Suggest treatment for social anxiety
Low dose Olanzapine can be added
Hello thanks for asking from HCM
I can understand your concern. You are on treatment since last 19 years and have received medicines, CBT, rTMS etc and still symptoms are persisting. Currently you are on Venlafaxine 300 mg per day, Tianeptine 25 mg, Clonazepam 2 mg, Lorazepam, Inderal 40 mg etc but some of your symptoms are still persisting.
Currently you have symptoms of social anxiety like difficulty to express facial expressions freely, nervousness, difficulty in social situations etc. These are part of persistent anxiety.
In my opinion you are taking adequate doses of medicines and the symptoms should be under control. But if the symptoms are persisting then you should try Behaviour therapy especially relaxation exercises. Progressive muscles relaxation exercise in social situations will reduce your autonomic outbursts and the anxiety will decrease. If with behaviour therapy the symptoms persist then low dose antipsychotics like Olanzapine or Risperidone can be added. Low dose of Olanzapine will help to supplement the actions of the drugs your are taking and will help in reducing the anxiety too. Olanzapine in dose of 2.5 to 5 mg daily will help you. You can talk with your doctor for prescription of the drug.
Thanks and Take care
I think you are on right medicines and right doses.
Yes you are on right medicines but if the symptoms are persisting then low dose Olanzapine can be added to the prescription. This will help in improving the symptoms.
Early morning worsening of symptoms and then improvement of symptoms as day passes is one of common feature of depression. The improvement is happening immediately after taking Venlafaxine because of psychological reasons. No need to worry about that.
Reduce the dose to 2.5 mg
Hello thanks for asking again
If the 5 mg dose resulted in sedation and drowsiness even on next morning then in that case you can reduce the dose to 2.5 mg for a couple of weeks. Once you become better then the dose can be increased to 5 mg again.
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