Posted by mattdds on June 4, 2003, at 16:50:57
In reply to Matt/Viridis, Re: Will klonopin initial sedation, posted by McPac on June 3, 2003, at 19:56:33
McPac,
I have the exact same response to Klonopin as Viridis, and the same explanation as to why I think it works.
Just to parrot him, I have a very high degree of certainty that most of *my* depression is secondary to anxiety. All the depressive thoughts and feelings I get are related to relentless, enduring and untreated anxiety. It seems to develop much later in the course of things. I start to feel hopeless, because anxiety really prevents you from enjoying things. For me, relieve the anxiety, and the depression goes with it.
I also agree (totally my speculation) that for atypical depression -- the kind with neurovegetative symptoms like overeating, oversleeping, and *especially* depression without symptoms of anxiety -- Klonopin would not be very helpful, and could possibly exacerbate the depression.
However, depression is so frequently comorbid with anxiety that it is difficult to think of times where Klonopin couldn't be of at least *some* benefit.
For me Klonopin is without a doubt a potent antidepressant!
I just recently browsed a popular book from the 80's by Sheehan, called "The Anxiety Disease". His clinical experience with anxiety disordered people was that they went through a number of phases, starting usually with panic attacks, or severe anxiety and moving on to phobias, hypochondriasis, and depersonalization / derealization. The final endpoint of untreated anxiety, according to him was depression. He recommended high dose alprazolam (Xanax) or phenelzine (Nardil) as the best agents for anxiety. This was, of course, written before Klonopin was used for panic. I am pretty sure that most clinicians feel that Klonopin is a better choice because of the pharmacodynamics, longer half-life providing a more even anxiolysis. But Xanax tends to be even less sedating than Klonopin, and purportedly has some antidepressant properties (but I think most benzos do in the cases I described above). I am tempted to give Xanax XR a try, but my luck with Klonopin has been so good. If it ain't broke, don't fix it, as they say!
Hope this helps.
Best of luck,
Matt
poster:mattdds
thread:230656
URL: http://www.dr-bob.org/babble/20030604/msgs/231442.html