# Seriously, what is the best SSRI? or is there a good one?



## caslon

Seriously, what is the best SSRI? I've tried paxil, effexor, cymbalta, lexapro and zoloft (which i'm currently taking 100mg) none of these have really worked for me in any significant way. My pdoc says that my dosage might not be enough, so soon we will be upping my zoloft dose to 200mg. Hopefullly it helps.
What SSRI do you guys take, and at what dosage. Do you feel it's helping, and what does that feel like? Or do you take Nardil?
Thanks.

On the bright side :clap , Klonopin really helps, but it's effectiveness might taper off as m body gets used to it.


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## Sasha

I have tried a few SSRI's and they never really worked.
My doctor kept increasing my dosages, but still no improvement.


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## UltraShy

Zoloft was the final nail in the SSRI coffin. I went up to 300 mg and was on it for 13 weeks, with no positive results.

I've also tried Paxil, Prozac, and Lexapro. They all were total failures. I refuse to take another SSRI ever again and any doc who dares to suggest another risks having to get my size 13 foot out of his ***.


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## nenad

There really is nothing so special about SSRI's compared to older anti-depressants. If you fail on the zoloft you should ask your doctor about another class of antidepressant.


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## mserychic

I've only tried Prozac. Worked great for depression but not SA.


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## UltraShy

nenad said:


> There really is nothing so special about SSRI's compared to older anti-depressants.


TCAs (tricylic antidepressants) were very common before SSRIs came along with Prozac being the first to hit the market 20 years ago. One of the reasons docs liked SSRIs was that it's basically impossible to die by SSRI OD (and antidepressants are regularly used on suicidal patients). A TCA OD can kill, which made them a more dangerous choice.

TCAs have a nasty side effect of producing extreme dry mouth. I tried imipramine and had to give up after 28 days because it made it virtually impossible to urinate. I mean where an atheist starts praying to pee after standing before the toilet for 15 minutes and not getting a drop.

The other problem with TCAs is that they are generally deemed ineffective for SA. (not that SSRIs are that great)


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## michaelyuan

paxil is the best.


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## UltraShy

michaelyuan said:


> paxil is the best.


Can you cite any study to support this?


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## mserychic

michaelyuan said:


> paxil is the best.


Didn't you have a thread about hating paxil and wanting to quit it?


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## UltraShy

mserychic said:


> michaelyuan said:
> 
> 
> 
> paxil is the best.
> 
> 
> 
> Didn't you have a thread about hating paxil and wanting to quit it?
Click to expand...

I hated Paxil and I did quit it way back in August 2001.

I was asking if he could provide any objective research to back the claim that Paxil was best. Or perhaps that was just his personal opinion. My personal opinion is that Paxil sucks, as do other SSRIs.

I'm not aware of any reasearch showing any SSRI to be superior to other SSRIs.


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## mserychic

I just thought it was odd that he had a thread about hating it and now says it's the best :stu


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## michaelyuan

i v tried all ssri,and feel paxil has the strongest sedating effect.
so i think it is best in treating SA.
luvox tasts also good.
zoloft is good too.
celexa and prozac r bad.


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## michaelyuan

u know ,self medicate is so difficult . u will feel contravosy some time about one med.
i like the feeling after taking paxil,especially in its first several days,it give me strength ,my muscle become stronger and have strong confidence.
but as time goes by,it will make me more introvert and nervous seemingly.i don't know why.


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## michaelyuan

mabe i should combine some benzo to it .but only aprozolam is suitable to paxil.
but i dislike to take aprozalam 3 times a day. so i often take klonopin .but klonopin often offset paxil's effect.


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## Thunder

SSRI's are the modern day equivalent of [wiki:31gzaa95]bloodletting[/wiki:31gzaa95].


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## Maslow

SSRIIs are effective for a lot of people. Doctors usually start patients off with Paxil because it has the fewest side effects.


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## mcnabj

Paxil helped me some. Celexa work a little. Prozac made me more nervous and angry. Zoloft made me sleep an entire summer and feel horrible. Lexapro made me feel bad. Cymbalta work a little but made me sleep 12-14 hours a day. I think antidepressants dont really work for our problem. If I had only been depressed Prozac would of been my cure. Oh well.


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## Painted_Veil

Lexapro did nothing for me at all, Zoloft made me feel numb but that is about it, finally I am on Effexor XR and it is helping.


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## CoconutHolder

Is Effexor helping with the SA too?


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## michaelyuan

i am on effexor xr now .it does not better than paxil i feel.


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## michaelyuan

i edited,effexor xr is not better than paxil.


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## michaelyuan

klonopin is the best actually.


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## Bandit6

After an appropritate amount of time, they(SSRIs) can work great but that's the problem since heavier cases(ex: people who can't work) require them to work much faster. 

I know a lot of people around me who have been really helped by SSRIs so I'm not gonna sh&%t on them. I've been on Paxil for 2 months on a low dose(2.5 than 5mg) and from the results I got I think it can help me on a longer time and at more normal dose(10-20)....


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## Grantonio

I have read that Nardil is best for SA overall. However, Nardil is a Monoamine oxidase inhibitor so it increases dopamine, serotonin, and norepinephrine levels so it has lots and lots of side effects, drug interactions, food interaction that in my opinion make it not worth to take unless you absolutely have to. 

SSRIs generally do not work for SA because most people with SA generally have abnormal dopamine levels. SSRIs do nothing for dopamine levels, therefore, they mostly have no effect. Only about 20% of people on SSRIs who have SA get any benefit.

Klonopin is supposed to have an overall better effect than SSRIs, which makes sense based off it's mechanism of action, has far less SEs associated with it (mainly just avoiding alcohol and grapefruit juice). Overall, I would chose klonopin for SA if I ever were to take meds for SA.....

I am a pharmacy student FYI


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## UltraShy

Thunder said:


> SSRI's are the modern day equivalent of [wiki:3793hdlp]bloodletting[/wiki:3793hdlp].


Nobody held a patent on bloodletting.

Though if you pay out-of-pocket for an SSRI script it will feel like bloodletting.


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## UltraShy

Maslow said:


> Doctors usually start patients off with Paxil because it has the fewest side effects.


Paxil is generally regarding as the most sedating of the SSRIs. It's generally regarded as having the most chance of withdrawal issues (since it has the shortest half-life of any SSRI). And it's used off-label for the treatment of premature orgasm (which is great if you're a 13-year-old boy who is about to burst as soon as he sees a hot girl, but not so great for the rest of us who end up with anorgasmia).

Paxil is popular because they were the first to get FDA approval as an SA treatment and in 2000 they started running one of the largest pharmaceutical ad campaigns the world has ever seen. Being first to market is what made them a winner.


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## Noca

UltraShy said:


> Maslow said:
> 
> 
> 
> Doctors usually start patients off with Paxil because it has the fewest side effects.
> 
> 
> 
> Paxil is generally regarding as the most sedating of the SSRIs. It's generally regarded as having the most chance of withdrawal issues (since it has the shortest half-life of any SSRI). And it's used off-label for the treatment of premature orgasm (which is great if you're a 13-year-old boy who is about to burst as soon as he sees a hot girl, but not so great for the rest of us who end up with anorgasmia).
> 
> Paxil is popular because they were the first to get FDA approval as an SA treatment and in 2000 they started running one of the largest pharmaceutical ad campaigns the world has ever seen. Being first to market is what made them a winner.
Click to expand...

My GP says Paxil was his last choice of an SSRI because of its bad withdrawal.


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## No Limit

Celexa is the only SSRI that sort of worked for me. Lexapro, Paxil, Prozac, Effexor XR, etc never really did anything for me. For the most they SSRIs were useless for me. But then again, it's different for others. I've found MAOIs work for the most part. I've tried Nardil in the past and currently trying out Parnate.


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## Flinx

I find Zoloft to be very effective for my SA without the side effects of other SSRI's. I'm currently taking 100mg.


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## sab_07

I just started on Celexa, after Lexapro failed and Buspar's side effects were too much. So far so good, haven't had really any side effects, except maybe feeling a tiny bit nauseous.


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## crazychick

*not effexor*

hey before doing effexor check out this site... http://www.crazymeds.us/effexor.html its informative and funny. i am tortured with panic attacks and anxiety and i just dont know what to take, i do know that i have a hard time even going to work anymore, i just do because i have to and now need xanax just to go. im not agoraphobic because i can go anywhere else, just the stress that ensues at work i suppose. im miserable, i have a bottle of zoloft ive been too afraid to try for 4 mos now sitting next to me. my anxiety is about dying, im afraid i will take it and just keel over, i know thats crazy, but then again, so am i!!! :b


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## IDK

I'm taking Celexa and it didn't help me become more outgoing or reduce anxiety at all. Instead, I felt at ease with my situation and no longer care if I have no friends or gf and what not. All my emotions have been dulled. Also, with no weird side effects, I am pretty satisfied with Celexa. This is the only SSRI I've ever taken though.


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## shadowsandlight

Since other med class groups are mentioned, I assume the post title meant medication not just SSRI. I have not found a really good SA drug - they all have side effects I hate. I also have other issues such as depression and medication-triggered hypomania, so what doesn't work for me might be good for someone else.

Anyway, for what they're worth, my experiences with psych drugs for anxiety:

Celexa: First psych drug I ever tried. It made me tired, apathetic, gain weight, and numbed my emotions to where things that should bother me didn't. I don't recall it helping a whole lot with SA.

Paxil: It did help the SA a bit, but it was a nasty drug otherwise. I gained 20-30 lbs on it, which took forever to lose. I don't know if it's related, as it's not a listed possible drug effect, but I became hypothyroid after being on Paxil, and now have to take synthetic thyroid hormone for life. I was tired and apathetic. It triggered hypomania. It also made me do weird, scary things - I remember taking a razorblade and cutting on my leg, not because I was feeling bad (I'm not a self-mutilator), but because I just felt it was fascinating for some reason at the time. Basically, it was making me crazier than I am. It took months and months to finally get through all of the withdrawal symptoms. 

Wellbutrin: Gave me horrible, unbearable, constant anxiety. I remember having to drink some alcohol one night just to calm down because the WB was making me feel like crawling out of my skin. I have no idea if it helps SA as I couldn't tolerate it long enough to find out. 

Trazadone: Made me sleepy and helped me get to sleep. That's about it. It made me too tired to function so I didn't take it very long. 

Effexor XR: I found this the most helpful for SA. It didn't cure it by any means, but it allowed me to feel well enough to get to therapy and actually get something out of it, and to do all the work. It did trigger some hypomania, though, and also caused me to lose quite a bit of weight because I did not have any appetite (it makes some people gain weight though). It also made me very sleepy and lethargic, which is ultimately why I stopped taking it. I tried to quit cold turkey (from 150 mg) and had symptoms like I've seen in people going through opiate withdrawal. Like Paxil, it took quite a while to taper off and have the withdrawal symptoms finally stop. 

Ativan: Didn't seem to help much unless I took a whole lot of it, and then, by the time I felt the anxiety diminish, I was took sleepy to feel like socializing.

Klonopin: I have no idea if this helps with SA as every time I took it, I would fall asleep. Seemed to make me feel more depressed. My dr told me it is very addictive and the body can develop tolerance to it very quickly, and so not to take it every day.

Prozac: seemed to do nothing but make me irritable. Also think it was making me retain water weight. Hard to say how well it really works as I was only taking a low dose of it to ease the withdrawal off Effexor.


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## milo001

paxil help a little.zoloft doesn't seems any different.i have not taken any SSRI for more than a month.


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## Foh_Teej

yay lets resurrect more old posts please


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## KurtG85

No one can tell you what med of any kind will work best for you nor if any will or wont work for you at all. You simply have to try each one yourself and see.

This site really needs a giant banner across the top of every page like on depressionforums.com that states this for all posters and even passersby. It is rule #1 of psych meds. 
http://www.depressionforums.org/forums/index.php?act=SR&f=55

"The treatment of mental disorders is a personal trial and error process. Just because one person has severe headaches when they use Zoloft doesn't necessarily mean that if you take Zoloft YOU will have headaches too. Conversely, the fact that Paxil didn't work at all for one member does not mean that Paxil cannot be your success story. Your wonder drug or combination of, will be discovered totally independent of what may or may not work for another individual. If one drug was the answer for everyone, then there would be only one drug on the market. We all react differently to different medications and varying dosages. It may satisfy your curiousity to learn about other people's experiences, BUT this should never be the deciding factor as to what will work best for you. Sorry, it just doesn't work that way."


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## Medline

I also don't think these posts will really help people. I mean there is no "best SSRI" and what is a thread like "my doctor started me on xyz, is it good" for? Sorry, just my opinoin. Inform yourself about the best treatments for SA, talk with your doctor about it. If he sucks, search another one. Make CBT if you think it's good for you. Try an SSRI first, at a high enough dose for a long enough time. If it didn't help, consider an SNRI like Effexor XR. Then you can try Pregabalin, Clonazepam, a MAOI like Nardil/Parnate if necessary combined with a potent Benzodiazepine like Klonopin. If all that fails, more complex and less common treatments like Adderall XR + Klonopin can be considered...

Don't play the "you didn't respond to 4 SSRIs, so try another one"-game. Don't get involved with Antipsychotics if you have no schizoaffective disorder. Forget about TCAs, they haven't proven efficiency for SA.


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## CopadoMexicano

good luck in finding the right drug


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## screwjack

KurtG85 said:


> No one can tell you what med of any kind will work best for you nor if any will or wont work for you at all. You simply have to try each one yourself and see.
> 
> This site really needs a giant banner across the top of every page like on depressionforums.com that states this for all posters and even passersby. It is rule #1 of psych meds.
> http://www.depressionforums.org/forums/index.php?act=SR&f=55
> 
> "The treatment of mental disorders is a personal trial and error process. Just because one person has severe headaches when they use Zoloft doesn't necessarily mean that if you take Zoloft YOU will have headaches too. Conversely, the fact that Paxil didn't work at all for one member does not mean that Paxil cannot be your success story. Your wonder drug or combination of, will be discovered totally independent of what may or may not work for another individual. If one drug was the answer for everyone, then there would be only one drug on the market. We all react differently to different medications and varying dosages. It may satisfy your curiousity to learn about other people's experiences, BUT this should never be the deciding factor as to what will work best for you. Sorry, it just doesn't work that way."


Bingo.

The doctor just anlysis your symptoms and gives you what best fits, if that dosen't work they keep on throwing things at you till they find what sticks. There is no "best" it's all subjective which is why psychiatry/psychology is considered more of an art than a science. Maybe in the future they'll have scanning machines where they can scan your brain and see exactly what meds you need, but that dosen't exist yet by a long shot.


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## pita

http://www.cbc.ca/health/story/2009/01/29/antidepressants.html


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## jacinta22

Hey Casion,

I was diagnosed with a social anxiety disorder a few months ago and I actually have decided not to take anything for it yet... Have you tried natural alternatives? It may not be a quick fix, but it may be better for you in the long term. Sometimes a pill just won't work because it isn't a physical problem, its a mental one. My anxiety is slowly getting better and better, I have been seeing a chiropracter and kineseologist (it seems weird but I feel fantastic whenever I leave a session) and also getting couselling. My next step is to see a hypnotherapist, a natureopath and try CLP which deals with mind scrambling. Herbal supplements such as St Johns Wort or medititation may also help. 

If you have already tried these or want specifically a SSRI, I can suggest one SSRI that my friend swears by. She has GAD and depression and she feels fantastic on it. It's called Cipramil, its not addictive or has very few side affects, It's not very well known but it is similar to lexipro and its quick acting. Usually you will have to take it for about 6-12mnths depending on the person. I hope I have helped. Good Luck


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## euphoria

All the SSRIs have different properties, but if I had to choose a "best" I would go with fluoxetine (Prozac). It has a much easier initiation period than the shorter-acting SSRIs, apparently is not susceptible to a type of genetic drug resistance affecting others, antagonises the 5-HT2C receptor (which is the mechanism of the new anti-depression/anxiety drug agomelatine), and more.



jacinta22 said:


> Hey Casion,
> 
> I was diagnosed with a social anxiety disorder a few months ago and I actually have decided not to take anything for it yet... Have you tried natural alternatives? It may not be a quick fix, but it may be better for you in the long term. Sometimes a pill just won't work because it isn't a physical problem, its a mental one. My anxiety is slowly getting better and better, I have been seeing a chiropracter and kineseologist (it seems weird but I feel fantastic whenever I leave a session) and also getting couselling. My next step is to see a hypnotherapist, a natureopath and try CLP which deals with mind scrambling. Herbal supplements such as St Johns Wort or medititation may also help.


Just because something is "natural" doesn't automatically make it safe to put in your body. In fact, pharmaceutical drugs are subject to much stricter control than supplements.

"Herbalism" is particularly bad because it encourages the flawed assumption that plants are safer than synthetic drugs -- both can kill you.

To be honest it sounds like you're wasting your money with a lot of that stuff.


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## John Smith

jacinta22 said:


> Hey Casion,
> 
> I was diagnosed with a social anxiety disorder a few months ago and I actually have decided not to take anything for it yet... Have you tried natural alternatives? It may not be a quick fix, but it may be better for you in the long term. Sometimes a pill just won't work because it isn't a physical problem, its a mental one. My anxiety is slowly getting better and better, I have been seeing a chiropracter and kineseologist (it seems weird but I feel fantastic whenever I leave a session) and also getting couselling. My next step is to see a hypnotherapist, a natureopath and try CLP which deals with mind scrambling. Herbal supplements such as St Johns Wort or medititation may also help.
> 
> If you have already tried these or want specifically a SSRI, I can suggest one SSRI that my friend swears by. She has GAD and depression and she feels fantastic on it. It's called Cipramil, its not addictive or has very few side affects, It's not very well known but it is similar to lexipro and its quick acting. Usually you will have to take it for about 6-12mnths depending on the person. I hope I have helped. Good Luck


Mental problems are physical. The mind is the result of physical matter.


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## RockiNToM

Agreed. I mean if I were to consider prozac/fluoxetine based on what euphoria said, it would sound promising, however the reaction I have to prozac is not a good one, and although it may sound great on paper, the experience I had wasn't. I probably had the worst anxiety I have experienced ever in life while on that med and over time it didn't get any better.

Mirtazapine is another, on paper it should be better for me than the other SSRIs I've taken, but it wasn't. Maybe it might've been with a combo going with an SSRI, but all I know is on its own it wasn't much fun.

So in conclusion, like Jim Morrison says: best to take whatever works best for you.


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## jim_morrison

Unfortunately that's usually how it is, big pharmaceutical company's probably paint a promising picture of their certain medication, they may even publish some biased study's, but real world experience shows that most antidepressant responses aren't that linear.


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## Raptors

Prozac. 

Made me an extrovert. nuff said.


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## Dane

*Different SSRI = different effects for me*



nenad said:


> There really is nothing so special about SSRI's compared to older anti-depressants. If you fail on the zoloft you should ask your doctor about another class of antidepressant.


Not true, at least for me. A whole summer on gradually increasing doses of Zoloft did nothing for me, but when I switched to Paxil I had great results.


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## RockiNToM

Exactly, if I assumed all the SSRIs were going to be like Prozac after having a bad experience with it, I would've never discovered Paxil which literally saved my life back in the day.


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## wwefwjndrg3274

For social anxiety, do the SSRIs or SNRIs, avoid the tricyclics, and MAOIs,


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## jijiji

UltraShy said:


> I refuse to take another SSRI ever again and any doc who dares to suggest another risks having to get my size 13 foot out of his ***.


hahah, how many times have you said this

it's hilarious though, i love it


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## ncloutz87

michaelyuan said:


> paxil is the best.


Paxil is of no help to me and i can NOT wait to get off it and onto something new. I take 40mgs of paxil now .50 of xanax as needed and 25mgs of amitriptyline. i have depression, panic attacks, agoraphobia, insomnia, borderline personality disorder, PTSD, GAD and SA.


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## jestech

michaelyuan said:


> klonopin is the best actually.


Yep. I've never been impressed with SSRIs for anxiety or PD. I think you're better off with low dose long acting benzo in combination with a beta blocker.
The big negative with benzos are the horrible withdrawl symptoms.


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## lmaster

If you don't know what to expect from SSRI, there is no much help anyway...

Meds aren't enough...


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## mr t

Grantonio said:


> I have read that Nardil is best for SA overall. However, Nardil is a Monoamine oxidase inhibitor so it increases dopamine, serotonin, and norepinephrine levels so it has lots and lots of side effects, drug interactions, food interaction that in my opinion make it not worth to take unless you absolutely have to.
> 
> SSRIs generally do not work for SA because most people with SA generally have abnormal dopamine levels. SSRIs do nothing for dopamine levels, therefore, they mostly have no effect. Only about 20% of people on SSRIs who have SA get any benefit.
> 
> Klonopin is supposed to have an overall better effect than SSRIs, which makes sense based off it's mechanism of action, has far less SEs associated with it (mainly just avoiding alcohol and grapefruit juice). Overall, I would chose klonopin for SA if I ever were to take meds for SA.....
> 
> I am a pharmacy student FYI


Nardil should be a FIRST-line drug for SA. Textbooks are outdated on MAOIs and so are most professors knowledge because the drug is rarely prescribed nowadays because of all the fear mongering. (Source: my pdoc who has won top 100 psychiatrist in U.S. award for 12 years straight- Dr. James Barbee, New Orleans, MD with PhD in Neuropharmacology) I think I'll trust his opinion more.

SSRIs have way worse side effects than MAOIs. Being on SSRIs was hell, now i'm on Nardil with no side effects.

I've taken multiple neuropharmacology courses and MAOIs increasing serotonin, dopamine, and norepinephrine all at once doesnt mean you have "lots and lots of side effects". Having a balancing effect of dopamine and serotonin activity would actually lessen side effects like sexual dysfunction. Dopamine and serotoinin have a balancing effect. If you raise one alot with for example with an SSRI, dopamine activity drops which will eventually cause the "SSRI poop out". Learn more about MAOIs then from your textbook and proffessors that say MAOIs=bad. Its silly. The food interactions are way overhyped, i've eaten plenty of things of the "forbidden list". The drug interactions on the other hand are life threatening. Dont use cold medicines that decongestants in it and you're pretty much fine.

SSRIs are useless for SA. If you want to treat SA you must address multiple NTs including GABA.


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## vcntmnd

I just wanted to chime in here, the brain is -extremely- complex, a single individual often has vastly different experiences with nearly identical drugs, add to that things like mood, life events, placebo effects, (yes, hearing bad or good things about a drug -can- effect your experience with it) or even the time of year, etc etc.

That being said, the best treatment hands down for SA or depression is exercise. Even a very small amount of exercise works wonders. From my own experience, alcohol has a subtle but very significant negative long term impact on SA, and marijuana can go either way, although Ive personally seen more negative impact than positive.

One thing that I find very important is having a third party observer involved, often other people notice significant positive changes before you do. Start smiling twice as often for example, you'll never notice, but people around you certainly will.

As far as meds are concerned, unfortunately you do have to try them, for extended periods of time, as there is currently no way to predict their effect on an individual. It can be a slow painful process, but these medications are lifesavers for a great number of people. Again, people close to you will notice a change in attitude before you will.


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## GotAnxiety

i recommend exercises, diet , supplements you will induce more natural euphoria and get through your problems better then antidepressant anyways false power ain't good it may take hard work and determination, but no one said anything is gonna be easy your confidence in your self will grow, when your power comes from within.

have faith believe in your self you will prevail, anti depressants do work and can help but technically its still you they may just numb your feeling's with or without it you got the power in you you may just not notice it yet.


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## blue the puppy

i like zoloft.


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## Lauren10409

paxil is known to be the most effective SSRI for social anxiety. It worked WONDERS for me. Literally changed my life. The side effects are another story. Lowered libido and difficulty having an orgasm are killing me. I am trying to figure out what to do. I am going to see my doc next month.


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## xDan

Grantonio said:


> SSRIs generally do not work for SA because most people with SA generally have abnormal dopamine levels. SSRIs do nothing for dopamine levels, therefore, they mostly have no effect. Only about 20% of people on SSRIs who have SA get any benefit.


This is illogical. Most people with dopamine deficiency have Parkinson disease and not Social Anxiety. This is because Dopamine plays a huge role in body movement but it also does play a role in feeling pleasure, but Serotonin (and GABA) is linked with Social Anxiety - which is why SSRIs and Benzodiazepines and even MAOIs such as Nardil which act on Serotonin and GABA are used. If it was the other way round then DRI's and Dopamine agonists such as Bromocriptine and Apomorphine would be used instead - and they are barely used for SA. As mentioned above GABA and Serotonin are the main SA related chemicals, Dopamine is linked more so with Depression than SA.


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## xDan

In addition to the above statement, Sertraline acts on Dopamine - particularly at high doses, but is no more (or less) effective than other SSRIs such as Paxil - which may actually be more effective.


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## CopadoMexicano

theyre all the same. if there was one best or more potent ssri than everyone would just get the same thing.


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## xDan

CopadoMexicano said:


> theyre all the same. if there was one best or more potent ssri than everyone would just get the same thing.


But if they were all the same then if one worked you can be sure another won't. They are chemically very different and their selectivity/reuptake inhibition vary, but generally they are similar. The difference in pharmacokinetics is the reason as to why a medication may work for one person and not another.


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## Hordak

Medline said:


> Forget about TCAs, they haven't proven efficiency for SA.


People beg to differ :roll


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## Hordak

wwefwjndrg3274 said:


> For social anxiety, do the SSRIs or SNRIs, avoid the tricyclics, and MAOIs,


*lol*


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