# Prozac working well for SA



## analysisparalysis (Jul 2, 2009)

I started taking 10mg/day of Prozac three weeks ago for my depression and it has been helping my SA dramatically. I haven't always had SA - I was social in college, but became socially withdrawn and paranoid since I moved to D.C. I would struggle with small-talk and over the course of a conversation get uncomfortable, feeling that the person I was talking to was judging me. Then I would just totally shut down and stop talking. The medication has together helped my depression and taken away my paranoid/brooding thoughts. As a result (or as a side-effect), it's freed up my social anxiety and I can be more like I was like in college.

I'm really curious if anyone here has had a similar experience or knows how SSRIs or antidepressants in general are supposed to help SA. I'm asking because if it goes well with Prozac for my depression I might start taking less or stop altogether, and I don't want my SA to come back. Basically, one thing I noticed was that I no longer over-analyze situations, which before made me dwell on negative things and had led to paranoia/inhibition in social situations. Now, I'm comfortable again in social situations (maybe even too comfortable, especially if I've been drinking) and I find pleasure in small-talk, going out, or partying with people. Although I don't feel that big of a change in my thoughts since I've been on Prozac, lately, if you put someone in front of me, I will just chit-chat away. My fear/inhibition is just gone.

Does the Prozac lift my mood, which is in turn somehow making me less paranoid, and in turn more social? Or does the Prozac kill my brooding thoughts, which then makes me more social, and in turn, less depressed? I'm just wondering if anyone has thought about this.


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## jim_morrison (Aug 17, 2008)

analysisparalysis said:


> I'm really curious if anyone here has had a similar experience or knows how SSRIs or antidepressants in general are supposed to help SA.
> 
> Does the Prozac lift my mood, which is in turn somehow making me less paranoid, and in turn more social? Or does the Prozac kill my brooding thoughts, which then makes me more social, and in turn, less depressed? I'm just wondering if anyone has thought about this.


I could be wrong, but as far as I'm aware theory goes that by indirectly activating the 5HT1a serotonin receptor, SSRI's reduce anxiety. Paradoxically they can also increase anxiety through activation of the 5HT2a receptor and others, until they gradually downregulate them after about a period of 6 weeks or so. SSRI's have also been shown to lead to a slight to moderate increase of cortical levels of GABA (an inhibitory neurotransmitter), thus their anxliotic effects are not merely just a secondary result of mood improvement.


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## Edwin (Jun 19, 2008)

Prozac lowers anxiety and other stress symptoms (like depressive feelings) through serotonine reuptake inhibition. This will make it easier to stop focussing on these feelings (as they're not as prominent a stimulus) and instead put your attention where it should be.

If you were on something that increases dopamine, which increases focus, you would be able to withstand focussing on stronger negative stimuli, and it would also help with feelings of enjoyment. 

When you're drinking beer, you increase your dopamine (and focus), while also getting sedative effects, which decrease feelings of anxiety even more. This results in well... basically a temporary "cure" of social anxiety.

Thoughts are shaped after the emotions we perceive when dealing with things in the world. They sometimes take a bit longer to adjust to the new experience.


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## analysisparalysis (Jul 2, 2009)

that's interesting, thanks.


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## RockiNToM (Jun 15, 2009)

Prozac can be a good med for a lot of people. For me, in the beginning, it really helped, but I couldn't tolerate the heightened agitation that I kept getting from it, so I had to come off.


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## Black_Widow (May 23, 2008)

Many thanks for including this here. I always thought Prozac was for depression, rather than both depression and anxiety. I didn't know till now it could be effective for treating SA. 
But this has made me realise it might be worth me considering this as an alternative to another SSRI drug I'm taking at the moment for SA and am considering discontinuing.


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## RockiNToM (Jun 15, 2009)

Certainly worth giving it a try. It might work out really good for you.


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## jim_morrison (Aug 17, 2008)

may I ask what dosage of prozac your currently on?


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## daveuk (May 12, 2009)

Glad Prozacs working for you. Im on 20mg Prozac, its working well (Less blushing, more confidence) apart from I feel kind of distant from everything such as emotions. So when talking to people I dnt really have honest reactions such as laughing n it makes things awkward because I fake laugh and smile n its just weird. Better than blushing and being nervous like before tho


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## RockiNToM (Jun 15, 2009)

dave, that happens with most SRRIs. It's very common to have blunted emotions while on these type of meds. Unfortunately for me, it was creating too many problems being slightly too apathetic towards things and not doing me any real favours in terms of getting on with people - it just made me cold and emotionless.


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## honastud (Jul 13, 2009)

Edwin said:


> If you were on something that increases dopamine, which increases focus, you would be able to withstand focussing on stronger negative stimuli, and it would also help with feelings of enjoyment.


Not buying it. If you were on something that increases dopamine you would ponder on the neg stimuli because of the increased focus. Schizophrenia patients have elevated dopamine levels.

The seratonin in SSRIs would dull your focus and allow you to take in neg thoughts and emotions more easily.


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## Edwin (Jun 19, 2008)

A high increase in dopamine makes you paranoid, that is what happens with Schizophrenia patients. Extreme levels of dopamine give you such a narrow focus that it is impossible to even slightly notice stimuli that don't have your attention.

So dopamine is useful in Social Anxiety, it is an inhibitory neurotransmitter and can help reduce the impact of certain unwanted stimuli on your cognition.

When I was on a very high dose of serotonine reuptake inhibitors through a combination of 80mg Celexa and some St. Johns Wort, I would still focus on the negative, although these emotions (as well as the rest), were strongly reduced in intensity. A serotonine increase is useful, but I noticed no useful difference between a high level and a low level after being on it for a year. Emotional blunting is the reason I went off of it.

There's a very useful test to see if you can you use some more dopamine when you've got SA. Go to a party (which you would probably hate) and see how able you are to keep your focus on 1 person, or 1 interesting thing in particular. I used to just have my attention bounce all over the place, making my anxiety uncontrollable.

Dopamine also increases confidence (probably because you feel more in control).


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## euphoria (Jan 21, 2009)

honastud said:


> Not buying it. If you were on something that increases dopamine you would ponder on the neg stimuli because of the increased focus.


If you were on something that increases dopamine, you would be too happy to care about negative stimuli.



> Schizophrenia patients have elevated dopamine levels.


Only in certain areas of the brain though, due to glycine receptor blockade. If schizos had more dopamine everywhere in their brain, they'd all behave like crackheads (euphoric).



Edwin said:


> When I was on a very high dose of serotonine reuptake inhibitors through a combination of 80mg Celexa and some St. Johns Wort, I would still focus on the negative, although these emotions (as well as the rest), were strongly reduced in intensity. A serotonine increase is useful, but I noticed no useful difference between a high level and a low level after being on it for a year. Emotional blunting is the reason I went off of it.


That's because SSRIs don't work very well. If you tried a selective serotonin releaser, the experience would be a lot different, and there would be a difference between high and low doses.


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## honastud (Jul 13, 2009)

Edwin said:


> Extreme levels of dopamine give you such a narrow focus that it is impossible to even slightly notice stimuli that don't have your attention.


Ok...you know you have social anxiety and you know from the past that when your around people you act weird or nervous and your use to filling this way, so your uncomfortable and your focus is on this when your around groups. What is your "NARROW FOCUS" attention going to be on once you have an increase in dopamine and your put into this situation? You going to be that much more focused on others and what there thinking.

I know when I take adderal I feel great and feel like I can do anything but when I get around others on it my focus is still on what they think of me. When I take SSRI's and adderal, this isn't the case.


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## Edwin (Jun 19, 2008)

honastud said:


> Ok...you know you have social anxiety and you know from the past that when your around people you act weird or nervous and your use to filling this way, so your uncomfortable and your focus is on this when your around groups. What is your "NARROW FOCUS" attention going to be on once you have an increase in dopamine and your put into this situation? You going to be that much more focused on others and what there thinking.
> 
> I know when I take adderal I feel great and feel like I can do anything but when I get around others on it my focus is still on what they think of me. When I take SSRI's and adderal, this isn't the case.


Well, as I said, dopamine makes you more able to divert your attention away from things, but if the stimuli are strong enough, a heavy increase in dopamine might not be enough. Purely focussing on dopamine isn't the answer either, you need to at least increase levels of serotonine somewhat, though you might not need an SSRI (change in diet worked for me).

I'll be going on a tiny bit of Prozac soon, as it has a nice synergy with Wellbutrin.


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## RockiNToM (Jun 15, 2009)

I don't know whether my dopamine levels increase when I'm off anti-depressants but I certainly feel like I can concentrate better without them. While on them it almost creates a ADD type of behaviour and I can't think clearly. While at the same time, when I'm off despite being able to think clearer I am more anxious, so who knows.


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## honastud (Jul 13, 2009)

Edwin said:


> I'll be going on a tiny bit of Prozac soon, as it has a nice synergy with Wellbutrin.


Can you provide links for the two together? I could probably use a little pro with my well


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## Edwin (Jun 19, 2008)

honastud said:


> Can you provide links for the two together? I could probably use a little pro with my well


http://www.sciencedirect.com/scienc...serid=10&md5=3b05f490877c4aa01bc8f9e1e074c5b6

This is an article about Buproprion and Prozac in rats.

The Wikipedia article about Prozac tells about the effects Prozac has on the enzyme that converts Buproprion into its metabolite (a metabolite which unlike the original molecule, acts more on norepinephrine than dopamine).


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