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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by johnnyjohn on January 27, 2002, at 17:36:06
Somehow JohnHill is listed on my post. I will try this again
I am new to the board and need some help. I started getting panic attacks 1 year ago and was started on Klonopin 0.5 mg per day. The panic is gone, but what is left is low energy-flatness-moderate depression. I have tried the TCA's, SSRI's and effexor with alittle help, but mostly they cause increased anxiety. I have tried to decrease the klonopin, but the panic returns. I don't know which way to turn now. Maybe-
1 add provigil
2 add serzone
3 replace klonopin with depakote
4 replace klonopin with zyprexaAny advice would be appreciated. Thanks.
John
Posted by Michael D on January 27, 2002, at 18:51:19
In reply to Try again-Anyone else with Depression/Anxiety, posted by johnnyjohn on January 27, 2002, at 17:36:06
> Somehow JohnHill is listed on my post. I will try this again
>
> I am new to the board and need some help. I started getting panic attacks 1 year ago and was started on Klonopin 0.5 mg per day. The panic is gone, but what is left is low energy-flatness-moderate depression. I have tried the TCA's, SSRI's and effexor with alittle help, but mostly they cause increased anxiety.John,
I had the same thing when I first started taking medication: my anxiety went up. My doctor said this is normal, that anxiety sometimes increases *temporarily* when a patient is first on SSRIs. I don't think he realized that if you never reach a high enough dose, the anxiety will never leave.
Recently I was increased to 40 mg of Celexa. For a day or two I felt the need and the comfort to cry; a real breakthrough! Before then I had always felt too anxious to cry.
I've since come to the conclusion that anxiety while on an SSRI means you need a higher dose.
I have found that SSRIs affect me very much like a machine that holds my eyelids wide open. It forces more awareness, and often it's very uncomfortable. There is a comfort in the numbness of depression.
They first make me more aware of the unpleasant feelings.I hope this helps.
By the way, if you have had bad side effects on some SSRIs, try a different one. I'm now on Celexa, which is far easier, for me, than Serzone and Paxil were.
Michael Dewolf
Posted by OldSchool on January 27, 2002, at 20:34:35
In reply to Try again-Anyone else with Depression/Anxiety, posted by johnnyjohn on January 27, 2002, at 17:36:06
> Somehow JohnHill is listed on my post. I will try this again
>
> I am new to the board and need some help. I started getting panic attacks 1 year ago and was started on Klonopin 0.5 mg per day. The panic is gone, but what is left is low energy-flatness-moderate depression. I have tried the TCA's, SSRI's and effexor with alittle help, but mostly they cause increased anxiety. I have tried to decrease the klonopin, but the panic returns. I don't know which way to turn now. Maybe-
> 1 add provigil
> 2 add serzone
> 3 replace klonopin with depakote
> 4 replace klonopin with zyprexa
>
> Any advice would be appreciated. Thanks.
>
>
> JohnFirst of all I wouldnt take zyprexa for panic. Thats an inappropriate use of zyprexa. You are putting yourself at risk for all sorts of bad, potentially longterm side effects (movement disorders, diabetes). Zyprexa should be reserved for psychosis and bipolar mania.
There are many other drugs for panic which have good side effect profiles. Among them are Buspar, Neurontin and sedating serotonergic antidepressants. Antidepressants good for panic include Paxil, Remeron, Serzone and Luvox. Remeron in particular has some excellent anti-anxiety properties...it is rather sedating but shouldnt leave you feeling down like the klonopin does.
It sounds like you might benefit from just going on a serotonergic antidepressant for your anxiety. You might find you could totally get off the Klonopin after youve been on an AD a while, maybe...maybe not only way to know is to try it.
Posted by Ritch on January 27, 2002, at 22:17:40
In reply to Try again-Anyone else with Depression/Anxiety, posted by johnnyjohn on January 27, 2002, at 17:36:06
> Somehow JohnHill is listed on my post. I will try this again
>
> I am new to the board and need some help. I started getting panic attacks 1 year ago and was started on Klonopin 0.5 mg per day. The panic is gone, but what is left is low energy-flatness-moderate depression. I have tried the TCA's, SSRI's and effexor with alittle help, but mostly they cause increased anxiety. I have tried to decrease the klonopin, but the panic returns. I don't know which way to turn now. Maybe-
> 1 add provigil
> 2 add serzone
> 3 replace klonopin with depakote
> 4 replace klonopin with zyprexa
>
> Any advice would be appreciated. Thanks.
>
>
> JohnHi John,
Clonazepam (and other benzos) are the *only* meds thus far that actually can *prevent* a panic attack(for me). SSRI meds reduce avoidance and get me into situations that I normally might avoid, but I still experienced panic anyways. You might try some Neurontin or Lithium for the depression if other AD's have caused you troubles. I would continue the clonazepam (since it works!), and add some Neurontin or Lithium to see if the depression (caused? by clonazepam) could be ameliorated.
good luck,
Mitch
Posted by undecided on January 28, 2002, at 11:30:40
In reply to Re: Try again-Anyone else with Depression/Anxiety » johnnyjohn, posted by Ritch on January 27, 2002, at 22:17:40
i have been hospitalized 3x for depression/anxiety, and have found remeron by far the best antidepressant that also helped my anxiety tremendously, I would still take it today but i can't stand the weight gain. Remeron also had a very positive sexual effect on me, which is also a plus.
Posted by Cmatt on January 29, 2002, at 5:18:53
In reply to Try again-Anyone else with Depression/Anxiety, posted by johnnyjohn on January 27, 2002, at 17:36:06
John
It is not abnormal that a person may feel very heightened anxiety symptoms when trying to wean off of a benzodiazpine after having taken the benzodiazepine for several months or longer, and to what I have heard from some other people that have used Klonopin, it is not abnormal that a person may feel as if his or emotions have been sort of numbed while on the Klonopin.
What I have learned over the past 5 years is that each person responds to medications in his or her own way.I don't know what TCA's you have tried, but you can discuss with the doctor about using Vivactil with the Klonopin, or use Elavil or Surmontil to help you achieve a lowered dosage of the Klonopin, although you may still feel some heightened anxiety until your body adjust to a lower dosage of Klonopin.
I myself couldn't get rid of that depressed feeling when I used Klonopin until I was able to lower the Klonopin dosage. I was able to use Elavil to help me get off the Klonopin, but it wasn't easy.
I now use Xanax and Elavil, and although it's troublesome at times, I feel much much better that I did on Klonopin
Other options to discuss with the doctor would be adding a low dosage of a stimulant, or try switching to a less sedating benzodiazepine such as Xanax. Furthermore, another option to consider would be to lower the Klonopin dosage and add some Xanax to the regimen, so that you would be taking Xanax and Klonopin together, and that might be just enough change to eliminate that
low energy-flatness-moderate depression feeling.I wish you well.
Cmatt
Posted by JohnX2 on January 30, 2002, at 18:33:47
In reply to Try again-Anyone else with Depression/Anxiety, posted by johnnyjohn on January 27, 2002, at 17:36:06
Just curious, which SSRI's increased agitation?You may want to try Wellbutrin. It has interesting
response profile whereby for a lot of people it
decreases anxiety (worked for me).
Its good for anergic depression as you discussed.Regards,
John> Somehow JohnHill is listed on my post. I will try this again
>
> I am new to the board and need some help. I started getting panic attacks 1 year ago and was started on Klonopin 0.5 mg per day. The panic is gone, but what is left is low energy-flatness-moderate depression. I have tried the TCA's, SSRI's and effexor with alittle help, but mostly they cause increased anxiety. I have tried to decrease the klonopin, but the panic returns. I don't know which way to turn now. Maybe-
> 1 add provigil
> 2 add serzone
> 3 replace klonopin with depakote
> 4 replace klonopin with zyprexa
>
> Any advice would be appreciated. Thanks.
>
>
> John
This is the end of the thread.
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