Anti-(social)Anxiety Drugs & Combinations

[obliguhl]

So what are the best drugs to overcome anxiety related problems? I've been struggling with social anxiety for a long time now, and i do not have any illusions, that this will change at all. So my main goal is to identify the best pharmaceutical agents to provide enough relief to maintain the most basic functions in order to prevent negative life outcomes.

Kava Kava

Some strains are really great in providing general anxiety relief, but they are very short acting (1-2 hours) and also produce a bit of a mental fog - so not that great for public speaking etc

Benzos

Only taken them in hospital settings, and the feeling of relaxation is par to none, but the risks involved are high, i believe.

Cactus extract

The only substance i've taken that actually helps with social anxiety. But the mind fog can be pretty intense. It's also ridiciolously expensive so i take it only 2-3 times a year and reserve it for precious moments.

I was interested in ß-blockers as i don't have mental anxiety in some situations, but my body creates this whole bunch of anxiety. Unfortunatly, i'm asthma prone and an alternative does not seem to exist? I'm close to going down the benzo road for situations that do not require my initiative or situations which are highly scripted and do not need any creativity or mental capacities (visit to the doctors office for instance, or any kind of buerocratic activity). I don't really want to, but i don't want to die either.

Am i right to assume, that the highly grail of anti-anxiety drugs has not been found yet?

I think for social anxiety, there is nothing that really works because the drug in question would need to provide anti-depressive, anti-anxiety, relaxing and stimulating effects at the same time. For instance, 200mg caffeeine is somewhat effective in providing a social stimulation, as is a handful of cacao beans....but it does not help diminishing anxiety.
I was close to discovering something neat which was cacao+kava, but i kinda developed a weird effect after a while, possibly maoi buildup, i don't know. It's a short lived but sweet combination that's for sure... but possibly dangerous also.

Perhaps one should look into finding potent drug combinations which pose an acceptable risk. The older i get, the heavier the burden becomes and the stronger i need to push against...so, any...thoughts? Suggestions ?

 

[DreaMTripper]

Sorry to hear that but you CAN beat it..Dont take benzos habitually.
Have you tried hypnosis?
How about St Johns wort? DMT helps!

 

[Vodsel]

I was interested in ß-blockers as i don't have mental anxiety in some situations, but my body creates this whole bunch of anxiety. Unfortunatly, i'm asthma prone and an alternative does not seem to exist?

I looked into Beta-Blockers years ago as a symptomatic treatment for essential tremor (which often appears closely related to social anxiety) and the usual contraindications in patients with asthma and chronic obstructive pulmonary disease need some clarification. I will try to explain AFAIK, please keep in mind I'm not a doctor and hence my comments may not be taken as medical advice.

Think about BBs as beta-adrenergic blockers. They act as antagonists in beta adrenergic receptors, and since these beta receptors mediate the fight-or-flight response, BBs can be effective in reducing physical symptoms of social anxiety like tremors, sweating or pounding heart.

Now for the tricky part. There's several subtypes of beta receptors, and for your purposes we can focus on beta-1 and beta-2. B-1 are specific to the heart and B-2 are specific to the lungs. Initially, prescribed BBs were non-selective, which means they bind to both B-1 and B-2 receptors. For breathing treatments, for instance, beta-adrenergic agonists are used to stimulate the B-2 receptors in the lungs and the bronchial muscle is relaxed, opening the airways. So what happens if you give someone with breathing difficulties a beta-adrenergic antagonist such as a non-selective BB? Higher risk of constriction, broncospasm... and well, you get the idea.

But there are cardio-selective BBs specifically targeting the B-1 receptors in the heart. The first time I went to the doctor to get a BB prescription I was particularly thinking about propanolol, and he gave me atenolol instead. I did not understand the reason until I found out propanolol is non-selective, and atenolol is cardio-selective hence safer for the purpose of treating social anxiety disorders in the eventuality of lung conditions. Not that I have one, but I understood that was the reason for his prescription.

Take a look at this paper for further explanation:

Over the past 20 years, nonselective ß blockers have largely been replaced with cardioselective blockers. Cardioselective ß blockers such as atenolol and metoprolol are at least 20 times more potent at blocking ß-1 receptors than ß-2 receptors.[1] At therapeutic doses the ß-2 blocking effect, and therefore the risk of bronchoconstriction, is negligible.

I found a mnemotechnic trick for cardioselective BBs - "Beta blockers Acting Exclusively At Myocardium" - Betaxolol, Acebutelol, Esmolol, Atenolol and Metoprolol. Just keep in mind that when used in large doses, they can become non-selective. Sporadic use when needed seems an option, and although they do have some minor side effects (i.e. dryness in mouth and eyes, slight drowsiness) I personally preferred them to overusing alcohol.

And of course if any doctor reads this comment, please point out any inaccuracies.

 

[bindu]

meds are not a good solution to social anxiety problems

better to go to courses which deal with that by approaching new people constantly

some specific theater classes can also be an option to remove your fears slowly but permanently



if you are very disciplined then you can use meds as cruches while you approach new people everyday

in any case you need to desentisise your system to what you are afraid of.

Much like soldiers get deseintisised towards killing, just that you will do it for a healthy outcome.



if you need meds in these situations then benzos can work, you might not have gotten the right dosage or type of benzo for you

better then benzos, not as limiting (no fog), are pregabalin and gabapentin. But should not be used too often.

The drugs mentioned (gaba drugs) as well as benzos should not be used more then two times a week in appropriate dosages if you dont want to risk getting addicted.


Benzos/GabaD are some of the most physically addicting substances, you can be physically hooked after two weeks of daily use.





Therefore focus on directly desentisising yourself to your fears, better with some coaching help, maybe with some seldom help of drugs

 

[corpus callosum]

Vodsels post covers most aspects pretty comprehensively.

Regarding asthma and B blockers, ideally they should be avoided if an appropriate alternative exists but its not an absolute contra-indication.For example an angina patient has the option of cautiously using a cardio-selective (B1>>B2) B blocker, but alternatives such as nitrates,diltiazem/verapamil/amlodipine (calcium channel blockers, with some significant but not relating to asthma, differences) or nicorandil (acts on potassium channels) do exist.

If ones symptoms of anxiety are predominantly physical then these cardioselective B blockers may be tried; the risk of bronchospasm on these exists but is lower.Propranolol is much less cardioselective so the risk of bronchospasm is higher in an asthmatic.

In terms of anxiolysis, especially if theres mental symptoms of anxiety, propranolol is a better choice because it crosses the blood-brain barrier which is not the case with, say, atenolol..For example, should you be an agitated post-headinjury patient on a high dependency unit then propranolol could be used to quell agitation and is actually a pretty good choice as it lacks the adverse cerebral effects of the anti-psychotic agents (chlorpromazine, haloperidol etc) which should be avoided if possible in such a scenario.

Generally speaking B blockade becomes riskier with more severe asthma (which can be judged from the number of different therapies required to control it, past history of frequent or severe exacerbations, slower response to treatment in an exacerbation previously etc) but this rule is not absolute.Ive seen patients for example whose asthma is pretty mild ie uses ventolin via inhaler very infrequently as the only treatment, who have developed bronchoconstriction after a single dose of aspirin. Ive seen cardioselective B blockers used cautiously in asthmatics with close monitoring of peak expiratory flow rate to detect adverse effects; these were however cardiac patients.

Benzos are very good anxiolytics as Im sure most here know but the risk with these largely arises from too frequent use and the attendant risks of tolerance, habituation etc.They are excellent if needed very infrequently and would be my drug of choice under these circumstances.

Some SSRIs are also licenced for anxiety disorders and there is also choices such as pregabalin but these are not used on an as required basis (although pregabalin would work); these also have their downsides and are correctly indicated for anxiety which is pervasive and not just situational.

 

[Aviator]

I had extremely bad social anxiety for a couple years a couple years ago.

It was so bad that while just talking to a grocery store clerk while checking out would send a rush of adrenaline through my body. My face would turn red and my heart would pound out of my chest. It sucked.

The way I defeated this was first self diagnose myself with social anxiety. Then once I knew what it was I would purposely do some self talk before an encounter with a person and say, "Come on you... go talk! You're awesome! There's nothing wrong. You're doing great!" Basically, I'd muster the balls to go do it then dive in regardless if I wanted to or not.

Seems like you've got some good advice from the other people that posted here. I'd like to add that you can do things that bolster your self esteem like maybe working out. I did. Not only is my self esteem extremely high now but I'm also very healthy!

Good luck!

 

[Auxin]

I'm curious if anyone here has tried Heimia for this.
Its a mild sedative, relaxant, anxiolytic that has been noted by many to specifically reduce the withdrawal effects of benzodiazapines (suggesting some sort of GABAergic activity similar to that of benzos).
I gave some to a friends daughter on her way to the emergency room for clonazepam withdrawals and it reduced her symptoms enough to cancel the trip and wait 2 days to see her GP, it also made the difference of being able to sleep or not.
I wonder if, in the absence of benzo addiction, it could find general use for anxiety as xanax's little brother or something.

 

[SpartanII]

the drug in question would need to provide anti-depressive, anti-anxiety, relaxing and stimulating effects at the same time.

Kratom has these effects.

It not only helped me quit using heroin, but has also tremendously helped my mild social anxiety.

 

[sleepypelican]

the drug in question would need to provide anti-depressive, anti-anxiety, relaxing and stimulating effects at the same time.

Kratom has these effects.

this. it has done wonders in helping me overcome social anxiety related to drug psychosis

 

[obliguhl]

Thank you for your replies. The clarifications on beta blockers are very interesting vodsel and CC! I searched for quite a bit to find an answer on this on the Internet and now i got it "There is risk, but a low dose of selective BB can be tried". I will think about it as my asthma was very mild and then got "cured" ... but i think it might have come back to an extent.

I've read up on the anti-convulsive drugs you suggested bindu, and even the common side effects seem pretty nasty....

I took sinichuici a many years back (10?) and i dont remember any anxyolitic effects unfortunatly.

I'm astounded to find Kratom here, because it has none of these effects on me. It just sort of numbs me, puts me into some sort of pleasant half-sleep ...feels a bit like a warm bath after a long day. Perhaps i have not tried the right strain yet. I've recently purchased a new batch but have not really started testing it yet.

Also, listing drug alternatives is well meant, but im also severely depressed. Telling a depressed and anxious person to "just do it" is a bit like telling a man without limbs to run a marathon. No offense....My goal is to just get by, there is not much time for ambition left, only to play catch-up to the best of my abilities.

 

[jamie]

I think you just need to go and meet a nice girl obliguhl..it seems from all the past conversations with you that this would do you a world of good.

Whatever approach you take, I hope you find what you are looking for..but from *extensive* experience with social anxiety, I can tell you that there is no quick fix, and psychoactive substances do wear off. It can be useful in making a connection, but beyond that you still have to maintain those connections, and you have to feel confident. You cant fake or pretend confidence, as I am sure you know..from things you have said in the past you don't seem to have much confidence, so I would work on that. Your ego can be useful here.

Being anxious and all alone is never a good place to be at, it is vastly different from simply being content and wanting to be alone. Wanting to reach out, with your own anxiety crippling you ability is bound to make you depressed, so it is not a surprise to me you are depressed.

I would avoid heavier things like pharma benzos and kratom etc..that's no way to maintain. Milder herbs like chamomile and passiflora can help somewhat and have some benzo activity..but really man I think you need to go out and meet people. would you really need benzos etc if you were in a spot where you were comfortable with the people around you? Are you only anxious with strangers?

 

[olympus mon]

Although my following comments are not what you asked about or for I'd just like to tell you Oblig ole friend you ate an incredible person and who's ever company you do choose to share they are very fortunate. You have a lot to offer so I do hope you are able to overcome this anxiety. Just always be yourself when you do. Good luck brother.

 

[dtrypt]

I am bipolar with comorbid general anxiety disorder. My bipolar is pretty much under control because of epilepsy medication.Go figure.Can't take any SSRI's or tricyclics or pretty much any antidepressant because it induces mania in me and the side effects are just not worth it.

I'm not depressed anymore but my anxiety has become debilitating. I've tried antipsychotics, buspirone and milder antidepressants to no avail. The only thing that makes me feel like a normal person are benzos. I started a new high pressure job 2 months ago. I'm under intense scrutiny and one mistake by me could cost the company thousands. I do enjoy the pressure and don't really stress about my work... but dealing with the people at work is a different story.
I find myself in boardrooms with CEO's and the like, having to think on my feet and appear totally composed and in control.

My psychiatrist gave me a script for 5 weeks worth of low dose Xanax to ease me into my new job. When you suffer from physical anxiety, benzos don't make you high. You just feel like a normal person. My psych went to an overseas seminar and I ran out. Most people can cold turkey 5 weeks worth of Xanax. Not me though. I spent a whole weekend in the foetal position on my bed, feeling that I could die. I have never had physical withdrawal in my life. It was hell.

First thing on Monday I went to my GP and asked for an alternative to benzos that could at least help with the hellish rebound anxiety. I told her that I didn't want to touch benzos ever again. She told me there was no way I could stop and that my body is now used to it and physically needs it in order for me to not end up in withdrawal or even experience seizures. She gave me another script add Xanax to last until my psych was back.


Saw my psych and told him about my experience and asked for an alternative. He told me that I am now physically dependent on the stuff. He worked out a tapering down regimen for me over the next 3 months with the help of Diazepam. I'm on 20mg diazepam per day now. From next week I'll do 15 a day for two weeks, etc, etc.

So I am a drug addict for the first time in my life. If you discount the 22 years that I smoked. But stopping cigarettes was merely uncomfortable and frustrating. Real withdrawal is incapacitating.

The sad thing is that benzos are the only thing that makes me feel normal. I have 200 Valiums in my bloody cupboard and when it's done, it's done.

I fear that day.

 

[olympus mon]

Dt- man I'm very sorry you are in this difficult situation. I have a good amount of direct experience with addictions and recovery and benzodiazepine family are a very serious even life threatening withdrawal and addictions. It's a double edge sword treating anxiety with them because often times it's a life sentence to dependency or an incredibly difficult transition off them. They actually make a persons anxiety 10x worse. I certainly hope your doctor informed you of this before you began taking this medication but it sounds as if he or she did not.

For me and my best friend idtravler exercise has been extremely effective in reducing anxiety without medication. It's so valuable and a very healthy alternative that us often looked pass. If you aren't already consider trying a vigorous exercise routine 4-5 days a week. The more intense the workout the better I feel, sleep and handle anxious feelings. I was doing crossfit for more than 2 years and never felt better. Mentally physically and spiritually.

I have fallen off my regiment the past few months for multiple reasons and very much need and look forward to getting back into my routine.

I wish you all the best.

 

[adam]

Im with olympus mon on this one. I had very bad anxiety and depression. And exercise and eating better really are what got me out of it. Exercising vigorously on a regular basis truly does increase confidence which is the real issue I think with anxiety. I wouldn't worry so much about diet because at least for me as I began to exercise more I just naturally craved healthier foods, so that fell in place kind of on its own.

I would suggest going to a yoga class or getting a personal trainer, or just getting a nice pair of running shoes and hitting the pavement. I think if you go this route you will be uncomfortable at first but I bet within 3 months of sticking to it you will feel like a new and better person.

 

[jamie]

sounds crazy but making art and music can do amazing things for your mental well being..and it's a good energetic practice for moving stored up energies/emotions. Even if you suck at art, no one really sucks.

 

[SpartanII]

I'm astounded to find Kratom here, because it has none of these effects on me. It just sort of numbs me, puts me into some sort of pleasant half-sleep ...feels a bit like a warm bath after a long day. Perhaps i have not tried the right strain yet.

White vein kratom has more stimulating qualities to it.

If you stay active, you tend to feel the stimulating as well as euphoric, motivating effects. Then when you decide to lay down, you tend to feel the sedating qualities. It's a way to control the effects like a tuner, up and down by being active or passive.

I would avoid heavier things like pharma benzos and kratom etc..that's no way to maintain.

Categorizing kratom with pharmaceuticals seems a bit extreme.

We have a good thread on this plant here: Kratom Information Thread - Other Psychoactives - Welcome to the DMT-Nexus

I've personally found many beneficial qualities in it.

 

[DreaMTripper]

Vitamin b6 has been proved to help remedy anxiety, it may be worth a go try 50-100mg twice a day to start.
You must check first whether its compatible with your current meds.
Good luck anxiet is like a prison but I'm sure you can beat it you are here asking advice now so thats a positive move.
Low dose DMT is also effective.

Have you thought about a complete lifestyle change? Many anxieties come about in my opinion, and I say this from my experience, are simply that you are not where you should be, an indicator from nature that you need to get on the right path.

 

[Jin]

For instance, 200mg caffeeine is somewhat effective in providing a social stimulation,

are you talking about pure caffiene as 200 mg of caffiene would be really insane however i guess youre talking about coffee , i've found 250 mg of coffee to be much better and anything above 300 mg is counterproductive and causes stress

also space the coffee (4 hours 30 mins ) apart from each other , and dont drink cola or tea to cause caffiene imbalance

i've also noticed eating dark chocolate or drinking cocoa worsens anxiety , dont ask why as i have no valid reason except my own experience


also there is nothing like a physical workout , train with weights and build some muscles , eat a few bananas to help you with vitamin b-6


also one thing that really helps is knowing there is nothing to be anxious about when surrounded by monkeys :twisted:

also do not smoke cannabis ,

edit : also paying attention to sound all the time , paying attention to breath , a few deep breaths here and there is all it takes to overcome anxiety with ease ,

also its kinda hard to pay attention to breath all the time so i go with sound technique mostly

 

[Jellyfox]

I would recommend getting yourself some Valerian root. Valerian root has worked wonders for me by calming me down and helping me take a little more time to think about things before I do them.

Valerian root is often taken at night because it can make you quite tired but its effects last into the next day. Valerian is also used as an alternative for benzo's.

don't know if it will help you but it helped me.