Is it crude.... combining antagonists and an ssri..... Options

[The450Man]

Remeron+Trazadone+ssri

reasoning=

-tired of anxiety and eating klonopin like candy when i go out
-from what ive read.... most therapeutic effects of ssri's stems from 5ht1a activation, undesirable effects come from activation of 5ht2 5ht3 receptors (possibly more from the other handful of known receptors)

Blocking 5ht2a, 5ht2b, 5ht2c, 5ht3 receptors should "push" more of the serotonin towards the 5ht1 receptor(s) and prevent common ssri side effects like sexual dysfunction and nausea allowing a lower dose of an ssri.

granted i know this is way more complex then what im making it...

[KimberCT]

Actually, the primary therapeutic effect of SSRIs would be activation of 5-HT2C. By chronic activation of this receptor, it downregulates. This downregulation is responsible for the anxiolytic effect of SSRIs.

5-HT2C is an interesting receptor that will downregulate in the presence of agonist and antagonists. A SSRI and a selective 5-HT2C antagonist would be ideal for generalized anxiety disorder.

In my experience, hitting 5-HT2C cures symptoms of "free floating anxiety" while 5-HT1A cures symptoms of "obsessive worry anxiety".

Do you have anxiety when there is no reason for it? Is it just constantly there in the background? Look at 5-HT2C.

Do you lay in bed at night unable to sleep because you're over thinking and worrying? Look at 5-HT1A.

Some other interesting tidbits I've learned. SSRI induced sexual dysfunction is caused by activation of 5-HT2A, which is why drugs like cyproheptadine can reverse it. The nausea SSRIs can cause is caused by 5-HT3 activation and can be reversed by 5-HT3 antagonists like ondansetron.

My recommendation for 5-HT1A anxiety... buspirone alone and then add a SSRI if needed.
My recommendation for 5-HT2C anxiety... citalopram and nortriptyline/mirtazapine.

When agomelatine and tianeptine become available in the USA, I imagine they would be fantastic for 5-HT2C anxiety as well.

edit: Afterthought... social anxiety seems to be a feature of the above, but from my reading there seems to be quite a few people with social anxiety disorder by itself. These folks seem to response well to ADHD-like treatments such as stimulants or NDRIs like bupropion.

[djremix]

hit some mdma every two weeks.
a lot of people i knew with social anxiety pretty much killed it and a lot fo them done use mdma anymore

or if you can find something to get you excited and not think about any negative shit for a few hours a day
then do it(downregulate your anxiety and stress responce)

on a side note, do you still feel anxious when alone at home. with or without a problem on your mind?

[Jimmy Jam]

Another one you might consider that alot of people overlook is nefazodone ( similar in structure to trazodone) - it is a 5ht2a antagonist, as well as a 5ht2c antagonist - and at higher doses has very moderate SRI and NRI inhibition. It will get rid of anxiety and I think it actually improved my libido/sex life while I was on it. It was especially good for preventing panic attacks.

[KimberCT]

Another one you might consider that alot of people overlook is nefazodone ( similar in structure to trazodone) - it is a 5ht2a antagonist, as well as a 5ht2c antagonist - and at higher doses has very moderate SRI and NRI inhibition. It will get rid of anxiety and I think it actually improved my libido/sex life while I was on it. It was especially good for preventing panic attacks.

Interesting... how do you take the nefazodone? Before bed, as needed, 3x daily, etc.?

Nefazodone looks very promising for my anxiety, but the moderate D2 antagonism scares me a bit. I already have tremor and that tends to make it worse.

[The450Man]

Yea my anxiety tends to be the worry obsessive type. I have a history of OCD as a kid... But it is not limited to obsessive worrying, free floating is deff there.

I was thinking of trying luvox. SSRI great for OCD (dont really have OCD anymore but figured since i had it as a kid it may do something for my anxiety), plus its one of the strongest sigma 1 agonists of the ssri group. Plus its said to have limited sexual side effects when compared to other ssri's.

[The450Man]

hit some mdma every two weeks.
a lot of people i knew with social anxiety pretty much killed it and a lot fo them done use mdma anymore

or if you can find something to get you excited and not think about any negative shit for a few hours a day
then do it(downregulate your anxiety and stress responce)

on a side note, do you still feel anxious when alone at home. with or without a problem on your mind?

i feel best when im alone in a corner on my laptop.

seems like a "safe zone"

get me away from the laptop and BAM anxiety. Include other people, eh fun ride.

[krazyj]

"free floating anxiety"

Care to elucidate on this a little? What debilitating scenarios did you have in mind for this, too?

I've found that I frequently experience a free-floating type of anxiety that isn't debilitating, just manifests itself as mental intertia to getting meanial things done. Anxiolytics can sometimes make me super productive because I spend less time thinking/plotting and more just doing.

[djremix]

i feel best when im alone in a corner on my laptop.

seems like a "safe zone"

get me away from the laptop and BAM anxiety. Include other people, eh fun ride.

so you never tried mdma? because thats exactly what it would help with. hopefull theory being two or 3 experiences will help you normalise your anxiet responce to the outside world.

i dont know any other substance with such an acute effect, that it would not be needed daily, or form a dependance.

[KimberCT]

Care to elucidate on this a little? What debilitating scenarios did you have in mind for this, too?

I've found that I frequently experience a free-floating type of anxiety that isn't debilitating, just manifests itself as mental intertia to getting meanial things done. Anxiolytics can sometimes make me super productive because I spend less time thinking/plotting and more just doing.

"free floating anxiety"

You know that feeling you get right before you have to give a speech in front of a crowd, or the feeling you get while waiting for your girlfriend to piss on a pregnancy test? It's that feeling, but it appears for no reason whatsoever. You can be reading a book, watching TV, getting dressed, driving to work and suddenly you feel anxious. When it's real bad, it can strike while you're sleeping and you actually wake up in the middle of the night feeling anxious. The feeling might fade in an hour or stick around all day. The most debilitating part is that, because you're already anxious for no reason, the slightest bit of real life stress can send you into a near panic attack.

[Section 8]

"free floating anxiety"

You know that feeling you get right before you have to give a speech in front of a crowd, or the feeling you get while waiting for your girlfriend to piss on a pregnancy test? It's that feeling, but it appears for no reason whatsoever. You can be reading a book, watching TV, getting dressed, driving to work and suddenly you feel anxious. When it's real bad, it can strike while you're sleeping and you actually wake up in the middle of the night feeling anxious. The feeling might fade in an hour or stick around all day. The most debilitating part is that, because you're already anxious for no reason, the slightest bit of real life stress can send you into a near panic attack.

IOW, womanitis.

[KimberCT]

IOW, womanitis.

Perhaps you should stick to the M&M Lounge and Supplements 101.