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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by ta5 on February 12, 2012, at 13:40:13
Are there any effective anxiolytics (for social anxiety) that can be taken daily long-term that will not result in tolerance and require dose-escalation and eventually stopping? If so, which ones?
Thanks.
Posted by phidippus on February 12, 2012, at 16:11:46
In reply to Long-term anxiolytics with no tolerance?, posted by ta5 on February 12, 2012, at 13:40:13
Gabitril or Topomax
Eric
Posted by jono_in_adelaide on February 12, 2012, at 16:33:56
In reply to Re: Long-term anxiolytics with no tolerance?, posted by phidippus on February 12, 2012, at 16:11:46
1. SSRI antidepressants are usualy 1st choice
2. Gabapentin is a second line choice (only because it is more expensve)
These two can be taken together because they work in different ways
3. Mirtazapine (a tetracyclic antidepressant)
4. MAO Inhibitor antidepressants (treatment of last resort)
I'd start with an SSRI such as Zoloft (25mg per day for a week, then 50mg per day, maybe increase to 100mg per day after 5 or 5 weeks depending on response) and see how you go from there.
Posted by SLS on February 12, 2012, at 19:28:52
In reply to Long-term anxiolytics with no tolerance?, posted by ta5 on February 12, 2012, at 13:40:13
> Are there any effective anxiolytics (for social anxiety) that can be taken daily long-term that will not result in tolerance and require dose-escalation and eventually stopping?
You want everything!
> If so, which ones?
Someone mentioned Gabitril. I think this drug is worth trying, but be aware that some people experience agitation as a side effect. If agitation does appear, I wouldn't wait too long to see if it disappears. My impression of Gabitril is that it is unpredictable.
Topamax has also been mentioned. This drug has potential to be helpful according to a few studies. I think lower dosages are recommended for social anxiety. The lower you start and the more gradually you increase the dosage, the better are your chances of avoiding cognitive side effects. You may not need any more than 100 mg/day.
The combination of Nardil and Klonopin is probably the most potent treatment for social phobia/anxiety. It doesn't seem to lose efficacy or require escalating dosages.
- Scott
Posted by Phillipa on February 12, 2012, at 21:23:07
In reply to Re: Long-term anxiolytics with no tolerance? » ta5, posted by SLS on February 12, 2012, at 19:28:52
Benzos low doses of Phillipa
Posted by BrainDamage on February 15, 2012, at 6:33:07
In reply to Re: Long-term anxiolytics with no tolerance? » ta5, posted by SLS on February 12, 2012, at 19:28:52
If you look outside the US-UK pharmacopeia there are some very interesting Medicines
Etifoxine:
http://en.wikipedia.org/wiki/EtifoxineThere are loads of obscure Russian Meds for Anxiety
They range from useless to really quite effective I believe, but there're not well known in the West
This is the end of the thread.
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