# Sticky  Creating an FAQ for SA drugs.



## Medline

The same questions are being asked here again and again. So I think an FAQ would be very helpful. It should concentrate on evidence-based treatments IMHO, but of course our extensive knowledge with other drugs shall be included. Too reckless or dangerous combos not.

What do you think about the idea? We might start with naming drugs that work. For creating the FAQ itself google docs is the way to go.

Everybody interested in helping please say so. Long-term members with good knowledge of psychopharmacology are preferred.


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## jim_morrison

I think this is a good idea .

I guess the first step is to create a standardized set of values, for example;

# Drug class
# Mechanism/s of action
# Therapeutic dosage range
# Medical interactions (Drug, Food, etc.)
# Common Adverse effects
# Anything else you can think of adding?

I'll sticky a Medications FAQ thread when complete.


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## crayzyMed

There are many meds that have shown effiacy that are only rarely being discussed like tiagabine, we must make a list of them and i'm willing to do that to add to the faq.


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## broflovski

crayzyMed said:


> There are many meds that have shown effiacy that are only rarely being discussed like tiagabine, we must make a list of them and i'm willing to do that to add to the faq.


Yeah, and there are some meds known only in the countries there they are developed and manufactured, like afobazol and bromantane in Russia. We also need Japanese and Chinese contributors, because they have scarcely known but probably effective drugs there.


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## popeet

I would love this so much you guys are just so great, thank you.


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## Recipe For Disaster

sounds like a good idea im willing to contribute


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## Medline

Can we begin with naming drugs useful for SA, thanks. Let's start with standard drugs and then use more experimental ones. Those should at least not be extremely dangerous.


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## crayzyMed

SSRI's
Benzodiazepine's
Levetiracetam
Oxcarbazepine
Acamprosate
Tiagabine
Pregabilin

(il keep updating this post, with links to study's).

Anecdotal effiacy:
Adderall and dexedrine
Memantine
Baclofen

Theoretical effiacy:
GABOB


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## crayzyMed

> J Clin Psychopharmacol. 2007 Jun;27(3):263-72.
> The role of anticonvulsant drugs in anxiety disorders: a critical review of the evidence.
> Mula M, Pini S, Cassano GB.
> 
> Department of Psychiatry, Neurobiology, Pharmacology and Biotechnologies, University of Pisa, Pisa, Italy. [email protected]
> Abstract
> Antiepileptic drugs (AEDs) have been successfully used in the treatment of mood disturbances, leading clinicians and researchers to investigate their use in other psychiatric disorders. This article reviews the literature about the potential efficacy of AEDs in anxiety disorders. An updated MEDLINE search (January 1970 to September 2006) using the terms "panic disorder," "agoraphobia," "posttraumatic stress disorder," "obsessive-compulsive disorder," "generalized anxiety disorder," "social phobia," "phobia," "carbamazepine," "phenobarbital," "phenytoin," "valproate," "lamotrigine," "topiramate," "vigabatrin," "tiagabine," "gabapentin," "levetiracetam," and "pregabalin" showed more than 70 articles and 38 published studies. Only articles published in English were reviewed. We have assigned level 1 of evidence to meta-analysis and replicated randomized controlled trials, level 2 to at least 1 randomized controlled trial, level 3 to uncontrolled trials with 10 or more subjects, and level 4 to anecdotal case reports. The strongest evidence has been demonstrated for pregabalin in social phobia and generalized anxiety disorder, lamotrigine in posttraumatic stress disorder, and gabapentin in social anxiety. The available data about gabapentin in panic disorder are somewhat mixed, and more definitive conclusion would require additional studies. This review suggests that AEDs can be an alternative treatment in some anxiety disorders. Further investigation is needed to determine in what circumstances they should be used in individuals who are partially responsive or nonresponsive to conventional therapy.


Anyone that can share the full text? Thx


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## Noca

Also a FAQ about how to start with treatment, which type of doctor to see, what questions to ask, etc.


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## jim_morrison

*SSRI's
*SNRI's
*Benzos
*Beta Blockers
*MAOI's

*Atypical Antidepressants (Mirtazapine, Bupropion, etc.)
*Stimulants
*Novel agents; Tiagabine, Pregabalin, Tianeptine, etc.


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## Giraffe

Isn't this kind of thing mostly covered by crazymeds.us?


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## Raidiant

http://www.socialanxietysupport.com...currently-working-for-you-please-do-a-116617/

I am a troll....don't ban me lol


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## crayzyMed

Giraffe said:


> Isn't this kind of thing mostly covered by crazymeds.us?


Not really, many meds effective for social anxiety arent mentioned there, except their official uses. This one will have alot more info


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## jim_morrison

Yeah crazymeds.us is really based more around depression, both unipolar and bipolar (or bi-winning...if you happen to be Charlie Sheen).


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## Raidiant

lol at bi-winning , he was funny for like the first two days

imagine if an hollywood douche like him had his fortune handed to solving something like SAD (okay cancer is first priority really), but seriously how many miserable ****s can he make happy with the money hes got

I mean check out half of these hollywood douches like bryan singer, cage they are all born into it.


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## upndownboi

a good idea. i don't think that compiling it will be the major problem. Rather we need to think about how we can make it *extremely accessible*. how can we make it so people looking for SA answers feel its easier to go to our faq than re-ask it in forum?

i like the crazymeds site, its got an engaging style of writing


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## popeet

i agree that crazymeds doesn't cover sa. it _is_ written in a very engaging style that i'd come to trust over the years, but it doesn't have nearly the kind of technical information specifically about social anxiety meds that this forum does. there's so much i don't find there that i'd find here sifting through these threads were my attention span not so short.

then my fantasy is that some amazing psychiatrist who loves us would find the FAQ and then become the SAS official doctor willing to prescribe and tweak the cocktails.


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## broflovski

I don't think re-asking on the forum is inevitably evil... it keeps the board alive... we need not only information, but communication sometimes.


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## Medline

broflovski said:


> I don't think re-asking on the forum is inevitably evil... it keeps the board alive... we need not only information, but communication sometimes.


Absolutely right, but answering the exact same questions permanently can be avoided with a good FAQ.


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## Raidiant

Actually its kind of hard considering how people seem to respond so differently to meds on this forum.

Isn't it hard to generalise? maybe the faq should be more about where to start and so on, like essential reading and why not to trust uninformed pdocs. Those would be far more useful than a bunch of pages about meds.

edit: also it should aim at combating selective bias, e.g. not everyone gets horrible withdrawal, or builds tolerance quickly, it should inform the reader "scientifically" about risks and potential benefits 

meds should be split into classes, there seems to be the clinical treatment meds (ssris, benzos), the clinical self treatment (amps, memantine, ritalin), off label meds , and the experimental stuff.

one thing I like about crazy meds which they don't really develop too much is the funny combinations. I think we should know if a certain SSRI works really well with alcohol and so on, I guess thats the engaging writing you are on about.


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## Medline

upndownboi said:


> Rather we need to think about how we can make it *extremely accessible*. how can we make it so people looking for SA answers feel its easier to go to our faq than re-ask it in forum?


jim_morrison will sticky a good and useful FAQ. To make it more accessible for google users and to create more traffic the title is important, e.g "Drugs for Social Anxiety Disorder | Social Phobia" is good.


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## Ramondo

I think it would be useful to make a distinction between which drugs are good for primary Social Anxiety Disorder, and those which can work for - perhaps a large percentage of people here - people with conditions such as schizophrenia, Bipolar Disorder, and other undiagnosed disorders that can cause anxiety in social situations.


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## Duke of Prunes

If it's being based on evidence, I take it SSRIs will be completely discounted just like they deserve?


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## Medline

Not for SSRIs & social phobia ... SSRIs & depression is a different subject.


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## crayzyMed

Would a list of substances with potential usefullness in addiction disorders be usefull here? Have been researching the past few days, il just post it here no idea wheter it could be usefull to add in the faq.

NAC
Ibogaine
Acamprosate
Memantine
Vigabatrin
Modafinil
Topiramate
Lobeline
Wellbutrin
Magnesium
DXM
Baclofen
Rimonabant
Naltrexone
Clonidine
Tiagabine
Galantamine
Ondansetron
Varenicline
Oxcarbazepine
Disulfiram
Gabapentin
Pregabalin


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## Ramondo

Duke of Prunes said:


> If it's being based on evidence, I take it SSRIs will be completely discounted just like they deserve?


Wasn't Paxil the first SSRI approved by the FDA for treatment of Social Anxiety?
I'm not arguing with you. I'm interested. I thought FDA approval was based on scientific evidence.
Can you post some references to peer reviewed scientific papers that have proven SSRIs don't work for SA. Thanks.


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## Medline

Vigabatrin causes irreversible damage to the retinal nerve fiber.


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## Rbk

Ramondo said:


> Wasn't Paxil the first SSRI approved by the FDA for treatment of Social Anxiety?


Yes. I know that many people do not like SSRIs in general but the truth is that paroxetine IS the best not-addictive drug for SA. It works for many people with SA with very good results.


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## upndownboi

broflovski said:


> I don't think re-asking on the forum is inevitably evil... it keeps the board alive... we need not only information, but communication sometimes.


agreed


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## upndownboi

also, I think arriving at our each optimal regrimes is often a fairly slow iterative process,you can tell a person that so and so is a good meds regrime in general but it probably won't really 'sink in', people are more likely to follow their optimal regrime after they have knowledge and understanding and experience of it and I think the back-and-forth nature of the forum is a good way of achieving this, cos it gives custom service to each person.


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## Arisa1536

Raidiant said:


> lol at bi-winning , he was funny for like the first two days
> 
> imagine if an hollywood douche like him had his fortune handed to solving something like SAD (okay cancer is first priority really), but seriously how many miserable ****s can he make happy with the money hes got
> 
> I mean check out half of these hollywood douches like bryan singer, cage they are all born into it.


See i do not think charlie is a hollywood douche, he was a bloody decent actor back in the 80's and 90's

but anyway thats not important

Good idea about an FAQ thread :yes


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## jim_morrison

This page might be handy as a basic quick go-to guide for creating the FAQ;

http://www.slschofield.com/medicine/psychiatric_drugs_chart.html


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## mark555666

http://en.wikipedia.org/wiki/User:El3ctr0nika/List_of_Antidepressants ?


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## Medline

Ok, short brainstorming:

We start with disclaimer.  Users should take the Liebowitz Test: http://www.socialanxietysupport.com/disorder/liebowitz/

Short overview of psychological ways to treat SAD (CBT...). Sometimes people are so anxious they can't even start exposure (therapy) without medication.... Psychopharmaceuticals like antidepressants do NOT change the personality of people, but in fact can lift the shadow over it like depression, SAD.... Having to take medication does not mean one is weak... ADs are not addictive, but can result in discontiuation syndrome if not tapered down slowly (how to do that later). People with no drug abuse problems do not get addicted to benzos taken as needed. Distinction between abuse, addiction and physical dependence...

If situational SAD -> Drugs like Propranolol, shorter acting benzos as needed... For mainly (situational) hyperhidrosis we have some good threads about we can extract the info / drugs.

If generalized SAD -> Starting with an SSRI at a high enough dose for a long enough time... Maybe we'd suggest Escitalopram / Sertraline as good first choice because of the big meta-analysis? If it helps, but not enough we can mention augmentation strategies. If it doesn't help trying another SSRI, but NO SSRI marathon which is usually just a waste of time and money. If that also doesn't work out, next step is an AD with a different mechanism of action (SNRI like venlafaxine). If it doesn't help other ADs like mirtazapine...? Then GABAergic drugs like pregabalin, gabapentin, tiagabine...? MAOIs, long-term benzo medication with e.g. Klonopin (How to avoid dependence by alternating with other substances, reducing tolerance, how to withdraw safely from benzos....).

Drugs that should be avoided for "just" SAD: Antipsychotics ...., those that usually don't work (well) or have never shown to be effective (buspirone, Moclobemide?, TCAs?)

Non-standard / off-label ways for treatment resistant SAD (adding stimulants...).

Natural treatments (Theanine, Valerian, 5-htp?, Phenibut...)

Just some ideas...


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## jim_morrison

Looking good Medline! 

P.S. - This may be a good easy-to-follow resource for the MAOI diet list.
http://www.upmc.com/HealthAtoZ/patienteducation/Documents/MaoiDiet.pdf


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## Arisa1536

Rbk said:


> Yes. I know that many people do not like SSRIs in general but the truth is that paroxetine IS the best not-addictive drug for SA. It works for many people with SA with very good results.


Yeah true, it is effective for SA, its a shame about the unwanted side effects though because it was the best for combatting social anxiety, especially in my late teens (18-19) but people steer clear of it because of the physical side effects which can sometimes be worse than the SA itself


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## crayzyMed

Freesix88 said:


> http://en.wikipedia.org/wiki/User:El3ctr0nika/List_of_Antidepressants ?


This is where its at, make a list of ALL possible compounds that could help, and not just the compounds that your psychiatrist presents to others, because you know there may be something that CAN help, and many being called "treatment resistant" can often find a working cure, it may be a combination of meds that screams synergy, it may be a unknown med normally used for other things but now as a bad *** mother****er works as a off label agent, and we got some sexy underground things, wich carry risks and should be presented in a way that only treatment resistant people get interested to try them.

Besides that what jobs still need to be done? What stuff has to go in the faq? I can dig some **** up that still needs to be added.


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## duffo

old wise man once said ..quote 'the squeaky wheel always gets the grease" social anxity isnt noticed as much in the community as bipola,depression,skitafrina,you will never see or hear us ..this is a good idea
btw what is a FAQ ??


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## Arisa1536

A question for medline and crazymed
Being recently officially diagnosed with BPD my doc had recommended since most typical antidepressants, antipsychotics and maoi's dont work for it that herbal and other remedies are worth a try

So I have Kava extract one me, the proper stuff
I have ordered Kratom and my fiance has ordered Methoxcetamine
will these be better alternatives?

since i am unable to get a mood stabalizer such as Oxcarbazepine or lamictal until i complete one year of DBT therapy

Any ideas??? thanks


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## Medline

I don't see a reason why you can't combine medication with DBT, Lamictal would be my suggestion as there exists more evidence it works for people with BPD. Honestly, I don't think supplements will help you much here compared to real drugs like mood stabilizers.


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## 49erJT

..


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## Medline

The risks of MAOIs are clearly exaggerated, especially by doctors who don't even have experience with those drugs (e.g. never prescribed them). Of course one has to be careful when on Nardil or Parnate, but NSAID analgesics kill more people per month than MAOIs did in the last 50 years.

When antidepressants... don't help then benzos and / or stimulants can be useful. To avoid tolerance / physical dependence NMDA antagonists like memantine, regular drug holidays and alternating e.g. GABAergic substances are good (altough no perfect) strategies.


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## Arisa1536

Medline said:


> I don't see a reason why you can't combine medication with DBT, Lamictal would be my suggestion as there exists more evidence it works for people with BPD. Honestly, I don't think supplements will help you much here compared to real drugs like mood stabilizers.


Thanks for your advice, its is greatly appreciated :hs
So while the supplements help its likely they will not have the same benefits as something like Lamactil?

My pdoc is dead against it, he thinks depression is my comorbid symptom of BPD and effexor on its own is enough which i disagree with and have fought and pushed for lamactil but i may need to order it online because aside from Valporic acid (Depakote ) there were no other mood stabilizers he wanted to put me on but out of all the mood stabilizers surely thats one of the worst
Valproate causes birth defects in pregnancy, weight gain, hair loss, fatigue, and hyperammonemia, which can lead to brain damage so WTH was he thinking?


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## Medline

Some supplements like EPA/DHA can probably augment psychopharmaceuticals without producing dangerous interactions in physical healthy people, but they can't compare to e.g. mood stabilizers. 

Lamictal can increase the action of antidepressants, reduce mood swings (especially) working on the lows and help with impulse control problems. It's one of the antiepilepicts that doesn't require blood tests, has a good side effect profile in general and does not have a lot of drug interactions by inducing hepatic drug metabolism.


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## KarenR

So glad I found this site again. I have major depression and take Wellbutrin XL and Celexa.....I also have GAD and Social Anxiety. My dr has had me on Lorazepam for about 5 yrs now. Presently I take 1/2mg in morning and 1mg nightly. Its not enough for the anxiety but anymore than that during the day just makes me sleepy and I yawn all day long. He has suggested switching to Xanax but I'm a little afraid of it. Don't know why other than my friends son is so addicted to Xanax. I did try clonazepam but it actually made me more depressed. Any suggestions greatly appreciated. I'm also finding that with the lorazepam I seem to be having a bit of a problem with memory loss or is that normal for all benzos?

Thanks


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## Drew

I've added Wiki functionality to the SAS forums. You can see here:
http://www.socialanxietysupport.com/forum/f148/

I think this will be the best environment to collaborate on useful medication information.

The user manual for the wiki software we are using is here:
https://www.vaultwiki.org/books/User-Manual

They did a pretty good job making it integrate well into vBulletin.

Start adding articles and playing around with the system and over time we can figure out exactly how we want to organize everything.


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## CD700

Can someone smarter then me tell me if taking seroquel could be counter-productive against my Parnate treatment. I'm thinking about the effects both these drugs have on dopamine mainly


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## Medline

Depends pretty much on the Seroquel dose, how much do you take?


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## CD700

200 mg
I could lower it if I had 2


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## Medline

For significant dopamine-antagonistic activity higher doses are needed, so you should be fine.


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## CD700

Thanks mate


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## duffo

it came to my attention that the danger of long term use ofSSRIs ,SNRIs medication seratonin sits in your gut ...long term use eats away your bones..there is no dangers of long term use of MAOIs,NDRIs ,NDRAs to this extent 
i will not take something that doesnt work and eats my bones away in the long term


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## 49erJT

..


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## Medline

We have less experience with NMDA antagonists like memantine and tolerance development to opioids than to stimulants. Very likely it will help to some extent, but without regular breaks from (strong) opioids tolerance to the euphoric effects will occur. 

Personally I have tried buprenorphine (Temgesic) for treatment resistant depression and SAD, but it didn't do much for me. Of course Suboxone ist much higher dosed. If you have no opioid addiction it will be very hard to get Suboxone prescribed. 

On a side note: Mixing buprenorphine with benzos is very dangerous and has resulted in deaths.


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## CD700

I am about to add imipramine to my Paxil and i came across this abstract......."Paroxetine induced significant elevations of approximately 50% in half-life, area under the curve, and Cmax of imipramine and decreased clearance twofold. The effects on desipramine pharmacokinetics were even more pronounced. These findings indicate a significant interaction of paroxetine with the CYP2D6 isoenzyme."

What exactly does this mean ? I should keep a low dose imipramine to my 40mg Paxil ?


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## AngelEyess

Don't take meds at all. I took them for years and they didn't help much and only work temporarily. You'll regret taking them later because of all the withdrawals and crazy side effects. They cause liver damage and so many other side effects. Why take such a risk when you can handle stress and anxiety in better ways such as through exercise and therapy...?


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## Duke of Prunes

AngelEyess said:


> Don't take meds at all. I took them for years and they didn't help much and only work temporarily. You'll regret taking them later because of all the withdrawals and crazy side effects. They cause liver damage and so many other side effects. Why take such a risk when you can handle stress and anxiety in better ways such as through exercise and therapy...?


That's a ridiculous generalisation. What meds were they, how long did you take them and what were they for? If you're talking about blindly taking SSRIs or irresponsibly taking long-term benzos, I'd agree a little, but some people genuinely need medicating to function even remotely normally.

And what about people with neurological disorders? What exactly will exercise and therapy do for them?

Derp derp derp...


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## QuackQuack

I'm not at all affiliated with this site, but I want to encourage everyone to go there, make accounts, and take surveys on the symptoms you have, drugs or other treatments you have tried, side effects, etc. If the drug isn't listed, you can add it (they manually clean up duplicates, etc). All the data is aggregated and written up in reports like this: 6,100 Patients with Anxiety Report Which Treatments Work Best










Much more organized way to measure success of different drugs than a wiki or forum.

For the ones where they don't have enough data for fancy infographics, they still have lists of treatments ordered by how well they worked for people: http://curetogether.com/social-anxiety-disorder/treatments/

But that chart needs more data points.

Edit by Drew: toned down number of links


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## Drew

This is an interesting idea and I really like the visual presentation of data, but the I'm not sure how I feel about the actual data points being presented. This of course is dependent on how they are collecting this, their traffic, sample bias, etc.

I might get in contact with them.


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## DK3

Medline said:


> The same questions are being asked here again and again. So I think an FAQ would be very helpful. It should concentrate on evidence-based treatments IMHO, but of course our extensive knowledge with other drugs shall be included. Too reckless or dangerous combos not.
> 
> What do you think about the idea? We might start with naming drugs that work. For creating the FAQ itself google docs is the way to go.
> 
> Everybody interested in helping please say so. Long-term members with good knowledge of psychopharmacology are preferred.


Sounds like a sensible idea! I think some kind of "meds primer" would be a good idea that outlines the established approaches to medicines and then perhaps go into the FAQ about different meds or treatments. I imagine this could get quite large though with so many drugs and questions. You might end up having a general medicines FAQ and then separate medicine-specific FAQs for each type or brand of medicine.


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## QuackQuack

Drew said:


> I might get in contact with them.


You should, I've talked to them about ideas I had for the site, too.

Why'd you delete the links? I'm trying to get people to visit by pointing them to the problems they're likely to have from being on this forum.


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## The Professor

broflovski said:


> Yeah, and there are some meds known only in the countries there they are developed and manufactured, like afobazol and bromantane in Russia. We also need Japanese and Chinese contributors, because they have scarcely known but probably effective drugs there.


have you tried afobazole?


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## The Professor

QuackQuack said:


> I'm not at all affiliated with this site, but I want to encourage everyone to go there, make accounts, and take surveys on the symptoms you have, drugs or other treatments you have tried, side effects, etc. If the drug isn't listed, you can add it (they manually clean up duplicates, etc). All the data is aggregated and written up in reports like this: 6,100 Patients with Anxiety Report Which Treatments Work Best
> 
> 
> 
> 
> 
> 
> 
> 
> 
> 
> Much more organized way to measure success of different drugs than a wiki or forum.
> 
> For the ones where they don't have enough data for fancy infographics, they still have lists of treatments ordered by how well they worked for people: http://curetogether.com/social-anxiety-disorder/treatments/
> 
> But that chart needs more data points.
> 
> Edit by Drew: toned down number of links


There is a difference between anxiety and social anxiety disorder, so that graph doesn't really apply to us. I don't think masturbation and inspiring music help with SAD  . and spending too much time with animals could send you in the wrong direction.


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## broflovski

The Professor said:


> have you tried afobazole?


Yes, I have tried both afobazole and bromantane. Afobazole is hardly noticeable, but may be effective for drug-naive users. I mean those on benzo will hardly appreciate it. But it may be an option to start with. It's mechanism is not clear, that MAOI component mustn't be very prominent. Sigma-agonism is not well researched, though they have an approved anxiolytic with primary sigma-action opipramol in Germany. Afobazole's effect on melatonin receptors seems to be opposite to that of valdoxan, that complicates the story even more.
About bromantane - look my post. It's quite effective.


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## Andre

See how exercise is the most effective treatment for anxiety? That's what we all need to be doing.


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## Andre

The Professor said:


> There is a difference between anxiety and social anxiety disorder, so that graph doesn't really apply to us. I don't think masturbation and inspiring music help with SAD  . and spending too much time with animals could send you in the wrong direction.


The difference being that one is an official diagnosis for people with severe anxiety? Anxiety is anxiety. Having a disorder only means that it's severe and entrenched enough to have become a characterization of the self.

Animals and music help my anxiety. Masturbation, no.


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## The Professor

Rufus said:


> The difference being that one is an official diagnosis for people with severe anxiety? Anxiety is anxiety. Having a disorder only means that it's severe and entrenched enough to have become a characterization of the self.
> 
> Animals and music help my anxiety. Masturbation, no.


Social anxiety is anxiety (emotional discomfort, fear, apprehension, or worry) about social situations, interactions with others, and being evaluated or scrutinized by other people.[1] The difference between social anxiety and normal apprehension of social situations is that social anxiety involves an intense feeling of fear in social situations and especially situations that are unfamiliar or in which you will be watched or evaluated by others. The feeling of fear is so great that in these types of situations one may be so worried that they feel anxious just thinking about them and will go to great lengths to avoid them.
*A psychopathological (chronic and disabling) form of social anxiety is called social phobia or social anxiety disorder, and is a chronic problem that can result in a reduced quality of life*. Standardized rating scales such as Social Phobia Inventory can be used for screening social anxiety disorder and measuring severity of social phobia.[5][6] Overcoming social anxiety of this type can be very difficult without getting assistance from therapists, psychologists or support groups. Social anxiety can also be self-integrated and persistent for people who suffer from obsessive-compulsive disorder, which can also make the social anxiety harder to overcome, especially if ignored.[1]

There is a big difference. It mostly has to do with how much it interferes with your life... because everyone experiences social anxiety at times. Some people experience it a lot but are still able to function without trouble. And then there are those with SAD. The point is: petting a dog or listening to music may reduce current anxiety at the time, but how will it help me at my job interview?


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## Andre

I don't disagree with what you said, it's actually what I meant, only wordier. SAD is chronic anxiety that has become a part of your programming, and plain anxiety is a normal biological function. Obviously petting a dog won't directly help you with your interview; that requires diligent practice in a mindful state. I do know that simple exercises like being with animals and listening to music can elevate ones self-esteem, sense of place, and overall mental health, which can lessen ones anxiety response. I'm speaking from personal experience.


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## Duke of Prunes

Rufus said:


> See how exercise is the most effective treatment for anxiety? That's what we all need to be doing.


...for everybody with SA? No. That's ridiculous. SA isn't a disease, it's a symptom that could be produced by any number of causes, most of which probably won't respond to exercise in any way.


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## viet

Originally Posted by Rufus 
See how exercise is the most effective treatment for anxiety? That's what we all need to be doing.

Originally posted by Duke of Prunes
...for everybody with SA? No. That's ridiculous. SA isn't a disease, it's a symptom that could be produced by any number of causes, most of which probably won't respond to exercise in any way.

I agree with Duke of Prunes. Whenever I hear of a monotherapy "cure" for SA I'm very skeptical. Everyone is different and while one modality may work for someone it can have detrimental effects on someone else. Now having said that I must say that a little exercise is helpful for everyone. It makes your body feel better and as I suffer from depression it helps lift my mood. Also channeling my anxiety symptoms, (rapid heart beat, tremors, tunnel vision and sweating) into some exercise reduces these symptoms. Again exercise is not a cure for me its just ONE of the tools I use for SA/Depression.


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## Andre

Duke of Prunes said:


> ...for everybody with SA? No. That's ridiculous. SA isn't a disease, it's a symptom that could be produced by any number of causes, most of which probably won't respond to exercise in any way.


I didn't say SA was a disease... your point doesn't make sense. Of course exercise helps. You shouldn't even need a graph to understand that.



viet said:


> I agree with Duke of Prunes. Whenever I hear of a monotherapy "cure" for SA I'm very skeptical. Everyone is different and while one modality may work for someone it can have detrimental effects on someone else. Now having said that I must say that a little exercise is helpful for everyone. It makes your body feel better and as I suffer from depression it helps lift my mood. Also channeling my anxiety symptoms, (rapid heart beat, tremors, tunnel vision and sweating) into some exercise reduces these symptoms. Again exercise is not a cure for me its just ONE of the tools I use for SA/Depression.


No, not monotherapy. Both of you just put words in my mouth, what's that about? Exercise never has detrimental effects; it's essential to one's health. No reason to make this more complicated than it needs to be.


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## QuackQuack

The Professor said:


> There is a difference between anxiety and social anxiety disorder, so that graph doesn't really apply to us.


Did you click the link? They don't have an infographic for SAD, but they still have the info.

http://curetogether.com/social-anxiety-disorder/treatments/

The more people who take the surveys, the better their data.


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## gilmourr

Rufus said:


> I didn't say SA was a disease... your point doesn't make sense. Of course exercise helps. You shouldn't even need a graph to understand that.
> 
> No, not monotherapy. Both of you just put words in my mouth, what's that about? Exercise never has detrimental effects; it's essential to one's health. No reason to make this more complicated than it needs to be.


To me, I treat SAD equally as horrible as depression. Since I have only panic disorder and depression I can't really talk for people that experience SAD. But I think it's completely ignorant to think that exercise is the BEST treatment for anxiety. It isn't. Anyone who has had so much apprehension that they've passed out before getting to a stressful situation can back this up. No amount of exercise will help this, period. When my anxiety was at its worst (not SAD, but anxiety) I couldn't do anything or see anyone. I ran 10 km every 2-3 days, and was in peak condition. NOTHING CHANGED. It was not until I tried medications where I could begin to see a change, enough so that I could begin to do things again (just uncomfortably).

What I will say, is before all of this when I had no anxiety, except maybe a little nervousness before a huge interview, I used to run to feel better. This did work, but its also because my anxiety was incredibly insignificant. The people that you are talking to on this forum have anxiety that is off the ****ING radar. So please, stop talking about exercise as a realistic form of treatment, because it isn't.


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## AxlSlash

Ive been working out? exercising for over 15 years. If thats the cure why do i still have anxiety lol. Sure working out makes you feel goodf about yourself, for maybe a half hour after your done working out while the endorphins are kicking. But to say that working out is going to stop me from having a panic attack tomorrow when i go to the store is ridiculous. What should i just say to myself " hey i work out all the time i shouldn't be having a panic attack" when it happens? will that stop it? lol.


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## zendog78

Exercise helps but has diminishing returns. It is the endorphin release that makes you feel better. As your fitness level increases you need more and more to get the high. Eventually the depression catchs up, you crash, stop exercising, your fitness drops and you can start it alllll over again


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## just want to stay home

I think it's a good idea to make an FAQ for drug effectiveness rates and side effects, etc. Just please make it easy to find your particular med because I looked for a while and gave up and posted a new thread just now. Thanks.


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## Burnt1

Appears to be a good idea...

Another idea would be to list typical combinations (combo) of drugs and how the combo has affected folks. 
That is something that is not available and it is frustrating because I am on several meds but often the combination of meds is not affective...would just like to know typical combinations for anxiety or depression etc. so that when one combo may not work another one may...it may be difficult to do this because everyones reaction to a combo of meds may be different....however to have a list like this could be extremely beneficial for those that may want to recommend a certain combo to doctors because that combo doesn't have as many side effects as another and works well....just an idea...


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## starrlamia

Did this every get off the ground? I have some basic biochem/pharm classes from uni under my belt if help is needed to get this together....


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## Lauris

zendog78 said:


> Exercise helps but has diminishing returns. It is the endorphin release that makes you feel better. As your fitness level increases you need more and more to get the high. Eventually the depression catchs up, you crash, stop exercising, your fitness drops and you can start it alllll over again


Yes, the opioid receptors get tolerance to the endorphins, but it's not the only method of action that helps anxiety and depression. It normalizes your noradrenaline and cortisol levels which cause panic attacks when disbalanced by stress. Sedative people have trouble using oxygen properly and distributing it to brain/muscles, the heart is weak and when anxiety kicks in, the crazy heart rate by having weak heart adds up to the anxiety, some people even think they are having heart attack.

It increases production of chemicals such as dopamine, glutamate, norepinephrine, and serotonin which all are linked to depression and anxiety when at least one of them is depleted by stress and since exercise reduces overall cortisol and adrenaline, the reduction of stress leads to increase of these It helps sleep which again is linked with stress, therefore the levels of 5HT, dopamine and others. You sleep less, but it's more restful, you have higher energy levels to do things which again indirectly helps depression and anxiety.

It also makes you eat more, which leads to consuming more nutritients, for example tyrosine, the precursor of dopamine and as you know dopamine is responsible for motivation, reward and sense of well being.


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## ines88

Hello ! I take xanax xr 0,5 mg since november 2014 , and want to know about the weaning of xanax xr 0,5 mg, how can i do the weaning ?


Can anyone help me !


Thank you.


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## 9872

Medline said:


> The same questions are being asked here again and again. So I think an FAQ would be very helpful. It should concentrate on evidence-based treatments IMHO, but of course our extensive knowledge with other drugs shall be included. Too reckless or dangerous combos not.
> 
> What do you think about the idea? We might start with naming drugs that work. For creating the FAQ itself google docs is the way to go.
> 
> Everybody interested in helping please say so. Long-term members with good knowledge of psychopharmacology are preferred.


This might be off topic.... but are you a nurse? How did you get through clinicals with SA


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## surviving

I agree with this.


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## marsia

I didn't read all the responses, so sorry if this is a repeat, but it would be great to have an FAQ for treatment options and terms, as well. For instance, the common ways of coming out of depression, or common ways of getting out of a panic attack, ways of addressing low self esteem, common skills for learning small talk and contributing to making a conversation interesting... It seems like we all have similar problems, and instead of everyone addressing each person with these problems, a forum for common issues would be great, too.


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