Posted by anodyne on April 28, 2004, at 12:45:47
In reply to Re: One more try - Klonopin and Wellbutrin, posted by Joe Schmoe on July 8, 2001, at 19:38:55
> Wanted to see if you still were taking the Klonopin/Wellbutrin combination. Your story is so similar to mine and I was prescibed this exact same thing, after similar reluctance to Klonopin. My doc was finally able to convince me through anecdotal cases that Klonopin can be effective at steady doses for long periods of time. I am still concerned though but willing to try it, I want relief.
I know this is an old post, but I would love to hear how it was working out after 3+ years.
> > There are certainly a minority of people who fall outside the typical pattern. It's generally been felt -- even by non-benzophobic docs -- that benzos should be "used cautiously if at all" for individuals with a history of substance abuse or addiction. But some very recent studies are demonstrating that even this caution has been overstated in many cases.
>
> I wonder how "substance abuse" is defined. Are we talking people who smoked pot in college, or hardcore crack users trying to quit their habit?
>
> What do these people do? Just take higher and higher doses of Klonopin to try to get high?
>
>
> > Can't you make sure you have at least a little Klonopin on you at all times, say in a little pillbox? (CVS has a great unobtrusive little round one. I taped some cotton to the bottom of the lid to keep the pills from rattling around as I walk.)
>
> How similar our lives are. I have a little round gold pillbox that I pad with tissue paper so the pills don't rattle around, that I keep Xanax and Inderal in. I am always afraid of someone finding it - when sitting in deep chairs I find sometimes it slips out of my pocket (women have an advantage with purses!) and I have left it behind on chairs before. Of course when I realized it, there was a frantic search to go find it before someone else did. The big problem is not the convenience, it is trying to hide this stuff all the time. I usually keep it in my locked messy desk drawer at work now to avoid this problem. It also keeps my body heat from breaking down the medicine as it would if it was sitting in my pocket all the time. I am tempted to put it in some kind of prescription bottle, say a Claritin one or something, and just not make an effort to hide my taking it. I am tired of sneaking around. There must be a way for men without purses to work these things into their lives conveniently.
>
> >Even if you took Klonopin regularly, missing a day probably wouldn't be too awful because of the long half-life.
>
> I was more worried about missing a few hours than a day. If you are on an all-day assignment somewhere for example, it would be a catastrophe if your xanax ran out halfway through the day!
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> >Did you run out of Xanax a lot?
>
> More of a case that I could really tell when a dose was wearing off. The anxiety would shoot upwards. Was it just my normal anxiety returning, or was it benzo-caused rebound anxiety? It is hard to tell, but it was a nasty effect, especially since it might take 30 or 45 minutes for the next dose to kick in. People would see you go from jumpy and nervous to dopey in the course of an hour. It must raise suspicions. And then you start taking the second dose earlier to avoid the anxious period between doses, and pretty soon you are taking more per day than you are supposed to because you don't wait the full time period between each dose...
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> > How distressful were the shakes? How much were you using at the time, and on what schedule?
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> I am an excellent responder to Xanax. My "mild relaxation" dose is .25 mg Xanax, and my "get ready to stand up and talk" dose is .5 mg. I have never taken more than that. .5 really knocks me out. If I take it around noon, it works for anxiety for maybe three hours, wears off, and then I start to get real tired, so by the time I get home I collapse on the couch and sleep for three hours in the evening. I am taking about occasional use mind you, not the "rebound" jumpiness that occurs with regular use. I have never taken xanax often enough to get a rebound reaction/shakes when a dose wore off, except that one month when I was tapering onto the imipramine long ago. I did not develop tolerance to Xanax in that time but I was addicted. When a dose started to wear off I was reaching for that bottle pretty quick, and when I came off it at the end of that month, for withdrawal I had overwhelming anxiety, muscle rigidity (neck would turn in little jerks, like a Parkinson's patient) and so on. That was over a decade ago and it was under bad circumstances (I had to do all this while working in a fairly stressful environment in a new job, and hide everything I was going through) so I have blotted much of this memory out. Suffice to say I have never been tempted to abuse xanax in the decade since, despite always having a bottle of it within reach. I get nervous if I take two or three Xanax doses in the same week, even though I know ratonally I would have to take it for weeks to get addicted.
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> > Perhaps it's because I'm already in a long-lasting, strong relationship,
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> I am too.
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> >but my biggest ongoing benefit from Klonopin has been been for my career. It's made a world of difference. I still don't like getting a sudden performance request thrown my way
>
> who does?
>
> >(and not just for reasons related to anxiety), but it's so refreshing not to suddenly panic. (On the other hand, I sometimes perversely enjoy watching myself calmly but firmly speak my mind during the confrontations that would freak me out in the past.
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> Man that is my dream scenario. Right now my throat tightens up and I get the feeling that I will lose muscular control of my neck (shivering and shaking) if I do not break eye contact.
>
> > BTW, how are things going so far with the new meds? I know it may be a little early to talk about theraputic benefits, but is everything going OK side-effect-wise?
>
> Very well. The first few days on the Wellbutrin I felt very upbeat (probably a little mania, I got this when starting Serzone as well) and high/euphoric (I assume this is the dopamine effects of Wellbutrin kicking in). I felt like I had taken a happiness pill. I mean it felt great. Since upping the dose to 300 mg I feel more normal. I went sparingly on the Klonopin at first but now I am taking it several times a day to get used to it. It is very subtle, doesn't make me continuously yawn like the xanax would.
>
> The chemistry is complicated here. I am not sure if .5 mg per dose will be enough Klonopin; and if it isn't, I am not sure if that is because of the Wellbutrin; and if it is because of the Wellbutrin, I am not sure if that is because I have to get used to the Wellbutrin, or whether the Wellbutrin will always be activating and require more Klonopin even after the initial three weeks. In time I will get it sorted out. I suspect I may have to take more Klonopin for the first few weeks till the Wellbutrin settles down, and then cut back on the Klonopin. But that is assuming the Wellbutrin will settle down. It has not really made me anxious yet, except for occasional tightness in the chest which the Klonopin seems to relieve, but the effect of the Wellbutrin could well be simply negating some of the benefits of the Klonopin. I wonder if Wellbutrin becomes less activating after two or three weeks? I am definitely enjoying the reduced appetite (I am somewhat overweight) - wonder how long that will last!
>
>
> > Since I referred to "studies" several times,I feel compelled to include one small study abstract.
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> Thanks for all the information. The data on Konopin sounds very positive. My question is this: what is your dosing regimen? Do you take it three times a day? It sounds like that would be, say, 7 AM, 3 PM, 11 PM. But what is the point of taking a social anxiety drug at 11 PM at night? Is it to avoid a withdrawal reaction, or is there some therapeutic benefit to maintaining steady-state of this stuff?
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> Thanks again. So far I have been taking Klonopin once a day (first several days) and then twice a day (the last several days). Have not taken one late at night yet.
poster:anodyne
thread:68599
URL: http://www.dr-bob.org/babble/20040423/msgs/341007.html