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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 21 to 45 of 71. Go back in thread:
Posted by laima on February 7, 2007, at 8:26:52
In reply to Re: Benzo Confidential - trigger maybe, posted by Squiggles on February 7, 2007, at 8:00:06
I'm not at all anti-benzo, either. They are extremely important meds. I just think they are not casual, and need to be used with caution and care-maybe better used on an as-needed basis to minimize chance that they won't work when one needs them most? Not sure. Clonazepam is great, but comes with a few potential glitches.I beg to differ about clonazepam not building tolerance. It happened to me, and my doctor didn't act surprised at all. He commented just, "Yes, I'm sure you have- you've been on it a few years. Since it's not helping, we should get you off now, this cycle will go on indefinately, setting you up for a far worse withdrawal later from a much higher dose." I developed impervience to any anxiety benefit, and it ceased to be very effective for the myoclunus and restless sleeping, too. Even ceased to be much of an antidolt to hyperventilation/suffocation. What REALLY sucked- was not being able to alleviate panic attacks!
The withdrawal, if too rapid, has been compared to coming off heroin. Even on a taper, it's not fun. Having once used up my supply early, in a desperate effort to alleviate panic attack out of hell- the amount which used to work did zero- I ended up starting a cold withdrawal- and oh.my.god. I wouldn't wish that on anyone. Without the steady stream of clonazepam which apeared to no longer be helping or even doing anything, it was shocking how dramatic my body's shock was: wavy floors, paranoia, every noise like a clock ticking shattering through my brain- those sorts of withdrawal effects are plenty written about elsewhere. But what I'm getting at is, how curious that the sudden withdrawal can be so dramatic, after the drug ceased to be therapeutically effective or even experiencially detectable? Why? How can this be?
Perhaps then, Squiggles, the tolerance issue, the threshold even, varies person to person? Or, perhaps the tolerance is slow to develop compared to other benzos?
> I know what it is. I would rather take an anaesthetic than go through panic attacks again for so long. You must have completely misunderstood my curiousity... it is not aimed against benzos AT ALL. I am curious about the nature of clonazepam-- why all the other benzos build tolerance, but clonazepam does not. However, its withdrawal, at even a low constant (15yr. approx.) dose is one of the worst.
>
> So, it's basically an academic question, not a stance against benzodiazepines, which I personally think are necessary for states of anxiety, rage, panic, etc.
>
> Squiggles
Posted by Squiggles on February 7, 2007, at 8:40:18
In reply to Re: Benzo Confidential - trigger maybe » Squiggles, posted by laima on February 7, 2007, at 8:26:52
I don't know laima. I appreciate your post
which shows a personal understanding of the
nature of withdrawal-- a disturbing thing if
the only drug you have ever taken was a benzo
and you get misdiagnosed for example.I tend to shy away from the "each person is different" theory, because it is only used for the unexplained cases, but when a drug goes on the market, esp. OTC, such a question is never seriously considered.
What I will do, is look for the most informative site on this question, and stop flooding the board with little chunks of information.
If anyone knows about the unique nature of anticonvulsant type benzo withdrawal, it would be nice to see.
Posting later... much later :-)
Squiggles
Posted by laima on February 7, 2007, at 9:03:19
In reply to Re: Benzo Confidential - clonazepam's history, posted by Squiggles on February 7, 2007, at 7:53:48
> -It's a default kind of luck.
Seriously- You Lucky! Especially if tolerance hasn't been an issue.
I started the clonazepam after ativan proved insufficient, and I am a very restless sleeper, prone to periods of myclonus. Clonazepam seemed like a better choice. I was experiencing severe general anxiety, as well as physical manifestations of anxiety, and panic attacks. Lots of agitation, day and night. I was on it to aleviate these symptoms. He warned me it might not work forever, and urged me to get into therapy and rexamine my lifestyle, etc. but I didn't believe it, because it was working out great. I started with .5, some 4-5 years later was at 2mg- which I would take and not even be able to detect I took anything. And feeling worse than before. Why not raise higher? For one thing, he said most doctors don't like to go over 4mg, and I've actually seen that in print- I wish I could remember where. But it was a mainstream source- maybe medline or something like that. Again, I know all good doctors won't agree for their own reasons. Well so it was a decision I couldn't argue with- why keep raising indefinately, until reaching unsafe levels? I could see plain as day I was getting worse- and then I'd have to eventually come down from a very, very high dose? That would be worse, and I would have gained nothing. And it was already making me cognitively "fuzzy"- that I only see now in retrospect. I didn't really WANT to stop- it just wasn't working anymore, I was worse off than before, and I could see how this would continue. More than anything, I just wished it still worked like it used to. I was very, very disapointed and disillusioned.
No, zyprexa wouldn't touch seizures. Tapering the clonazepam prevented seizures, the zyprexa was to help out with the rebound anxiety associated with withdrawal, and to help sleep. Very hard to sleep through withdrawal- body is on high alert.
Yes, I am aware Drt. Ashton recommends valium or other benzos to aid withdrawal- I guess this guy's philosophy was different. Just wanted the benzos out, asap. Figured that would be in my best interest. He's no dummy, either- I'm sure he had his reasons for his choices.
Funny you mentioned stims- adderall (the brand version in particular) seems to have given me an awesome grip on my anxiety- I guess I feel both more outgoing and capable. Capable in my abilities, capable to face people, situations. No more bodily manifestations of anxiety, panic, any of that. It's weird. No jitteriness or anything like that. Agitation not a problem. Far less worrying, though I still worry too much. I started it about 6 weeks ago. My doctor says tolerance is unlikely if I stick to the low dose I use, and never take it late in the day. It's a short acting drug, short half life, and so the theory is that the brain gets some recovery time overnight. He said drugs which bathe the brain for 24 hours a day (ie, klonopin, many antidepressents) are far more likely to cause tolerance. (Note-didn't say "never" or "always" or use any other words like that.)
Feeling less anxiety off clonazepam-
> -That's odd... is it because you had been in a state of withdrawal while on clonazepam? I don't understand why you feel better having withdrawn.It is very surprising, isn't it? I feel amazed, still. I saw Dr. Ashton wrote about the possibility of having daily or constant "mini-withdrawals" while still on the drug, as its effectivess wanes. Larry Hoover wrote about a similar experience just yesterday, about his experience with oxycodone, and did a little research on the phenomena. While I gather Ashton's asssertation is controversial, I still speculate breaking that cycle most likely explains my experience. I can't come up with a better explanation for why my anxiety got worse as clonazepam went up, then near vaporized after it flushed out of my body- and the real weird thing- after starting an amphetamine! Well, the one other theory I have is this: benzos disrupt sleep architecture, snipping out stages 3 and 4- which are crucial for solid mental health. After a period of deprivation, mental health can become strained. So maybe I'm getting more of these stages of sleep, and that's helping, too. I had a couple of sleep studies while using clonazepam at night, and sure enough, VERY short on these stages. Dr. is interested in me getting another study to see how sleep architecture looks now, but I can't bear to go through that again for an intellectual curiosity.
The one bummer- I am a VERY restless sleeper again, though thankfully no myoclunus. But, I think I'll choose to live with this rather than mess with chronic use of another complicated substance.
Psychopharmacology: weird and complicated.
Posted by laima on February 7, 2007, at 9:07:08
In reply to Re: Benzo Confidential - trigger maybe, posted by Squiggles on February 7, 2007, at 8:40:18
Many of us are on different cocktails of drugs which interact, for one thing. And if we were all the same, all we'd need is one antidepressent, which would work for everyone, one benzo, one antipsychotic. End of story. And we all know that's not true. Case studies are very valuable, you take a lot of case studies, you can look for patterns, build theories, design studies. I think biology and our personal "other factors" are too complex to come up with blanket answers.
> I don't know laima. I appreciate your post
> which shows a personal understanding of the
> nature of withdrawal-- a disturbing thing if
> the only drug you have ever taken was a benzo
> and you get misdiagnosed for example.
>
> I tend to shy away from the "each person is different" theory, because it is only used for the unexplained cases, but when a drug goes on the market, esp. OTC, such a question is never seriously considered.
>
> What I will do, is look for the most informative site on this question, and stop flooding the board with little chunks of information.
>
> If anyone knows about the unique nature of anticonvulsant type benzo withdrawal, it would be nice to see.
>
> Posting later... much later :-)
>
>
> Squiggles
Posted by laima on February 7, 2007, at 9:24:13
In reply to Re: Benzo Confidential - trigger maybe » Squiggles, posted by laima on February 7, 2007, at 9:07:08
Bottom line, Squiggles, I think you are incorrect in your belief that clonazepam can't produce tolerance. I am living proof, and didn't stun any doctors. I brought up withdrawal in context of discussing tolerance- primarily interesting the mini-withdrawals which can apparently start as the aforementioned tolerance developes. And regular withdrawal, for I find it curious that even after total tolerance to the therapeutic benefits of clonazapam develops, real withdrawal still occurs. And sudden withdrawal from clonazapam, a benzo/anticonvulsant, brings on danger of seizures, even in people who have never had a seizure before. It's then particularly important to taper off, not quit cold.
> > If anyone knows about the unique nature of anticonvulsant type benzo withdrawal, it would be nice to see.
Posted by Squiggles on February 7, 2007, at 9:31:43
In reply to Re: Benzo Confidential -)Squiggles, posted by laima on February 7, 2007, at 9:24:13
> Bottom line, Squiggles, I think you are incorrect in your belief that clonazepam can't produce tolerance. I am living proof, and didn't stun any doctors. I brought up withdrawal in context of discussing tolerance- primarily interesting the mini-withdrawals which can apparently start as the aforementioned tolerance developes. And regular withdrawal, for I find it curious that even after total tolerance to the therapeutic benefits of clonazapam develops, real withdrawal still occurs. And sudden withdrawal from clonazapam, a benzo/anticonvulsant, brings on danger of seizures, even in people who have never had a seizure before. It's then particularly important to taper off, not quit cold.
>It can produce tolerance but the tolerance seems to stop after many yrs. of taking the same dose. I can only conclude from this that withdrawal may have taken place, and you no longer have the action of the drug's activity-- just its shadow,
in the form of changes in the brain perhaps-- which you feel if you withdraw-- much like losing disturbing a receptor state-- it never comes back if it's asleep, but it hurts when you wake it up.Squiggles
Posted by laima on February 7, 2007, at 9:56:52
In reply to Re: Benzo Confidential -)Squiggles, posted by Squiggles on February 7, 2007, at 9:31:43
I guess I dont want to go through years of daily withdrawals or rebound anxiety- whatever one wishes to call it, to find out.You're brave :)
I'm confident, based on what I've read and been told though, that after a good break, if I use clonazepam or another benzo again, it will have regained some if not all efficacy. Whatever receptors slow or shut down from the effects of the clonazepam, I understand, are capable of rebound. (Whatever specifically it is that they do- sorry I am not so technical.) I've been doing much better now anxiety than I have in eons with the way things played out, for whatever reason, so I'll opt to not use benzos for the time being, so that they will be effective for me when I, should I, ever desperately need one again.
Like I said- I'm a huge fan of clonazapam and most benzos- just pretty bummed over the tolerance problems that are possible with chronic use- the possibility that benzo won't be effective for a dire episode, as well as withdrawal issues. I do not wish to in any way offend anyone using benzos of any sort, hope I haven't come across that way.
> It can produce tolerance but the tolerance seems to stop after many yrs. of taking the same dose. I can only conclude from this that withdrawal may have taken place, and you no longer have the action of the drug's activity-- just its shadow,
> in the form of changes in the brain perhaps-- which you feel if you withdraw-- much like losing disturbing a receptor state-- it never comes back if it's asleep, but it hurts when you wake it up.
>
> Squiggles
Posted by Chairman_MAO on February 7, 2007, at 11:58:20
In reply to Benzo Confidential - clonazepam's history, posted by Squiggles on February 6, 2007, at 17:27:15
--Most benzodiazepines have no physical toxicity. "The only way to kill a rat with xanax is to bury it alive in it." I believe there is one exception to this rule, and I cannot recall the drug.
--They're miracle drugs for status epilepticus and many neurological disorders. Unfortunately, they build tolerance to this.
--They are crappy hypnotics compared to barbiturates.
--Severe panic disorder is better treated with MAOIs, IMHO, especially phenelzine. It takes ~10mg/day alprazolam to fully suppress panic attacks. That's no life I want to have.
--Their therapeutic index is so high that IMHO they should be over-the-counter, certainly so long as ethanol is.
--The dependence/withdrawal problem can actually be _worse_ than even barbiturates, as seizures have been reported up to two weeks after the last dose of xanax. This, AFAIK, does not happen with barbiturates or alcohol.
Posted by madeline on February 7, 2007, at 14:00:11
In reply to Re: Benzo Confidential - trigger maybe » madeline, posted by laima on February 7, 2007, at 8:06:44
I'm sorry this happened to you, and you know it may happen to me too. If the anxiety worsens or I just start metabolizing klonopin at a rapid rate.
It may happen. But please try and understand, I can't think about that right now. I suffered with depression/anxiety for 30 years before I knew what was wrong. Not much of a life, but I lived it.
I also tried a lot of different things to feel better before I finally sought treatment.
So, after 30 years of not having one, I finally now can live, work, love people and be loved, enjoy things - all the stuff that makes life.
It may all come crashing down tomorrow. But at least I have today. I feel good today.
I think it is kind of like asking a heart patient not to take nitroglycerin because one day it may not relieve angina or stop a heart attack.
You take it to live. You don't live to take it.
Maddie
Posted by madeline on February 7, 2007, at 14:03:32
In reply to Re: Benzo Confidential - trigger maybe, posted by Squiggles on February 7, 2007, at 8:00:06
you're right, I did misunderstand your curiosity about the klonopin.
Maybe I'm a little defensive about klonopin and all of my medications.
It's just that I really feel as though they have given me a life worth living.
sorry for the misunderstanding on my part
Maddie
Posted by ed_uk on February 7, 2007, at 15:46:18
In reply to Re: Benzo Confidential - clonazepam's history, posted by bassman on February 6, 2007, at 19:05:47
Hi Bassman
>the therapeutic dose for epilepsy is 20 mg/day
It is exceptionally rare for patients to be prescribed 20mg per day! In the treatment of epilepsy, doses in excess of 8mg per day are not usually recommended.
Posted by Squiggles on February 7, 2007, at 16:12:28
In reply to Re: Benzo Confidential - trigger maybe, posted by madeline on February 7, 2007, at 14:03:32
That's ok madeline; i've been on Dr. Bob's long
enough to see how people's experiences can
put a different light on posts-- so many posts;
sometimes you forget what the same person said 30 posts ago.no problem
Squiggles
Posted by Squiggles on February 7, 2007, at 16:40:04
In reply to Re: Benzo Confidential - trigger maybe, posted by Squiggles on February 7, 2007, at 16:12:28
I found this on Klonopin from an anti-benzo
site-- it all looks familiar from long ago;
I am posting it because there is a lot
of information here. Surpisingly Valium is
not recommended for withdrawal-- wonder where
i got that idea-- someone told me on benzo.org.uk
-- that i recall.www.prozactruth.com/clonazepam.htm
Squiggles
Posted by willyee on February 7, 2007, at 17:02:01
In reply to Re: Benzo Confidential - trigger certainly, posted by Squiggles on February 7, 2007, at 16:40:04
> I found this on Klonopin from an anti-benzo
> site-- it all looks familiar from long ago;
> I am posting it because there is a lot
> of information here. Surpisingly Valium is
> not recommended for withdrawal-- wonder where
> i got that idea-- someone told me on benzo.org.uk
> -- that i recall.
>
> www.prozactruth.com/clonazepam.htm
>
> Squiggles
Lol wow what a pro klono site,double hockey sticks ...that site might as well just say youll be about dead due to side effects,lol you wont stand,youll fall over,etc......Aside from that,on that page,i seen this comment,and i HAD to make special mention,here is the comment snipped....
"Because of strong anxiolytic properties and euphoric side-effects it is said to be among the class of 'highly potent' benzodiazepines with a higher risk of abuse, misuse and dependence than other benzodiazepines, "
Now in this snip something jumps at me like a snake.....
"euphoric side-effects "
EUPHORIC,.......KLONOPIN???? Yeah skip the cheap accesable six pack buss and feel great on klonopin.In my earnest opinion,there is NOT A SINGLE THING EUPHORIC about klonopin other than when it works and provides anxiety relieaf.There is no additional EUPHORIC effect,gotta tell you squigles,this benzo.org site,really seems grossly anti-benzo and beyone.
In fact down right upsetting,that information put the way it is seems as if its casualy trying to scare the hell out of people,it lists almost a hundred side effects of withdrawal,..i dunno its just down right disturbing to me,after reading that i know i cant and i know i dont have to,but i wish you cease the benzo info,its out there for people to get,but seeing pages like that isnt helping anyone in my opinion,why would you even want a reader to read that horrid grossly exgagerated crap,........crap total crap is what it is.
Posted by Squiggles on February 7, 2007, at 17:16:51
In reply to Re: Benzo Confidential - trigger certainly, posted by willyee on February 7, 2007, at 17:02:01
I'll stay away from the Spinning Snapper site
from now on, i promise. Though there are some
of those side effects that I can testify to--
never mind which ones, but quite a few.I have to choose my key words carefully to
find the historical origins of the manufacture
of this drug-- i just have this hunch that they
would not have made a derivative without a good
reason.Squiggles
Posted by laima on February 7, 2007, at 17:18:46
In reply to Re: Benzo Confidential - trigger maybe » laima, posted by madeline on February 7, 2007, at 14:00:11
Believe me, I understand- why do you think I took it so long? But everything came to a much happier ending than I imagined possible, despite the trouble I ran into, so all is well now. The benzos can really be life-savers.Best wishes!
> I'm sorry this happened to you, and you know it may happen to me too. If the anxiety worsens or I just start metabolizing klonopin at a rapid rate.
>
> It may happen. But please try and understand, I can't think about that right now. I suffered with depression/anxiety for 30 years before I knew what was wrong. Not much of a life, but I lived it.
>
> I also tried a lot of different things to feel better before I finally sought treatment.
>
> So, after 30 years of not having one, I finally now can live, work, love people and be loved, enjoy things - all the stuff that makes life.
>
> It may all come crashing down tomorrow. But at least I have today. I feel good today.
>
> I think it is kind of like asking a heart patient not to take nitroglycerin because one day it may not relieve angina or stop a heart attack.
>
> You take it to live. You don't live to take it.
>
> Maddie
Posted by laima on February 7, 2007, at 17:29:01
In reply to Re: Benzo Confidential - trigger certainly, posted by willyee on February 7, 2007, at 17:02:01
I agree that a lot of the claims on the site seem extreme, exaggerated--but that doesn't mean it lacks any scraps of useful or accurate information. You know a bit of how it helped me? To learn that such a thing as withdrawal exists, I was't going insane, some description of how withdrawal effects differ from the base anxiety, and by bringing up the possibility of withdrawal while still taking prescribed dose-due to tolerance. I did find her estimates of how long it would all take to be considerably, extremely longer than what I experienced, though. And yes, the site seems to endorse a specific agenda, rather than being purely unbiased. The cold withdrawal from clonazapam, in my case, was every bit as horrific as she described-but again, reading what she wrote helped me to know why I felt that way, to know I wasn't going insane, to get an idea of what else might happen. To realize my sudden severe depression was also likely a drug effect-and would pass- not a clue that life should end. To give myself a break, and to get the guts to go back to the doctor and tell him what happened.
>this benzo.org site,really seems grossly anti-benzo and beyone.
>
> In fact down right upsetting,that information put the way it is seems as if its casualy trying to scare the hell out of people,it lists almost a hundred side effects of withdrawal,..i dunno its just down right disturbing to me,after reading that i know i cant and i know i dont have to,but i wish you cease the benzo info,its out there for people to get,but seeing pages like that isnt helping anyone in my opinion,why would you even want a reader to read that horrid grossly exgagerated crap,........crap total crap is what it is.
Posted by laima on February 7, 2007, at 17:34:07
In reply to Re: Benzo Confidential - clonazepam's history » bassman, posted by ed_uk on February 7, 2007, at 15:46:18
The most I ever took at once, for a severe, severe, SEVERE panic crisis episode was somewhere in the neighborhood of 14mg over a couple of hours- I was later accused of trying to kill myself by using that much, and was told by several medical personel, that indeed, It could have. I rather doubt that, and explained my tolerance- but the point is- 20mg sounds like an extremely high dose!> Hi Bassman
>
> >the therapeutic dose for epilepsy is 20 mg/day
>
> It is exceptionally rare for patients to be prescribed 20mg per day! In the treatment of epilepsy, doses in excess of 8mg per day are not usually recommended.
>
>
Posted by notfred on February 7, 2007, at 18:25:12
In reply to Re: Benzo Confidential - trigger certainly, posted by Squiggles on February 7, 2007, at 17:16:51
"i just have this hunch that they would not have made a derivative without a good reason."
This is very common in pharamacology, once a med
proves profitable. Try out all the possible changes (derivatives) you can make to the current med and see which ones work. A new brand is born. Sometimes it is not really that different from the original and mostly just extend patents or allow other companies to come out with their "me too" version. In other cases, such as benzos, there are signicifant differences.
Posted by Phillipa on February 7, 2007, at 18:54:52
In reply to Re: Benzo Confidential - clonazepam's history » Squiggles, posted by laima on February 7, 2007, at 7:22:53
Xanax although being short acting works as a mild antidepressant too and will stop a panic attack pretty quickly especially under the tongue as my pdoc told me to do. Love Phillipa ps never had a problem cutting down or stopping it. Did switch to different ones as they came into vogue or I chose to switch.
Posted by Phillipa on February 7, 2007, at 19:04:03
In reply to Re: Benzo Confidential - trigger maybe » Squiggles, posted by madeline on February 7, 2007, at 7:47:58
Maddie well said and I'm a lifer on a benzo and at my age who cares if I need more. So far in over 30 years I haven't and I'd say l5mg of valium and .5xanax and now 3mg of lunesta is not even as strong as two mg of klonopin. I'm not worried at all. Love Phillipa
Posted by laima on February 7, 2007, at 19:18:50
In reply to Re: Benzo Confidential - clonazepam's history » laima, posted by Phillipa on February 7, 2007, at 18:54:52
The only thing is, too bad about cross-tolerance between benzos.
If it doesn't work, it doesn't work.> Xanax although being short acting works as a mild antidepressant too and will stop a panic attack pretty quickly especially under the tongue as my pdoc told me to do. Love Phillipa ps never had a problem cutting down or stopping it. Did switch to different ones as they came into vogue or I chose to switch.
Posted by Squiggles on February 7, 2007, at 19:46:27
In reply to Re: Benzo Confidential - clonazepam's history » Phillipa, posted by laima on February 7, 2007, at 19:18:50
Do you people who are prescribed benzos,
take them every day or when/as needed;
that may be the missing link. I was/am
prescribed K every single day-- it's been
about 17 yrs. now taking 0.5-1.50mg. Still
can't figure out how w/d almost killed me
with a seizure/stroke-- maybe the anti-benzo
poltergeists were responsible.Squiggles
Posted by Phillipa on February 7, 2007, at 21:18:22
In reply to Re: Benzo Confidential - clonazepam's history, posted by Squiggles on February 7, 2007, at 19:46:27
Squiggles it must have been them just kidding. Love Phillipa
Posted by Squiggles on February 8, 2007, at 7:48:26
In reply to Re: Benzo Confidential - clonazepam's history » Squiggles, posted by Phillipa on February 7, 2007, at 21:18:22
> Squiggles it must have been them just kidding. Love Phillipa
Yeah, i'm not sure i got the joke.
Here's a neighbourhood find:
1: Prog Neuropsychopharmacol Biol Psychiatry. 1983;7(4-6):669-73. Links
New concepts in benzodiazepine therapy: rebound anxiety and new indications for the more potent benzodiazepines.* Chouinard G,
* Labonte A,
* Fontaine R,
* Annable L.Abrupt withdrawal of benzodiazepine treatment in generalized anxiety patients was found to induce a rebound anxiety state in addition to minor physical symptoms. Controlled clinical trials suggest that the newer high potency benzodiazepines (alprazolam, clonazepam and bromazepam) have novel psychiatric indications and greater anxiolytic effect than the classical benzodiazepines. Alprazolam, a triazolobenzodiazepine, was superior to placebo in the treatment of panic disorder, for which medium or low potency benzodiazepines are generally inefficacious. Clonazepam, an anticonvulsant which increases 5HT synthesis, was more efficacious than lithium in reducing manic symptoms. Bromazepam, a new potent benzodiazepine, was superior to diazepam in the treatment of generalized anxiety disorder.
PMID: 6141609 [PubMed - indexed for MEDLINE]
Dr. Chouinard seems to be the local expert on this. He shows interest in the application of benzos to various psychiatric conditions. I'm not sure if I would volunteer as a guinea pig for clonazepam monotherapy for bipolar, though he does qualify it for 'manic symptoms' and not the entire spectrum. But *that* he suggests it, at least show how exceptional clonazepam must be, not just on the grounds of its potency, but its chemical idiosyncrasy.
Squiggles
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