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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Griobhtha on May 25, 2004, at 10:36:22
I am a Major Depressive of 25 years. I have always had GREAT amounts of constant tension and anxiety.
My last regimen included Risperdal. Risperdal was a godsend to me in its ability to relax and melt away my tension. But it also completely melted away sexual eroticism and interest (much like the old man telling Plato that in age he is finally free from all those youthful forces of nature). But, I'm not that old yet and my wife and I of course want sex and eroticism.
On my newest attempt at establishing a new medication regimen, my doctor wants me to take Klonopin or Ativan to relax my tension (and anxiety). But believes that I'll be taking whichever long-term, indefinitely.
She trusts my ability to co-manage my medications, and has given me short prescriptions for both in order to try one, then the other, and tell her which I believe works better.
I know about benzodiazepines[sp] (the inferences, dangers, analogies to alchohol, etc...), but I would like to know if there are others who have used one of these or this class for a "long-term", and what is your experience.
Can anyone relay their experience concentrating on effect on symptons?
Thank you so very much
Griobhtha
Posted by Tony P on May 25, 2004, at 13:24:06
In reply to PD suggests long term Klonopin or Ativan, posted by Griobhtha on May 25, 2004, at 10:36:22
I also have had long term mixed depression and general anxiety and have been treated with several different ADs and anxiolytics.
I expect others can comment better than I can on the safety of long-term use of these benzos, but here's my 2 cents worth:
Klonopin is generally said to be considerably "safer" than Ativan, due to it's somewhat more gradual onset and longer half-life. I've found Klonopin to be have a rather dulling effect on my anxiety (I can't think of a better word), the anxiety and tension are relieved, but I don't really feel good (anhedonia?) or experience much activation from the relief of my anxiety. Whereas Ativan was more liberating, almost like an antidepressant - not only was the anxiety was gone, but I felt well, and could do more. I took it especially for performance anxiety when doing Broadway-style shows, and it greatly improved my usual rather stiff stage-presence due to held-in tension.
One word of caution where sex is concerned: I've never seen it mentioned as a side effect, and my own experience may be unusual, but large doses of benzos (esp. the long acting ones like Valium & Klonopin) give me anorgasmia. The feeling is great, but it just never ends ... good or bad according to how you think about it!
Have you ever tried Buspar (buspirone)? It works beautifully for a few people, me included, and not at all for others. It has a completely different effect and mechanism from the benzodiazepines and is pretty much guaranteed not to be addicting or even have any tolerance build up. I found it worked well for me for stress-related anxiety and consequent anger/depression, but had no effect on the usual GAD symptoms. For me, about 2 hours after taking it, I experienced an increase in confidence and assertiveness, and the ability to just get things done like "normal" people, as though some barrier had been lifted. And at the end of a stressful day I didn't feel lke biting anyone's head off. It is said to have a longer term effect (including a mild antidepressant component) that requires a week or ten days to develop, but for me the strongest effect was immediate, as I described. At the very least it's about as harmless a drug as there is, and combines well with most other meds. I have used it with Ativan, Klonopin, Serzone amongst others, with benefit with all of them except recently Lamictal, which seems to cancel its effect. The only side effect I experienced was a mild "dopiness" for about an hour after taking it, which quickly passed off. 10 to 20 mg/day worked well for me. It's at least quick and easy to try.
Tony P
> I am a Major Depressive of 25 years. I have always had GREAT amounts of constant tension and anxiety.
>
> My last regimen included Risperdal. Risperdal was a godsend to me in its ability to relax and melt away my tension. But it also completely melted away sexual eroticism and interest (much like the old man telling Plato that in age he is finally free from all those youthful forces of nature). But, I'm not that old yet and my wife and I of course want sex and eroticism.
>
> On my newest attempt at establishing a new medication regimen, my doctor wants me to take Klonopin or Ativan to relax my tension (and anxiety). But believes that I'll be taking whichever long-term, indefinitely.
>
> She trusts my ability to co-manage my medications, and has given me short prescriptions for both in order to try one, then the other, and tell her which I believe works better.
>
> I know about benzodiazepines[sp] (the inferences, dangers, analogies to alchohol, etc...), but I would like to know if there are others who have used one of these or this class for a "long-term", and what is your experience.
>
> Can anyone relay their experience concentrating on effect on symptons?
>
> Thank you so very much
> Griobhtha
Posted by Bill LL on May 25, 2004, at 15:18:31
In reply to Re: PD suggests long term Klonopin or Ativan, posted by Tony P on May 25, 2004, at 13:24:06
Just my 2 cents. I don't know if my experience applies to you. I have had life long major depression along with extreme anxiety. I am on 30 mg Lexapro which has eliminated the depression, but I still need to be more calm and to have better focus.
Lexapro is the only psycotropic drug that I have been on for a few years. To increase focus (ADD), my doc put me on Wellbutrin a few months a go. But I stopped it after a month due to increased jitteriness.
Then last week, he put me on Strattera (along with the Lexapro). So far it is working well. It makes me more calm and more focused. I am only on 40 mg at the moment eventhough the maintainence dose for my body weight is 100 mg. He wants to increase gradually.
Posted by zeugma on May 25, 2004, at 20:18:04
In reply to PD suggests long term Klonopin or Ativan, posted by Griobhtha on May 25, 2004, at 10:36:22
in my opinion klonopin is a MUCH (i do not capitalize here lightly)safer and more preferable med for the symptoms you describe than risperidal. buspar as Tony P says is an innocuous, and sometimes helpful, med, but klonopin's anxiolysis is in a completely different league from buspar's, and if Klonopin had been prescribed to me first I never would have used Buspar.
The analogies to alcohol are in my opinion ridiculous. Alcohol is hepatotoxic, causes poor judgement, has a high potential for abuse due to the euphoria it generates, and the quantities necessary for it to be 'therapeutic' for true anxiety disorder would cause all of the above problems and eventual delirium. Psydocs who compare Klonopin to alcohol (in the treatments of these disorders) are [... ellipsis indicates my deference to the civilty rules of this board].
Posted by Dr. Bob on May 25, 2004, at 22:27:16
In reply to Re: PD suggests long term Klonopin or Ativan, posted by zeugma on May 25, 2004, at 20:18:04
Posted by Viridis on May 26, 2004, at 3:41:17
In reply to PD suggests long term Klonopin or Ativan, posted by Griobhtha on May 25, 2004, at 10:36:22
I've taken Klonopin for about three years (1 mg/day), and aside from a little sleepiness during the first week or two, I haven't noticed any side effects or had to increase the dose. For me, it simply reduces anxiety and has been a tremendous help.
I haven't tried Ativan, but do take Xanax occasionally for especially stressful situations. It works quickly and has a subtle mood-lifting effect for me. However, I seem to develop tolerance to its effects very quickly if I take it often at all, so I really limit my use of it. It is helpful to have on hand, but Klonopin lasts much longer and is known for working well for years at the same dose. I recommend Klonopin highly.
This is the end of the thread.
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