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Re: Wellbutrin & Klonopin for bipolar

Posted by judi on October 2, 1998, at 16:57:51

In reply to Re: Wellbutrin & Klonopin for bipolar, posted by Daniel on August 28, 1998, at 1:10:19

> > I take 150mg Wellbutrin 2 x day and Klonopin 1mg 2x day. I am bipolar. The Wellbutrin works much better than Zoloft for energy, but I am a bit jumpy and speedy. The Klonopin helps, but I think I need to take 1.5 mg. Klonopin 2x day, but am scared of the addiction. I have been on Klonopin for over two years everyday, but Wellbutrin only three weeks. I have refused to take Risperdal, Neurontin or Zyprexa because of weight gain. I was on Zoloft for five years at 150mg., but was too unmotivated and zombie like. I no longer had a sense of humor. I do not have an addictive personality because I have been on other benzos for 31 years and was able to stop for years at a time. Please help.

> Klonopin has been a life saver! I have Bipoar I,w/rapid cycling and
> in my worst of episodes psychotic features. I have only been treated for eight years. During my initial treatment stage, in an episode of mania, my psychiatrist suggested treatment with antipsychotic meds (Mellaril, Stellazine, Navane...) I refused treatment w/ any neuroleptic/antipsychotic because of a horrible run in w/ side effects. Akathisia was intollerable. Mentally, the med didn't sedate me at all. About two minutes after the injection I began having waves of panic and feelings of terror as well as a disorientation to time and situation. The ugliest psychotic episodes I have ever had were more pleasant than treatment with an antipsychotic. So- My Dr. suggested Klonopin. There was immediate relief after taking the first dose. It has been completely successful as an alternative to antipsychotic meds. I have read several studies re:Klonopin-vs-antipsychotics for Bipolar patients. All three studies used Haldol as the control antipsychotic med. Over 60% Patients who were tapered off Haldol and started treatment w/ Klonopin concurrently and eventually stopped Haldol completely showed no re-emergence of psychosis. It controlled hyper motor activity as well. The whole point is: Don't be afraid of addiction. If you have already been on it for several years, such as I we are already technically addicted to it. If we stopped taking it today we would risk life threatening withdrawl. Titrate up to a dose that controls your symptoms but does not produce unwanted side effects. Thereis a difference between addiction and pathological addiction with abuse of meds.where the individual continualy increases dosage to obtain a "high". Personally, I don't see what abusers get out of benzodiazapines. I have never felt a buzz or a high or euphoria from being treated with them. I actually don't notice anything except it controls my symptoms. And- I have been on very hi doses of Klopin at times. When I have "breakthrough" manic episodes, my dose is increased to 1mg 3x daily & 1mg every 2 hours as needed. THAT'S A LOT OF KLONOPIN!!!!!! After several weeks I go back down to 1mg 2x day & 1mg as needed.
> As for Wellbutrin- I began that only six months ago at 400mg/day. However, I also take Zoloft 200mg/day and Depakote, Verapamil and Ritalin. Anyway- Zoloft has been generally good at controlling most depressive symptoms but I have always needed an antidepressant of another class (not an ssri) to completely control things. Wellbutrin has been doing a wonderful job and it helps counter some side effects from Zoloft such as male sexual dysfunction, and as you mentioned Zoloft can produce a sort of apathy, which Wellbutrin has relieved somewhat.
> In summary, Klonopin with the help of Depakote does a superb job in treating mania and taking away the jitteriness that some antidepressants produce.
> Good Luck.
I have the same diagnosis as Daniel, but as well as klonopin has worked for my panic attacks, during the worst of my manic episodes I've been up to 12mgs/day and had no relief from psychotic symptoms. The only thing that helps has been risperdal. I was unable to tolerate wellbutrin, and all the other Ad's cause me to cycle up despite depakote. I think my pdoc wants to change my mood stabilizer before trying any other ADs, but I'm really afraid I'm cycling down now, any ideas out there?




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