back for remeron.

I'm on remeron and it's ok, it has no sexual side effects, or any of the nasty side effects of SSRI's/TCA's, and it's fairly good for sleep, although I dont think you mentioned if you had insomnia or not. There can be some weight gain, but I find that if you control your diet and exercise regularly its not so bad.

 

[rtcpenguin]

I'm on remeron and it's ok, it has no sexual side effects, or any of the nasty side effects of SSRI's/TCA's, and it's fairly good for sleep, although I dont think you mentioned if you had insomnia or not. There can be some weight gain, but I find that if you control your diet and exercise regularly its not so bad.

Yeah, no real insomnia problems here. How much did it help your social anxiety?

 

[jim_morrison]

Yeah, no real insomnia problems here. How much did it help your social anxiety?

Is your only anxiety disorder social anxiety or do you also suffer from generalized anxiety disorder, panic disorder etc? coz I found it to be alot better for general anxiety than for specifically socal anxiety. But I'll tell you one thing ive found, it does enable me to get more benefit from lower doses of benzodiazapines oddly enough, it seems to potentiate them for me, and the combo works on SA fairly well.

 

[britisharrow]

I'm on Mirtazapine and have been for some time and it has worked better than SSRIs, from which I got almost no tangible benefit. Mirtazapine does seem to have, if not lifted the depression, given me the idea that there is hope. It's difficult for me to describe, it gves you a broader perspective on things.

You start thinking thoughts like "maybe that person doesn't hate me after all" or "maybe that person is too consumed with his own life to be thinking about how stupid I am."

I believe however that only therapy can really help, medication is just an addition. By therapy I mean cognitive restructuring, changing thought patterns, challenging beliefs.

 

[IllusionalFate]

Unselective MAOI + dextroamphetamine PRN is probably the most lethal (efficacy-wise) antidepressant (borderline euphoria)/sociabilizer/confidence-increasing combo out there.

 

[rtcpenguin]

I'm on Mirtazapine and have been for some time and it has worked better than SSRIs, from which I got almost no tangible benefit. Mirtazapine does seem to have, if not lifted the depression, given me the idea that there is hope. It's difficult for me to describe, it gves you a broader perspective on things.

You start thinking thoughts like "maybe that person doesn't hate me after all" or "maybe that person is too consumed with his own life to be thinking about how stupid I am."

I believe however that only therapy can really help, medication is just an addition. By therapy I mean cognitive restructuring, changing thought patterns, challenging beliefs.

Thats interesting. I've read a couple of accounts of people on SSRIs where after a couple weeks to a month their anxiety completely went away. One guy described it as a "light switch" where one day he couldn't imagine anything more terrifying than talking to a pretty girl or stranger to the next day when he just wanted to talk to everyone. It really got my hopes up.

Klonopin is sort of like that for me. If I take 1.5mg I'm friendlier, speak my mind, enjoy speaking to strangers etc. For example, on Klonopin I've actually given speeches and enjoyed it. I'll call friends to ask them questions when before I would have thought 'no don't bother them' even though I knew deep down it wouldn't bother them. The only problem is I sort of fear addiction to it, and at that dose it slightly affects my memory (slightly harder to remember things) and cognition (problem solving skills are slightly worse). If I could find a medicine that had the same anxiolytic effect without those I'd be perfectly happy.

 

[Ash09]

at that dose it slightly affects my memory (slightly harder to remember things) and cognition (problem solving skills are slightly worse). If I could find a medicine that had the same anxiolytic effect without those I'd be perfectly happy.

Opiates don't cause those problems.

 

[jim_morrison]

I'm on Mirtazapine and have been for some time and it has worked better than SSRIs, from which I got almost no tangible benefit. Mirtazapine does seem to have, if not lifted the depression, given me the idea that there is hope. It's difficult for me to describe, it gves you a broader perspective on things.

You start thinking thoughts like "maybe that person doesn't hate me after all" or "maybe that person is too consumed with his own life to be thinking about how stupid I am."

Yeah ditto, for me mirtazapine is a much better antidepressant than SSRI's. Rather than flattening the mood, it makes me more optimistic.

 

[euphoria]

The only problem is I sort of fear addiction to it, and at that dose it slightly affects my memory (slightly harder to remember things) and cognition (problem solving skills are slightly worse). If I could find a medicine that had the same anxiolytic effect without those I'd be perfectly happy.

I'm not sure how far they are in development, but there are drugs being researched that act on the specific GABA subunits responsible for relieving anxiety without the side-effects of benzos. Sort of like the "Z drugs" used for sleep that are [mostly] just selective to the sedative elements. Pagoclone was one of the anxio-selective nonbenzos, I think:

http://en.wikipedia.org/wiki/Pagoclone

I'd also recommend looking into boosting the function of acetylcholine, the "cognition neurotransmitter" that some Alzheimer's drugs work on. AFAIK benzos produce a lot of the cognitive effects by indirectly blocking this neurotransmitter. It'd be interesting to see how cholinergic drugs/supplements interact with benzodiazepines.