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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by LlurpsieNoodle on August 27, 2007, at 19:39:21
I started taking less klonopin about 2.5 weeks ago. Pdoc had me on 1mg day split am/pm. I tapered to .25 split and then to .25 prn.
Anxiety wise I am pretty agitated, but trying to manage that with things like rubbing paint spots off of the hardwood floors with acetone, ritual vacuuming, more floor polishing, obsessive party planning (now party is over tho).
I also applied to school haha. So, I've been busy...
My questions
1) pdoc tells me over and over that the klonopin is to PREVENT symptoms (possibly including things like rapid cycling mood swings; anxiety-induced dissociation etc.) Now that the abilify and zoloft and lamictal combo have calmed down the rapid mood swings, do I really need klonopin for this purpose?2) no acute anxiety attacks, but a lot of anxious agitation. klonopin helps slow things down, but often to the level that I need to nap. LOTS. Is there a benzo with less sedation? I USED to take provigil that helps. Tomorrow I start a job at a coffeeshop. perhaps that will help?
3) I feel acutely depressed when I take a dose of klonopin. Mostly things seem dimmer and sadder. Ruminations. Are there benzos that will not cause this symptom?thank you all,
-Ll
Posted by med_empowered on August 27, 2007, at 20:06:06
In reply to Less Clonazepam, posted by LlurpsieNoodle on August 27, 2007, at 19:39:21
maybe ativan? its cleaner, a little shorter-acting. Valium's good too, as is Serax; I would think you'd want to avoid Xanax, but maybe it could help. If you're anxious/agitated, I'd think that upping a benzo might be the way to go, but maybe not...
anyway, good luck.
Posted by Quintal on August 27, 2007, at 21:22:46
In reply to Less Clonazepam, posted by LlurpsieNoodle on August 27, 2007, at 19:39:21
Well I don't mean to be antagonistic to med_empowered, but the first thing that came to my mind was Xanax. It's the benzo that's least sedating for most people (I think studies have shown it has low affinity compared to other benzos for the sub-types of receptors that cause sedation) and it's the only benzo that has demonstrated an antidepressant effect in outpatients AFAIK. Benzos and other GABAergic drugs can aggravate symptoms like emotional instability/reactivity, but Klonopin has shown mood-stabilizing effects, so I suppose there's a risk that you could get worse in that sense if you switched to another benzo. It all depends on how you feel Klonopin is affecting you.
Q
Posted by Phillipa on August 27, 2007, at 22:02:01
In reply to Less Clonazepam, posted by LlurpsieNoodle on August 27, 2007, at 19:39:21
Klonopin did the same to me. Made me feel suicidal. I was immediately switched to xanax and no never had any desire to abuse it or take more. Only reason on valium now is I only need it once a day. Phillipa
Posted by Squiggles on August 28, 2007, at 8:12:04
In reply to Less Clonazepam, posted by LlurpsieNoodle on August 27, 2007, at 19:39:21
Most of the pharmacy monographs i have read,
including Roche, recommend 1.50mg clonazepam
for anxiety; beyond that dose the side effects become excessive and the effectiveness itself of the drug is not much greater for anxiety.Personally, i have always found this drug very strange, but it has the advantage of very slow tolerance.
Squiggles
Posted by LlurpsieNoodle on August 29, 2007, at 17:11:08
In reply to Re: Less Clonazepam, posted by med_empowered on August 27, 2007, at 20:06:06
I spoke with T, who knows a lot about psychopharm.
I told him that basically I was taking klonopin prn, and that I didn't like the fact that it made me groggy and gave me 'hangover'.
He also recommended a shorter-acting benzo, like ativan or xanax.
Now I have to convince my old-fashioned pdoc...
sigh...
Posted by LlurpsieNoodle on August 29, 2007, at 17:16:04
In reply to Re: Less Clonazepam, posted by Quintal on August 27, 2007, at 21:22:46
> Well I don't mean to be antagonistic to med_empowered, but the first thing that came to my mind was Xanax. It's the benzo that's least sedating for most people (I think studies have shown it has low affinity compared to other benzos for the sub-types of receptors that cause sedation)
*sounds good
>and it's the only benzo that has demonstrated an antidepressant effect in outpatients AFAIK.
*even better
Benzos and other GABAergic drugs can aggravate symptoms like emotional instability/reactivity, but Klonopin has shown mood-stabilizing effects, so I suppose there's a risk that you could get worse in that sense if you switched to another benzo. It all depends on how you feel Klonopin is affecting you.
I'd be willing to risk the mood destabilizing. Basically I'm using klonopin for periods of really anxious agitation. I have to wait an hour for it to kick in and then I lay in bed like a potato for the rest of the afternoon. Hardly the med to keep me functional... When I took it 2x day (up to 1mg daily) I felt less of the sedation, but I *think*?? that I may have become more habituated to the anxiolytic effects. Or perhaps I just became more psychologically clever and was able to allow more of my agitation (t things agitation is product of environment- I agree) to shine through a constant chemical mileu
thanks for your thoughts. Didn't know about the AD properties of xanax.
-Ll
Posted by LlurpsieNoodle on August 29, 2007, at 17:20:16
In reply to Re: Less Clonazepam » LlurpsieNoodle, posted by Squiggles on August 28, 2007, at 8:12:04
> Most of the pharmacy monographs i have read,
> including Roche, recommend 1.50mg clonazepam
> for anxiety; beyond that dose the side effects become excessive and the effectiveness itself of the drug is not much greater for anxiety.
>
> Personally, i have always found this drug very strange, but it has the advantage of very slow tolerance.
>
> Squigglesyeah, there was about 3 weeks when I took full dose of 1.5mg a day (was preparing for diss defense. ugh) everytime I take a vacation on this drug I find that I am able to cope better and better without it. The tolerance may creep up slowly (although I never have increased my dose, rather I feel compelled to decrease it!) but it only takes a little short vacation to return to no tolerance? at least in my opinion.
kind of reminds me of coffee in that way. tolerance to caffeine builds up quickly (although in many cases doses go up to compensate!) but after a week of no caffeine a small dose provides quite a kick!
thanks for your thoughts,
-Ll
>
Posted by jhj on August 31, 2007, at 6:29:56
In reply to Less Clonazepam, posted by LlurpsieNoodle on August 27, 2007, at 19:39:21
I have one question.I had taken clonazepam for around 1 year 1 mg/day and alprazolam for one month 0.5 mg/day for GAD and Social phobia.Now my question is was i given sufficient dosage to have any significant effect on my anxiety and was alprazolam given sufficient time to work on anxiety.As far as fast acting and slow acting benzo is concerned,i have tried diazepam,chlordiazepoxide and currently clobazam but i have not found any of them acting let alone fast or slow.They have completely failed in improving my anxiety nor i have felt any side effects except drowziness and i have not become addicted to them at all.So,are they anything more then placebo? Thanks.
Posted by cactus on August 31, 2007, at 17:25:13
In reply to Re: Less Clonazepam, posted by jhj on August 31, 2007, at 6:29:56
they all work great for me except for ativan and serax, which don't do anything for me at all. I'm on 2mg of clonazepam a day but I'm cutting it back to 1.5 now and feel ok. The Zoloft I'm taking is starting to help my anxiety finally so I don't need to rely on benzo's so much, I hope!!!
Posted by LlurpsieNoodLe on September 4, 2007, at 19:52:08
In reply to Re: Less Clonazepam, posted by cactus on August 31, 2007, at 17:25:13
yeah, I think the zoloft may be helping my anxiety too? Actually, having more structure in my life is helping more than anything else, and a good reliable therapist to help me sort things out.
In the last 6 days, I've taken .25 mg, although my T points out that I *did* have a panic attack yesterday. hmmm. I think I should switch to xanax for emergency use only.
pdoc next week, I believe.
-L:lll
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