Posted by viridis on November 23, 2002, at 15:35:58
In reply to Re: Clarification re: Gabatril » viridis, posted by HopeNotLost on November 23, 2002, at 13:09:29
Hi HNL,
For me, Klonopin has been excellent for anxiety, depression, and panic. I don't have constant panic attacks, but they come in clusters, and when I'm in one of those phases it makes life extremely difficult. I have to interact with people a lot, speak to large groups frequently, and so on, and having a panic attack (or just worrying about having one!) is extremely stressful. I'm sure you can relate.
Antidepressants I've tried (SSRIs, Wellbutrin) either made me more anxious or I experienced bizarre mood swings. These and other side effects didn't go away over time and were intolerable even at very low doses.
When I first saw my current pdoc I was in the midst of one of these panic clusters. He immediately prescribed Klonopin and Xanax -- K daily, X as-needed. The panic attacks stopped immediately and I felt much calmer. That was about a year and a half ago, and I still take the same dose of K daily, with very occasional Xanax. I get the same benefits as I did initially, and haven't had a panic attack or major episode of anxiety since.
For the first couple of weeks that I took K, I was a bit drowsy, forgetful, and clumsy -- nothing too serious, but I did notice it. I tried various dosing schedules (always sticking to 1 mg/day); first 1 mg before bed, then 0.25 mg 4X/day, then 0.5 mg 2X/day. The side effects went away pretty quickly, and I settled on 1 mg all at once in the morning. I haven't experienced any side effects at all since the first couple of weeks. However, if I don't take it for a day, I feel very anxious -- whether this is dependence or just a return to my pre-K state, I'm not sure, but my pdoc emphasized that if I choose to discontinue it, I should do so very gradually, with his supervision.
There's been a ton of discussion on the pros and cons of Klonopin here recently. There are dependency issues (which don't worry me too much any more), and some people say it causes them depression. For me, it actually stopped the cycle of severe anxiety followed by a massive crash into depression, which has been a regular pattern for me since childhood. So, in that sense, K acts as an antidepressant for me, but has the opposite effect in others.
I did have some low-level depression after starting K, but nothing like before. My pdoc made one last try with SSRIs (very low-dose Zoloft) and that was a disaster. Luckily (?) I'd also been diagnosed with ADD previously, and my pdoc agreed, so he suggested adding stimulants. We settled on low-dose Adderall, and that's helped greatly with both concentration and the remaining depression.
I also take Neurontin; I'm not sure it does much, but my pdoc suspects that it adds "background stability". It has no side effects for me so I'm staying with it for now.
Obviously, your doctor knows you much better than I do, but you might discuss Klonopin with him/her. If he/she is willing to prescribe Ativan, that suggests a willingness to use benzodiazepines when appropriate. Klonopin is a benzo, and is generally considered one of the safest and least subject to abuse.
All the best,
Viridis
poster:viridis
thread:128830
URL: http://www.dr-bob.org/babble/20021122/msgs/128958.html