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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by sleepygirl2 on July 26, 2012, at 8:46:59
I'm having trouble letting go of something I'm angry about, and it is really exhausting. The thoughts about it are intrusive, and keep interrupting my involvement in other things.
The truth is that I can do little to change the situation, and whether I am RIGHT! (and of course, I am :-) about it or not is of little consequence because the energy involved puts me on edge, and ready to argue/have an outburst, and everyone looks at me like I am nuts,
I took an extra klonopin because I just want to let it go.
Any advice about pharmacological or other ways to deal with this? Thanks,
Posted by Phillipa on July 26, 2012, at 10:06:55
In reply to What to do about flying off the handle?, posted by sleepygirl2 on July 26, 2012, at 8:46:59
Same thing happens to me. I reach a point where can take no more and just let it rip. Usually it doesn't help either. Other than letting the other know how really angry I am. It's me that allows it. Phillipa
Posted by Dinah on July 26, 2012, at 10:30:10
In reply to What to do about flying off the handle?, posted by sleepygirl2 on July 26, 2012, at 8:46:59
Risperdal works best for me from a pharmaceutical standpoint. Klonopin just makes me sleepy.
For behavioral fixes, I find one obsession often counters another. For me that might be endless mindless phone games. For another it might be something else. Some lucky people can exercise the obsessive quality out of their thoughts.
My therapist would say that meditation with calming phrases would help. Or visualizing the anger leaving your body.
For obsessions in general, making fun of them often works for me. And generally, with the bit of distance that Risperdal provides, I can find something to laugh at in myself. But that might work less well for anger, unless you can detect a certain amount of irony in your anger. For example, I sometimes find myself getting spitting mad about intolerance, and exaggerate my response so that I'm mentally jumping up and down shouting "I cannot tolerate intolerance!!" Finding something amusing in the other person's stance can also work.
Hope something in there gave you an idea. Just discard the rest.
Oh, there's a book I really like. I particularly like the part about singing the intrusive thoughts.
Posted by Dinah on July 26, 2012, at 10:34:17
In reply to Re: What to do about flying off the handle? » sleepygirl2, posted by Dinah on July 26, 2012, at 10:30:10
Sleepygirl, have you ever tried any other AP? I know yours makes you very sleepy, but there are less sedating ones. Taken as needed, in moderation, they can do amazing things with obsessions.
I have been dropping a single Risperdal in my morning pills the last few days because I recognized that I wasn't able to focus, probably because of underlying anxiety. It's amazing how I can almost instantly change from the laziest and most worthless creature on earth, in need of all the self-excoriation I can provide, to a reasonably productive citizen. I just have trouble recognizing when I would benefit from it.
Posted by ron1953 on July 26, 2012, at 10:35:35
In reply to What to do about flying off the handle?, posted by sleepygirl2 on July 26, 2012, at 8:46:59
Klonopin might actually be making it worse. If you think I have anger issues now, you shoulda seen me when I was taking Klonopin. This seemingly padoxical effect has been documented, so look it up or ask your doctor.
Posted by b2chica on July 26, 2012, at 11:21:27
In reply to Re: What to do about flying off the handle?, posted by ron1953 on July 26, 2012, at 10:35:35
i agree with Ron,
i was Awful when on Klonipin. i thought i was nuts for thinking such a thing till i came here and heard a couple people mention similar effects.
b2c.
Posted by SLS on July 26, 2012, at 12:37:51
In reply to What to do about flying off the handle?, posted by sleepygirl2 on July 26, 2012, at 8:46:59
> I'm having trouble letting go of something I'm angry about, and it is really exhausting. The thoughts about it are intrusive, and keep interrupting my involvement in other things.
> The truth is that I can do little to change the situation, and whether I am RIGHT! (and of course, I am :-) about it or not is of little consequence because the energy involved puts me on edge, and ready to argue/have an outburst, and everyone looks at me like I am nuts,
> I took an extra klonopin because I just want to let it go.
> Any advice about pharmacological or other ways to deal with this? Thanks,Q: How did you react to taking the extra Klonopin?
The reactions of aggression and impulsivity that others have noted with Klonopin and other benzodiazepines (BZDs) is sometimes the result of an effect called "behavioral disinhibition". It actually reflects a disinhibition of neural circuits in the brain. The effect is considered to be "paradoxical" and is not the usual reaction to these drugs. It is by no means rare, though. Disinhibition to BZDs is very much like that seen with some people when they drink alcohol.
If the additional Klonopin made things worse, I guess you have your answer. If that's the case, you could ask your doctor about trying Trileptal or using a low dose of an antipsychotic, as has been suggested. Trileptal is a "mood-stabilizer" with anti-aggression and anti-impulsivity properties. Actually, Zoloft has been used for aggression with some success. It sounds like impulse control is a problem, though. I don't know if Zoloft helps with that. If it were me, I would try Trileptal first. It generally has fewer risks and side effects than the antipsychotics. Hyponatremia (low blood sodium) is a risk with Trileptal, but it is easily screened for with a simple blood test. It doesn't happen very often.
Have you ever looked into addressing these issues psychotherapeutically? Perhaps you could post questions on the Psychology board. Even if a drug were to have a calming effect on you, there might be some important psychological dynamics that drive your reactions.
- Scott
Posted by sleepygirl2 on July 26, 2012, at 18:02:38
In reply to Re: What to do about flying off the handle? » sleepygirl2, posted by Phillipa on July 26, 2012, at 10:06:55
It is often a challenge, expressing oneself honestly.
Posted by papillon2 on July 26, 2012, at 18:55:55
In reply to Re: What to do about flying off the handle? » Phillipa, posted by sleepygirl2 on July 26, 2012, at 18:02:38
I've found the techniques learnt in Dialectical Behavioral Therapy to be helpful with intrusive, negative thoughts. Cognitive Behavioral Therapy is also useful, but I seem to reach for my box of DBT tricks when in a state of acute distress. Doing CBT exercises seems to make things worse, as I end up in a state of constant arguing with my thoughts which is distressing in itself.
Pharmacologically, low-dose Lithium helped, especially with persistent thoughts of suicide. It sounds like you should first investigate the Klonopin angle, though.
Posted by sleepygirl2 on July 26, 2012, at 19:46:56
In reply to Re: What to do about flying off the handle? » sleepygirl2, posted by Dinah on July 26, 2012, at 10:30:10
Sometimes, getting into a tetris game can focus my attention away for a bit.
They're all good ideas.
The klonopin worked, thankfully, I was much more reasonable and no longer agitated.
Posted by sleepygirl2 on July 26, 2012, at 19:49:11
In reply to Re: What to do about flying off the handle?, posted by Dinah on July 26, 2012, at 10:34:17
My doc is pushing the seroquel, but I just can't take the sedation.
I wouldn't mind trying it, but just as a prn.
Posted by sleepygirl2 on July 26, 2012, at 19:56:31
In reply to Re: What to do about flying off the handle?, posted by ron1953 on July 26, 2012, at 10:35:35
Thankfully, for me, I'm a bit less inhibited with a little extra klonopin, but in a good way, just relaxed, no agitation, no irritability.
I've been taking just .5mgs for the longest time.
My doc is cautious about the klonopin.
Posted by sleepygirl2 on July 26, 2012, at 19:57:37
In reply to Re: What to do about flying off the handle?, posted by b2chica on July 26, 2012, at 11:21:27
Really? What dose were you on?
Posted by sleepygirl2 on July 26, 2012, at 20:10:56
In reply to Re: What to do about flying off the handle? » sleepygirl2, posted by SLS on July 26, 2012, at 12:37:51
> Q: How did you react to taking the extra
It worked well, felt reasonable again, not agitated, relaxed.
> Disinhibition to BZDs is very much like that seen with some people when they drink alcohol.
I am less inhibited with extra klonopin, but only to a degree that lets me function more easily in a social way, not second guessing every comment, etc.
Do you know if lamictal has any effects on aggression and/or impulsivity?
Trileptal sounds interesting.Even if a drug were to have a calming effect on you, there might be some important psychological dynamics that drive your reactions.
I'm sure it's true. Maladaptive ways of thinking I'm sure, probably other stuff. It's just that when I'm that revved up, I can't calm down enough to think.
Sometimes, I'm just too reactive.
Thanks.
Posted by sleepygirl2 on July 26, 2012, at 20:14:55
In reply to Re: What to do about flying off the handle?, posted by papillon2 on July 26, 2012, at 18:55:55
I argue with my thoughts too. :-)
Since my early teens.
It's less now. I don't evaluate every thought anymore.
I've got some dbt stuff somewhere. I'll find it again.
Posted by gadchik on July 27, 2012, at 17:06:01
In reply to Re: What to do about flying off the handle? » papillon2, posted by sleepygirl2 on July 26, 2012, at 20:14:55
Hi,sleepygirl! ive found nothing better than klonopin to keep me on an even keel.But low dose,and only once a day.Too much and Id be dragging,you have to find the lowest dose that works,sounds like you have.i must add that exercise is remarkable in releasing pent up anger.And if I am having something going on that my anxiety goes thru the roof, I can take .25mg klonopin,and calm is restored.No weight gain either from daily dose!But should I ever decide to taper...cant think about that right now.
Posted by Dinah on July 27, 2012, at 17:30:16
In reply to Re: What to do about flying off the handle? » Dinah, posted by sleepygirl2 on July 26, 2012, at 19:49:11
But isn't that one of the more sedating AP's?
I found this. Table one has a comparison chart.
Posted by Phillipa on July 27, 2012, at 18:58:27
In reply to Re: What to do about flying off the handle? » sleepygirl2, posted by Dinah on July 27, 2012, at 17:30:16
Is this accurate based on fact that results were those with schizophrenia? Phillipa
Posted by Dinah on July 27, 2012, at 19:36:19
In reply to Re: What to do about flying off the handle? » Dinah, posted by Phillipa on July 27, 2012, at 18:58:27
In terms of relative sedation, it should.
Unless some behave differently at lower doses.
But I think I've always heard Seroquel is sedating.
Posted by sleepygirl2 on July 27, 2012, at 20:27:07
In reply to Re: What to do about flying off the handle? » sleepygirl2, posted by Dinah on July 27, 2012, at 17:30:16
It is, way too sedating, and there's weight gain. I just can't stay on it.
Posted by sleepygirl2 on July 27, 2012, at 20:28:16
In reply to Re: What to do about flying off the handle?, posted by gadchik on July 27, 2012, at 17:06:01
I'm working up the motivation. Exercise does really help.
Posted by Phillipa on July 28, 2012, at 9:51:03
In reply to Re: What to do about flying off the handle? » Phillipa, posted by Dinah on July 27, 2012, at 19:36:19
It is once given 50mg at night and almost fainted next morning was led back to be and it was discontinued that day. I wanted to talk words in head none would come out. Phillipa
Posted by Dinah on July 28, 2012, at 15:21:07
In reply to Re: What to do about flying off the handle? » Dinah, posted by Phillipa on July 28, 2012, at 9:51:03
With Seroquel? I never have tried that one. I'm very fond of my Risperdal, and it's never made me sleepy. When I take it regularly I do get an annoying dry mouth, and it's not great for my diabetes, I'd guess. But I do take it regularly for short periods of time when needed. I'm putting a pill in with my morning pills for the next little while. I am having stress and my concentration is shot. Risperdal helps.
I was just wondering why Sleepygirl's pdoc has never suggested a less soporific AP, if AP's work for her other than the sedation.
Posted by sleepygirl2 on July 28, 2012, at 19:45:19
In reply to Re: What to do about flying off the handle? » Phillipa, posted by Dinah on July 28, 2012, at 15:21:07
I tried abilify a few years ago, didn't like it. It started out ok, but then wasn't. Strange acidic burning feeling in my esophagus/back of my throat.
He didn't like the idea of geodon, and maybe risperdal's potential side effects bother him? I don't know.
This is the end of the thread.
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