I struggle with what I think is relatively mild, but persistent anxiety that heightens in social situations. I've tried a number of things, including, but not limited to, the following:
Ashwagandha
Lemon Balm
Bacopa Monnieri
Phenibut
Lysine
Magnesium (in various forms and combinations)
Niacinamide (the anti-inflammatory properties improve my skin...I don't really notice an anxiolytic effect at standard doses)
Valerian/Chamomile/Hops
Various amino acids
St. John's Wort
I regularly take the following, more for other issues and general health than specifically for anxiety:
Zinc (Abion chelated zinc, to be specific)
Melatonin (for sleep)
B-complex
Multi-mineral complex
NAC + C (mostly for avoiding hangovers when drinking)
Fish oil
Here's my current regimen:
AM:
- 250mg standardized (0.3% hypericin) Swanson's St. John's Wort (I have tapered and decreased this due to sexual side effects)
- multi-mineral complex (including 500mg magnesium oxide/magnesium amino acid chelate and 50mg glutamic acid HCl)
- 500mg niacinamide
- 500mg non-standardized bacopa
- 1g fish oil
Before bed:
- 30mg Abion chelated zinc
- 3mg melatonin
- 600mg NAC
- 500mg vitamin C buffered with 50mg calcium
- B complex
- 10mg cetirizine (Zyrtec)
- 500mg niacinamide
- 500mg non-standardized bacopa
- 1g fish oil
As needed:
- ~ 500mg phenibut (never more than 2x/week and mostly far less often than that)
- 450mg non-standardized ashwagandha (typically in the late afternoon/early evening, maybe 2-4 days/week)
- 500mg free-form L-lysine (for anxiety-triggered digestive issues, though it doesn't really seem to help)
- Rhodiola rosea: 250mg standardized (5% rosavins/15% polyphenols) + 100mg whole root
For me, phenibut can be moderately effective for situational anxiety (when I can anticipate it) in the manner that I've used it. I haven't felt the need to increase the dose or use it more frequently. I can sense the potential for abuse, mind you, but I seem to be disciplined enough to avoid either abuse or significant tolerance.
Ashwagandha has similar but much weaker and shorter duration effects as compared to phenibut, in my experience. For a time, I took this twice daily until I read more about GABA receptor downregulation. Now I take it once daily a few times a week.
I take bacopa and niacinamide together, twice a day, and don't notice much in the way of anxiolytic effects from either. Still, I believe they may have other benefits. Niacinamide works nicely to reduce redness/inflammation in my face. Whether or not bacopa can upregulate GABA receptors to any significant degree, I'm convinced that it does no harm.
I'm on the fence about St. John's Wort. On the one hand, I feel like shit on the second day if I stop taking it. On the other, I'm not sure to what extent it's helping and I don't appreciate the side effects. I suspect it may be disrupting my sleep in addition to the aforementioned sexual side effects. I believe I should try tapering off of it at some point. I'm already at half dosage. Disappointingly, I'm not entirely sure that the side effects are dose-dependent. To be honest, I find the diminished libido to be a bit of a relief, though the other sexual side effects are anything but. I don't believe I am or have ever been clinically depressed. I do see a therapist who, I believe, would classify me as mildly dysthymic. I can also be obsessive about certain things (can't you tell from this post? ), but I don't think that's on the level of any kind of clinically diagnosable disorder.
I've been taking rhodiola as needed for fatigue with reasonable results. I find that taking rhodiola after work and taking a 20-90 minute nap leaves me feeling more refreshed than simply taking a nap. Also, there doesn't seem to be a "crash" as you might experience with caffeine or other stimulants.
I haven't really experimented with lemon balm or the valerian/chamomile/hops combo quite enough to form strong opinions. Both seem to reduce anxiety, though perhaps not as effectively as ashwagandha and nowhere near as effectively as phenibut. I'm intrigued by lemon balm, though I still fail to understand why a GABA transaminase inhibitor would be any less likely to downregulate GABA receptors (as ScienceGuy claims) than a substance that increases GABA by other means or increases sensitivity to GABA. I think I'll try to use it in place of ashwagandha and try to get a better sense of its efficacy.
Things I would like to try:
Relora
Bupropion
Phenelzine (Nardil)
Baclofen
Low-dose naltrexone
Benzos (not kidding...if they are like phenibut, I would rather use such things with a doctor's supervision)
Afobazole
Theanine
Are there other things I should try with these goals in mind: decreased anxiety (particularly social anxiety), improved mood, and decreased fatigue? I also have some relatively mild gastric reflux that is well controlled by 10mg famotidine 2x daily, but I'd love to find some other solution to that issue (and I'm fully convinced of the gut/brain neurotransmitter connection). I have not seen a psychiatrist, but I intend to at some point.
Personally, I'm not convinced that there's no safe way to use GABAergics. I feel better even 36 hours after taking phenibut. The effect is marked and seems to be especially effective in the social situations that trigger my anxiety the most. I'm not willing to give that up, nor have I experienced the downside that many people warn about. That said, I appreciate the stern warnings since I'm sure that has helped me avoid abusing it. I certainly want to avoid withdrawal and tolerance that can result from chronic GABAergic usage. I think that goes without saying. Pick your poison, though. I can tolerate a reasonable level of risk in order to appreciably improve my quality of life.