Posted by viridis on December 5, 2002, at 4:07:30
In reply to Re: So why is upper/downer combo bad again?, posted by jackt on December 4, 2002, at 7:51:34
I take my whole dose of Klonopin (1 mg) in the morning, along with 5 mg of Adderall, and then I often take another 2.5-5.0 mg Adderall later in the day. I tried taking Klonopin before bed at first, but found that the anti-anxiety effects wore off by the middle of the next morning or so.
It did take me a couple of weeks to get used to Klonopin (I was a bit sleepy, clumsy, and forgetful). Initially I tried different dosing strategies, dividing it throughout the day, but the side effects wore off pretty fast and I soon found that one dose in the morning was fine. I no longer notice any side effects at all.
Are you taking it on a regular basis, or just occasionally? It's possible that you just haven't gotten past the side effect stage, or are taking it so infrequently that it affects you strongly when you do. Or maybe you're just one of those people who's very sensitive to K. For some, substitution of another benzo (e.g., Xanax) can make all the difference. I respond very well to Klonopin and Xanax, but Valium, another benzo, makes me feel dull and sleepy.
I've never tried Ritalin -- my psychiatrist was in favor of a stimulant (for my ADD), but said that he thought Ritalin was the most likely to increase anxiety. I tried Provigil for a while, and it was fine, but didn't help enough with concentration and focus. It might be worth a try, though; my pdoc says he's seen some people with attention problems respond well, but considers it kind of hit-or-miss. I did find it energizing without making me anxious, and had no problems taking it with Klonopin. For me, Adderall works well and if anything, has a calming effect at low doses.
I also take Neurontin (400 mg 3X/day). My pdoc considers it a very "subtle" mood stabilizer. It made me very mellow the first few times I took it, and now I don't notice anything. Some here find it to be very good for anxiety on a long-term basis.
I can't tolerate SSRIs or Wellbutrin at all; I haven't tried Serzone or Remeron, so can't comment there, except to say that I have a couple of friends with anxiety and depression who have done very well with Serzone.
So, for me, Klonopin + Adderall (+ Neurontin, which I'm not sure is doing anything) is a very good combo. Others here have also commented on a "synergy" between K and Adderall, so it might be worth a try, and Neurontin might be too -- most doctors seem to consider it very safe.
I should add that I also take Xanax occasionally. It's no longer a big part of my treatment, but is great for shutting down anxiety, ruminating thoughts, and insomnia. Some people find it much better than Klonopin, especially for quick anxiety relief.
I hope this helps!