Posted by blueberry on April 22, 2006, at 19:36:53
In reply to PLEASE - IMPORTANT - job/life on the line, posted by becksA on April 22, 2006, at 15:33:16
The klonopin is definitely a major player in the fogginess. But since it helps you so much, it probably needs to stay close to where it is, and instead of changing it much, look to counteract it with something. I wonder though, would it be possible to drop the dose slightly lower, or is that totally out of the question?
Depakote is also guilty. I was on depakote for a few months and it definitely caused major fogginess for me, even more than xanax or klonopin ever did. So in my opinion the klonopin and depakote together is a double whammy on fogginess.
But what to do about it? That's hard. Drop klonopin dosage a little if you can? Drop depakote dosage a little if you can, or drop it altogether?
If you need a mood stabilizer, it might be worth looking at zyprexa instead. I generally shy away from the antipsychotics, but in your case it could be great. That's because it will provide good anti-anxiety action, possibly allowing a lower dose of klonopin, and because it increases dopamine levels in the parts of the brain where you need it for cognitive function. One of the benefits schizophrenic patients get with the atypicals is improved cognitive function due to the increased dopamine. Also, zyprexa is the only one in the bunch that has some affinity for the GABA receptors, so will help klono work better too. To make it work even better, add in just a touch of prozac for no other reason than to turn up the volume on the dopamine, like maybe 5mg to 10mg prozac. That will really get the dopamine and norepinephrine juices flowing, and yet give anti-anxiety at the same time...more dopamine in the brain overall for cognitive function, but also partially blocked from the dopamine receptors preventing anxiety. Mood boosting, cognitive boosting, anti-anxiety, and mood stability all at once.
You've tried all the ADs. Does that include cymbalta? I ask because its norepinephrine effects and its ability to increase dopamine levels could be a big help. And you may only need a little bit, like 1mg to 20mg (by emptying out the capsule and counting 10 beads = 1mg). For me anyway, just a hint of norepinephrine is a big cognitive boost. And after the start-up anxiety is past, there is decent anti-anxiety from it too. Just a touch of strattera might be good.
With ADHD involved, do the stimulants cause too much anxiety?
Just some ideas. But yeah, the klono and the depakote are both guilty as far as I'm concerned. You obviously do not have the option of changing the klono, but maybe one of the other options I mentioned could be considered. Any one of them would be pretty easy and not too drastic of a change. Want to destabilize things as little as possible and not make any huge changes all at once. That's why I was looking at real low doses.
Right off the bat, if it were an emergency, I would lower the depakote, add 5mg prozac and 2.5mg zyprexa, with the possibility of later going up to 10mg prozac and 5mg zyprexa. Like I said, that would be anti-anxiety, mood elevating, mood stability, and cognitive enhancing all at the same time.
> i have been dx'd with ADHD, cyclothemia, and social anxiety (extreme)....although we're not sure if that comes from depression through anxiety, it all kind of seems to tie together.
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> My biggest problem lately is becoming bigger and bigger, and that is of brain fogginess, causing me to become extreme intattentive at work. I'm on a heavy dosage of klonipin, but also depakote. The klonopin (at this dosage) has been the ONLY thing that has helped my severe anxiety, so I don't want to leave it at ALL COSTS. If my anxiety goes back up, so does my depression, i can't make friends, etc. Is it possible the depakote can cause the "brain fogginess"?
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> Please help
>
> Thanks
poster:blueberry
thread:635899
URL: http://www.dr-bob.org/babble/20060417/msgs/635957.html