# list of meds that are immediate effect - prn - as needed



## feelalone (May 1, 2010)

Hi all,
I'd like to make a list of the legal meds we tried, or we know, that have a positive effect for social anxiety (even off label) from the first taking.
A list of meds that works well taken on a prn (as-needed) basis, no meds that require any therapy, even of few days, to take effect.

I begin, by listing the most popular 


- inderal

- klonopin and others benzodiazepines

- pregabalin 

- adderall, vyvanse (not tried, only know)

- phenibut

- tramadol




Put together our experiences, it might come out something new for everyone.


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## MBL (Oct 5, 2010)

HI!

This is my first post, I am new here (signed up Tuesday afternoon, 5 October).

I've used most of the meds you list there. Here is my opinion on each.

Inderal- I had this a long, long time ago. It was mildly effective. I can't say I felt sedated, but I did feel slightly calmer. Would not be among my first choices.

Klonopin (clonazepam) and benzos- Klonopin is one of the better benzos. I've had virtually every one that's in Canada. I find Serax (oxazepam) is fairly potent. I seem to have some kind of natural tolerance to benzos and thus would require a much higher dose than most people, really beyond what could be prescribed. Xanax doesn't even faze me! But IMO I think that benzos would work for the majority of people. Not everyone reacts to the same ones the same though.

Pregabalin- This was a strange one. People said I even spoke calmer on it. It definatly has a calming effect without being too sedating but is very expensive. It's better than gabapentin I believe.

Adderall- Another expensive drug. I have ADD, and this drug was the best I have had for that condition. Possibly boosts self-esteem.

Phenibut- I greatly want to try this one but cannot find a good supplier in Canada. I hear it works well and lasts a long while, the downside being that tolerance builds very quickly so you should only use it 2 times a week. If anybody knows a good Canadian source for this item, please contact me. 

Tramadol- I found that I'd have to exceed prescribed amount to get an effect. This is not a drug I would take for anxiety.

Other:

Chloral Hydrate. They don't prescribe this much anymore, but personally I find it better than benzos. Anxiety dose is usually 250. Sedative dose is up to 1000. Side effects are mild, usually mild upset stomach. Do not exceed dosage because it will literally knock you out. 

Buspar. Useless. It's long term though, not PRN.

GBL/GHB. These might of been an option but can knock you into a temporary comatose state if dose is too high. Both are outlawed now though. Highly addictive.

Phenobarbital. Not very useful.

Kava. I heard this had good anti-anxiety properties but it's hard to get these days. There was reports of possible harm to the liver or something.

Alcohol. I'd just use this socially of course... but too much and it kind of backfires I think.

Anyways, that's my outlook on most substances. I'd really like to try phenibut though. Also some amino acids are thought to be usefull. And I would not resort to an SSRI.

TTYL

MBL


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## redtogo72 (Jun 7, 2008)

*klonopin/clonazepam* (.5-1mg)
The Good: I'm more likely to talk to strangers, go places I never would have gone to before. It's good to take if you are already going out to go to work, school, etc. 
The Bad: I still feel physically sick. I still have too much anxiety. It doesn't really help agoraphobia. It also makes me sleepy and sometimes makes me feel tipsy.

*Adderall* (20mg IR generic)
The Good: I'm more social, talkative, comfortable around people that I know. Talking feels more enjoyable now. I can see and feel that the reward is greater than whatever the consequences might be from talking. I feel like I can focus better and enjoy things more. I don't exactly feel like I have excess energy, but now I can stay awake during the day.
The Bad: Adderall doesn't seem to help me at all around strangers. I'm still unable to sleep at night, but I've always had this problem. I still feel depressed, nervous, and have a lack of motivation at times.


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## Timboslice (Jul 28, 2010)

Welcome MBL!

Benzos (Valium, Xanax, Temezepam, Ativan) - All of these had their place, Xanax and Temezepam seemed to make me really tired, but at ease and comfortable. Valium actually worked only when I was having panic attacks, but did so well enough that i could take it at work if needed. Ativan really didn't do much at all.

Gabapentin- First introduced to this for shingles pain, and it did a good job of making that pain go away. Mildly sedating, but extremely handy for nerve pain-- also great for anti-depressant withdrawal by the by, gets rid of the brain zaps, dizziness, and stomach anxiety pretty well. Those who are going through Effexor w/ds would be wise to take this if they need the help.

Adderall - Am currently on this for ADD after going through the wringer with NRIs like wellbutrin and straterra. Currently on the XR formulation which is crazy expensive so I'll be going to IR next cycle, but it works great-- I feel better, have more energy, and am able to focus well enough to engage in conversation. I feel like me, but not super-me which is exactly what I needed.

Ambien- This one I have a long relationship with, as insomnia is something I developed in my late teens. This stuff really works for acute insomnia-- but as you probably have heard, can cause some other problems like sleep-everythinging. Having been on it for so long it no longer causes that, but it does make me comfortable in my own skin if I take a holiday from it-- GABA probably a big component for the anxiety I'd think.

Tramadol- Ah, love and hate with this drug. Originally prescribed for resistant migraine headaches after the death of my mother and father. Worked extremely well at getting me up and out, doing things, and being confident in society again. However, my tolerance grew fast and dosage became an ever-present worry. If I could get this drug without the opioid component, I'd take it in a heartbeat, but as it stands there are too many drawbacks to warrant steady use. Also, the withdrawal syndrome associated with this is terrible, Think effexor with an added 5-6 day acute opioid wd. Its also extremely finicky for people, some get great response, others nothing--- If you have low CYP26 enzyme activity (or take something like Prozac that already is using it) you'll get very little out of Tram, however if you have high activity (which I'm pretty sure I do) Tram will work extremely, almost too, well.

Thats all I have for now, great idea for a thread!


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## MBL (Oct 5, 2010)

*Ambien/Tramadol*

Hi!

What would be your dose for Ambien and dose for Tramadol?
Just curious.

MBL


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## Timboslice (Jul 28, 2010)

MBL said:


> Hi!
> 
> What would be your dose for Ambien and dose for Tramadol?
> Just curious.
> ...


Hey MBL!

Sure no problem:

Ambien (for anxiety related insomnia)- would be 5mg to start with for a maximum of 3 weeks of continuous use. 10mg if you're already cross tolerant to other zdrugs or benzos.

Tramadol - This one would vary depending on response to a regular 50mg dose. In my experience, less is more with it, so long as you keep concentration up. Therapeutically I'd do something close to VVV (another member here) 25mg 4-6 hours, making sure not to use the CNS depression as your sleep aid, and S and N release as wake up.


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## MBL (Oct 5, 2010)

*Ambien*

HI HI

I want to try Ambien badly. I don't know why it's not marketed in this country. Zopiclone is not very good.

Can you recommend some strong meds for serious insomnia?

I heard some people say they took ritalin for SA! I have to strongly disagree with that idea!!! 

Low dose Adderall perhaps...

-MBL


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## Timboslice (Jul 28, 2010)

Sure MBL,

If you've already run the gamut of zdrugs and benzos you're looking at probably TCAs (like amitriplyne), or low-dose antihistamine based anti-psychotics. Of those Seroquel seems to be the go-to med for severe insomnia. 

There are other drugs like Remeron, Restoril, and others that fit into the above categories in different ways, and its really more a trial and error thing.


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## euphoria (Jan 21, 2009)

Dexedrine


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## Recipe For Disaster (Jun 8, 2010)

how did you get chloral hydrate prescribed?


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## UltraShy (Nov 8, 2003)

feelalone said:


> - tramadol


I officially register my total disagreement with this.

It does nothing. It does nothing when taken at 400 mg (8 pills) daily for two months. It does nothing even when taken in insanely large doses. Seizure risk stopped me from ever consuming more than 800 mg in a single dose (16 pills -- literally a fistful).

Seems to work for some; but I'm not part of this some.


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## UltraShy (Nov 8, 2003)

MBL said:


> Chloral Hydrate. They don't prescribe this much anymore, but personally I find it better than benzos. Anxiety dose is usually 250. Sedative dose is up to 1000. Side effects are mild, usually mild upset stomach. Do not exceed dosage because it will literally knock you out.


This is one of the meds I'd like to try. Given my chronic insomnia that fails to respond suitably* to other meds I certainly have a valid medical justification.

*Note: "suitably" rules out junk like Seroquel that will certainly make me sleep -- all night and the next day. At a lower dose it takes forever to work and then results in drowsiness that lasts most of the next day, making it pretty much useless to me. If I wanted to simply sleep away a few days of my life it would be good, but otherwise useless, just like other sleep aids I've tried.


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## UltraShy (Nov 8, 2003)

MBL said:


> I heard some people say they took ritalin for SA! I have to strongly disagree with that idea!!!
> 
> Low dose Adderall perhaps...


To me Ritalin feels about the same as a real amphetamine, just weaker. I take immediate release dextroamphetamine.


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## euphoria (Jan 21, 2009)

I've found that Ritalin causes far more anxiety than Dexedrine.


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## jim_morrison (Aug 17, 2008)

UltraShy said:


> This is one of the meds I'd like to try. Given my chronic insomnia that fails to respond suitably* to other meds I certainly have a valid medical justification.
> 
> *Note: "suitably" rules out junk like Seroquel that will certainly make me sleep -- all night and the next day. At a lower dose it takes forever to work and then results in drowsiness that lasts most of the next day, making it pretty much useless to me. If I wanted to simply sleep away a few days of my life it would be good, but otherwise useless, just like other sleep aids I've tried.


So the standards like Ambien never worked for you at all?


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## rainbowOne (Sep 26, 2010)

When I was on Valium, it was AWESOME. No anxiety, I could take on the world! Of course it was horribly addictive and that wasn't good.


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## JohnG (Sep 3, 2010)

Timboslice said:


> Hey MBL!
> 
> Sure no problem:
> 
> ...


How do you compare tramadol and effexor? They are similar in effect? We can consider tramadol as a fast-acting-effexor with a little of opiod activity or they are far miles between them ?


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## Timboslice (Jul 28, 2010)

JohnG said:


> How do you compare tramadol and effexor? They are similar in effect? We can consider tramadol as a fast-acting-effexor with a little of opiod activity or they are far miles between them ?


In terms of actual physical chemical structure they are very similar, but the effects are different. I've only ever taken Effexor to help wean me off Tramadol, and for that purpose (along with gabapentin) it did a good job of fooling my body into thinking it wasn't spazzing out.

Effexor is an SNRI that does take time to work (from what I hear), so I can't comment on its "feel". Tramadol (when it works, again you may be a part of a group that gets no benefit). has sort of a mild warmth at onset, which only lasts an hour or so--- but then you're left with energy, an improved mood, and seem to allay socially much better than baseline.

Again, I'd look at Tramadol as an interesting drug that may be considered one of those prototypes for other drugs to come. Its primary focus is pain control, and for that it only skirted by a tougher scheduling because it effects Mu receptors sporadically and variably. Its other mechanism is serotonin release and norepinephrine reuptake inhibition, both of which are weak-- but it seems to congeal very well with the rather shoddy pain control.

While it sounds like I'm singing its praises, please let me stress that I don't see Tramadol as a good primary, or prn medication for social anxiety. First, it just plain doesn't work for some people minus the "weaker than codeine" pain control. Second, the variety of receptors hit makes for a very disconcerting W/D, while the acute stuff is kicked rather easily, PAWS for this drug lasts a while. I have also yet to see someone who has successfully stopped tolerance with a drug like Memantine--- even still, thats a lot of money and time spent for very little overall benefit.


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## MBL (Oct 5, 2010)

*Meds*

Hi guys!

About CHLORAL HYDRATE. 
It's more common in Canada than USA (I'm Canadian). It's an excellent alretnative to benzos if used as PRN.
I basically just request it if I need it and specify I need it only as PRN and once in a while. I find I need 500+ dosage for anxiety (thogh that's double than recommended) and 1000+ for sleep.
It tastes weird, like mild cough syrup or something. It can upset the stomach in a mild way. It's not available in caps anymore in Canada. Just the red liquid.
I wouldn't mix it with alcohol or depressants though. 
It's a favorite medication of mine.

About dexedrine.. :|
I am on it now. 40mg every morning. It used to help but it's like I became immune to it now and it has barely any effect (not tolerance, it's just like it stopped working to an extent-weird).

Ritalin.. :no
Coming up on it felt good. But high doses or coming down on it increased my social anxiety and even caused me to stutter at times.

Effexor...
When it first came out in tablet form it worked GREAT for me. When they stopped making tabs and started making capsules of slow released effexor, for some reason it stopped having an effect on me.

As you can tell, I have a lot of experience with meds! 

Oh, BTW, I had Atarax a LONG time ago and it seemed to not help at all.

Thx!

*-MBL*


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## BostonMike (Oct 6, 2010)

*Doxepin*

I swear by doxepin. It doesn't make you drowsy, but as soon as your head hits the pillow youre out!


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## Hulgil (Oct 4, 2010)

Any opioid. Hydrocodone, oxycodone, morphine, or even codeine - all excellent for any anxiety or any depression PRN (though more addictive than benzos, usually with fewer side effects and always with less severe withdrawals).


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## Canadian4Life (Sep 27, 2010)

Nothing actually helped my social anxiety besides antidepressants. I am on dexedrine as well which on its own worked for a week and then nothing. I used to use opiates but got hooked and found myself using them even when I wasnt around anybody. Also klonopin is the only benzo thats worked too but it just calms me down doesnt really make me social.


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## feelalone (May 1, 2010)

another class of med usually used on prn basis are hypnotics.
I read experiences of people who have tried these meds that seem pretty interesting, although they are used for insomnia, and as it may seem strange, someone speaks about euphoric effects.
I wonder if they may be useful for social anxiety as the benzodiazepines.


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## Hulgil (Oct 4, 2010)

feelalone said:


> another class of med usually used on prn basis are hypnotics.
> I read experiences of people who have tried these meds that seem pretty interesting, although they are used for insomnia, and as it may seem strange, someone speaks about euphoric effects.
> I wonder if they may be useful for social anxiety as the benzodiazepines.


Benzos are hypnotics. You may be thinking of the non-benzodiazepine hypnotics.


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## jim_morrison (Aug 17, 2008)

feelalone said:


> another class of med usually used on prn basis are hypnotics.
> I read experiences of people who have tried these meds that seem pretty interesting, although they are used for insomnia, and as it may seem strange, someone speaks about euphoric effects.
> I wonder if they may be useful for social anxiety as the benzodiazepines.


Are you referring to the class 'sedative-hypnotics'? (GABAergics)

Cause 'hypnotic' can generally just refer to a med from any class which is used to induce sleep.


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## feelalone (May 1, 2010)

yes sorry, non benzodiazepines-hypnotics, Zoplicone, Zolpidem (Z-drugs) like this: http://www.socialanxietysupport.com/forum/f55/lunesta-zopiclone-84118/


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## UltraShy (Nov 8, 2003)

jim_morrison said:


> So the standards like Ambien never worked for you at all?


I feel asleep 4 hours after trying Ambien once, though I suspect the 4 hours did it rather than the pill.

Seeing how Ambien is basically just a more targeted benzo, one wouldn't expect it to make me sleepy given that I'm exceptionally tolerant to the drowsiness effect of benzos to the point that I never consume any Xanax dose that makes me drowsy. I can tell you that up to 20 mg of Xanax in a day doesn't make me at all sleepy nor even mentally slow nor could anyone even tell I was "drugged" unless I told them what I took.


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## MBL (Oct 5, 2010)

*Ambien*

I take it that Ambien is an American thing only, not in Canada?

*-MBL*


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## jim_morrison (Aug 17, 2008)

MBL said:


> Can you recommend some strong meds for serious insomnia?


I guess it's trial and error, Ambien may work for you, but since other meds which work similairly to enhance GABA have not worked for you in the past (ie; temazepam, zopiclone) it may not.

Then there are the sleep meds which act as histamine and/or α1 adrenergic receptor blockers instead such as low dose seroquel, mirtazapine, amitriptyline, trazodone or doxepin.


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## Canadian4Life (Sep 27, 2010)

Dexedrine is definetly a PRN med for social anxiety I find. Taken 3 maybe 4 days a week to keep tolerance at bay. Opiates work too but as nasty stuff. I'd prefer an opiate over a amphetamine anyday though but don't because they cause some cruel withdrawals and the nastiest addiction i've ever had.


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## Sweeto (Jul 21, 2015)

Another prn meds:

Modafinil
GHB
Suboxone


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