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clonazepam/Klonopin and HPA axis issues

Posted by Beeb on December 22, 2012, at 12:12:08

Hi. Originally I posted this in the advanced section, but since almost noone ever posts there this may be a better location.

This is my first post on this forum. I'll try to be brief.

I'm not in the USA and getting a (mandatory) referral to a specialist can be incredibly hard.
I've been trying to educate myself for quite some time now. It seems there is a lot that docs don't know about this drug.

Originally I was prescribed this drug to treat neuropathic pain and for its muscle relaxant properties. I've been on it for years now, highest dose 4 mg a day as prescribed by my GP (repeat prescriptions).

I've tried to stop taking this drug but both that and starting to take this drug have been some of the biggest mistakes of my life !

Now to the specifics of my question.
I've never been able to take it at bedtime/for sleep. I used to take it during the day as a single dose but for quite some time I've been taking it in the evening to be able to sleep at all. Not that it really helps, it's more like a necessity.

The drug has always had both sedative and stimulating properties. No problem when I took it during the day while I was engaged in bodybuilding, sedation was minimal if nonexistant. I can't exercise properly anymore but if I don't exercise for about two weeks the drug tends to become more sedating.

How the drug actually works is for the most part a mystery, it has some serotonergic properties and anti-absence and antimyoclonic action.
Obviously, when you affect one neurotransmitter you affect others as well. The literature does not make a distinction between the short term effects and the long term effects of the unique properties of this drug.

I've been searching this forum for various phrases. HPA axis, cortisol and a few others.
It seems clonazepam definitely affects the HPA axis. Generally suppressing the HPA axis.

The specifics are more mysterious.
HPA axis activity is complex, and suppression may (?) be specific. Also, won't it distort HPA axis function if you take it once a day ? Difference between short term use and long term use ?
I just can't tolerate taking it twice a day. If I do, the daytime dose will be more sedating, the evening dose will be more stimulating ! Not good for sleep, or metabolism in general.

One post suggested that if it is not sedating in the evening it points to cortisol issues.
I may very well have an issues with glucocorticoids (cortisol) but I have learned that is an incredibly complicated matter.

If possible, I'd like to learn more about its effect on the HPA axis (corticotropin releasing hormone, ACTH, glucocorticoids, catecholamines etc.). And normally, there are time dependent interactions between the various components of the HPA axis. I wonder how clonazepam interferes with that.
Also, what does it do with serotonin and the other neurotransmitters ? Some sources suggest serotonin depletion, some the opposite.
And there is the HPT axis, which interacts with the HPA axis.

The weird thing is, clonazepam seems to speed up my metabolism ! When I take it in the evening, anyway.

I'll take any insight I can get. I'm male btw.


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poster:Beeb thread:1033537
URL: http://www.dr-bob.org/babble/20121217/msgs/1033537.html