Posted by fires on March 7, 2005, at 21:28:39
In reply to Re: Klonopin/Bipolar II, posted by med_empowered on March 7, 2005, at 19:19:16
> hey! Before you do anything else, *please* get checked out for any sort of physical problem/abnormality. Remember that, in general, before any psychiatric diagnosis can be made, physical causes must be *ruled out*.
I know that all too well. B 12 deficiency and Postural Orthostatic Tachycardia Syndrome, both dxed by me and then docs.
They both require continuous treatment.
>> On the psychiatric side of things...BP II is quickly becoming a slippery diagnosis. Some docs are careful with it, some include people who would be dx'd "cyclothymic" in it, some lump people with manic reactions to anti-depressants in there (not a good idea), and some use it for patients with more complex cases of depression and anxiety. So, basically, I wouldn't worry too much about the dx itself; treatment is what matters.<<
I was under the impression that the treatments for the 2 conditions were quite different (most of the time). Then again the more I read about BP II, the more confusing/complicated it gets.
>> Klonopin is popular in bi-polar b/c it is believed to be something of a mood-stabilizer, probably b/c of its anti-epileptic properties (ALL benzos have anti-seizure properties; Klonopin just happens to have been designed primarily for seizures). Anyway, what is absolutely known is that Klonopin can calm down people during mania, and can be very helpful when dealing with psychotic mania/mixed-episodes; in addition to keeping people calm, the Klonopin can reduce side-effects (such as anxiety and akathisia) from anti-psychotics and improve their efficacy, which should help keep the dose low. But, again: this is true of pretty much ALL benzos...Klonopin does last a long time, though, so it is more convenient. (Outpatients with mania are often given Klonopin; inpatient, Ativan is preferred b/c it is available in injection form). In my experience, .5-1mg Klonopin as needed was about as helpful for mood-swings/mania as, say, 2-4mgs Ativan or 10-15mgs valium. Klonopin lasted longer, which is nice, but it also takes longer to kick in than some others, such as Ativan, Xanax, and Librium. As for depression...here, things get interesting. Klonopin and other benzos (particularly high dose, as in epilepsy) are known for their ability to CAUSE depression. Then again...Klonopin and other benzos are commonly used in depression, especially in cases where anxiety and insomnia are prominent, and it seems like the benzos have an ability in these cases to alleviate depression. A number of clinical studies seem to indicate that, used wisely, benzos can help some people more than anti-depressant therapy alone. <<I've had good luck with Klonopin in the past, and still take 1 mg at bedtime. I've always thought that it worked for me due to its anti-seizure properties. Prior to Klon., I was on Parnate and Tegretol -- then Klon. replaced my Tegretol.
Did you get some of your info. from biopsychiatry.com ? That's the only place I've seen info. similar to yours.
Also, I hope I don't end up with a BP II dx because lamictal and seroquel make me to sedate/tired and zyprexa didn't seem to do anything.
Thanks for all the info.
poster:fires
thread:467929
URL: http://www.dr-bob.org/babble/20050304/msgs/468012.html