AboutDr Alan Galbraith Expertise I can answer most questions on drugs, both medical and "recreational". Answers can be given in either technical or layperson terminology. My main areas of interest are psychiatric, gastrointestinal and cardiovascular drugs.
Experience I have been a university lecturer/head of department for almost thirty years, but am now retired. My research interests were alcohol, smoking and cardiovascular disease.
Organizations Institute of Biology, London.
Publications Principal author of "Fundamentals of Pharmacology" 4th Edition published in November 2003 by Pearson Education, Australia.
Question QUESTION: My fiance has severe social anxiety. He was on Klonopin 6mg daily for about 12 years. He decided he didnt want to take that anymore because of the "dulled mind" feeling it gave him. He is soo smart and bright, but just cant do things that require social situations. Work is very tough for him, going out to resturants or anywhere is very tough. He alot of times would turn to alcohol to relieve his anxiety. He gets soo mad at hisself for not being able to bring out his "true" personality in social situations. Anyway, he attended a 28 day program to get taken off the klonopin and try new things. They have tried a couple of drugs so far. One of them is Abilify. Which isnt doing anytihng for his anxiety. We are at a loss. Are there any drugs out there that will give him the improvement on the anxiety and not make his mind feel so numb? I read that Nardil is the best? ? Please help if you can! I would really appreciate it!
Kristen
ANSWER: Dear Kristen
I am not sure exactly what the diagnosis of your fiancé’s condition. Without a name it is difficult to be precise. Your description of his symptoms suggest more of a panic type disorder which would be responsive to some of the newer antidepressants eg Prozac or Lexapro. Nardil is a very powerful antidepressant and is usually only used in recalcitrant cases not responsive to other antidepressants. Abilify is usually used for mood disorders and psychotic illnesses. Klonapin is an antianxiety agent and I agree with it cessation because of his symptoms whole on it and it is addictive. If it is a mood disorder than one of the antiseizure drugs may be useful.
I would suggest he see a psychiatrist for proper evaluation and sound treatment.
Regards
Dr Alan Galbraith
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QUESTION: thank you for responding. he is currenlt under psychiatric care in the program. his diagnosis has always been severe social anxiety/depression. I apologize I forgot to include he also takes 150 mg of effexor daily. we were confused y his doctor put him on abilify since he does not have bipolar/schitzaphrenia. (spelling?). does this info help at all? oh and he has tried the two you mentioned they didn't do anything. thank you again.
Answer Dear Kristen
I am assuming that he tried the antidepressants mentioned at for a month to see if there was any improvement?
There are other classes of antidepressants which could be tried before resorting to Nardil. I still believe that the older antidepressants have a place in modern therapeutics. Has he tried amitriptyline or imipramine (known as tricyclics) or a newer semi-related one called mirtazapine? There is also one semi-related to Nardil which has fewer problems associated with it called moclobemide. If these or other analogues prove unsuccessful then maybe Nardil is an option.
Regards
