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Re: Buspar and Klonopin for depression w/ anxiety?

Posted by micro on March 9, 2004, at 22:45:16

In reply to Buspar and Klonopin for depression w/ anxiety?, posted by spower_ette on March 1, 2004, at 13:27:06

> I've looked for information about Buspar and Klonopin being used for depression with anxiety components but can't find anything solid.
>
> From what I've read here it appears that Klonopin MAY increase depression long term?
>
> Is Buspar a strong enough antidepressant effect?
>
> I'm beginning to think my doctor doesn't know what he is doing.
>
> Help!
>
> power

Dear Power,
The question I have for you is regarding your diagnosis. Do you have a pure anxiety disorder or an anxious depression? Chronic anxiety left untreated can lead to depression or depressive symtoms. Also, depression in and of its self will manifest as anxiety or anxiety symtoms. This is where it really gets grey...Is anxiety a manifestation of depression, a seperate entity or or the two interelated. I think it would be logical to believe that a pure anxiety disorder exists if an antianxiety med alone eliminates the depressive symtoms. If it does not, there is likely an underlying depression which requires treatment. There is also a waste basket term used frequently as "mixed anxiety depression"
The real answer lies in the question; is or is not anxiety a prominent feature of depression. If it is truly mixed, and anxiety is a just a different manifestation of depression then it would appear to be more logical to treat anxiety with an antidepressant and the anxiety would abate. The current difficulty is : which came first or are they the same disease?
Buspar from all accounts appears to be a wash as a stand alone antidepressant and is frequently ineffective for the control of moderate to severe anxiety, but it has been used as an adjunctive med with some success. Klonopin causes depressive symtoms in those who are not depressed, hence the need for adjunctive antidepressive meds. While it may not be true to all cases, Klonopin causes depressive symtoms period for many people. I think you may be better off reconsidering this combination if you are continuing to be symtomatic. Some of the more sedating antidepressants titrated slowly may control the anxiety symtoms unless of course you have comorbid conditions.

As I have stated repeatedly [and don't mind doing so appropriate treatment] lies in proper diagnosis which can't be done in a twenty minute session in most cases. This is exactly why many bipolars that you read about are not diagnosed early while there is an abundance of literature that requires consideration of this diagnosis particularrly if depressive features were present early in life.
I teach this every day in my practice... History ,History, History--- Diagnosis etc, etc... A history taken well will led to a proper diagnosis which leads to proper therapy. A great diagnosis is in in great history. Treatments are in a receipe book which anyone can look up.
Does this help?
Let me know! regards, Micro


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