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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Jeff on May 25, 1999, at 7:43:58
I have been on Anafranil and Klonopin for over 3 years now. All is well except for the fact I have turned basically "Lazy", which is not a bad feeling at all compared to Depression, High Anxiety, and Panic Attacks that i suffered from prior to these drugs.
I have tried Prozac, Serzone, Effexor, Celexa, Paxil, and many others, but stopped due to side effects. I'm just curious if anyone out there has found a better combination without the Lethargic feelings.
Posted by JD on May 25, 1999, at 10:28:32
In reply to Anyone ever tried Anafanil with Klonopin ?, posted by Jeff on May 25, 1999, at 7:43:58
Enough klonopin will make anyone "lazy"! ;-)
How much are you taking per day? -JD
> I have been on Anafranil and Klonopin for over 3 years now. All is well except for the fact I have turned basically "Lazy", which is not a bad feeling at all compared to Depression, High Anxiety, and Panic Attacks that i suffered from prior to these drugs.
> I have tried Prozac, Serzone, Effexor, Celexa, Paxil, and many others, but stopped due to side effects. I'm just curious if anyone out there has found a better combination without the Lethargic feelings.
Posted by Jeff on May 25, 1999, at 14:44:48
In reply to Re: Anyone ever tried Anafanil with Klonopin ?, posted by JD on May 25, 1999, at 10:28:32
> Enough klonopin will make anyone "lazy"! ;-)
> How much are you taking per day? -JD
>
>
> > I have been on Anafranil and Klonopin for over 3 years now. All is well except for the fact I have turned basically "Lazy", which is not a bad feeling at all compared to Depression, High Anxiety, and Panic Attacks that i suffered from prior to these drugs.
> > I have tried Prozac, Serzone, Effexor, Celexa, Paxil, and many others, but stopped due to side effects. I'm just curious if anyone out there has found a better combination without the Lethargic feelings.Jeff<<< JD to answer your question re: Klonopin..I take one 1mg. tab (blue) at night, every night, and usually one 1st thing in the am, depending on what I am doing that day. I am in Sales, and cannot sell, or even meet with people without the anxiety relief I get with the Klonopin. Any suggestions?
(I think I'm hooked) Jeff
Posted by JD on May 26, 1999, at 6:06:51
In reply to Re: Anyone ever tried Anafanil with Klonopin ?, posted by Jeff on May 25, 1999, at 14:44:48
Well, 2mg/day klonopin is not tons considering what some epileptics seem to be taking, but it's certainly enough to make someone very lethargic! (I fall asleep within minutes of taking half of a 0.5mg tablet...) As you probably know, klonopin has a very long duration of action in the body, so whatever you take in the morning ends up sitting "on top" of the previous evening's dose...great for anxiety, but not great for your sense of get-up-and-go.
Xanax is a less sedating benzodiazepine but would probably pose several drawbacks: it's far more addictive than klonopin and I think has proved risky combined with clomipramine in certain people (serotonin syndrome, etc.). Have you ever tried Buspar? (Though again probably not a clomipramine...) There are other longer shots perhaps worth considering too: gabapentin and valproate come to mind, and heck, there are always MAO-inhibitors, those these are definitely a no-no with Anafranil !
>
> Jeff (I think I'm hooked) Jeff
Posted by JD on May 26, 1999, at 6:28:46
In reply to Re: Anyone ever tried Anafanil with Klonopin ?, posted by JD on May 26, 1999, at 6:06:51
Whoops--what I meant was that I wasn't sure if Buspar could be combined safely with clomipramine (Anafranil) ... Actually just checked medline and found a study claiming there to be no problem with it at all. On the other hand, valproate has been written up as causing a serious rise in clomipramine levels, and I couldn't find a thing on combined Anafranil/gabapentin. Long story short: make sure you have a doctor who knows his polypharmacy (better than me at least!), but there's much out there to be tried if the current tricyclic/benzo combination is making you feel like a lazy bum.
Best,
JD--------
Have you ever tried Buspar? (Though again probably not a clomipramine...) There are other longer shots perhaps worth considering too: gabapentin and valproate come to mind, and heck, there are always MAO-inhibitors, those these are definitely a no-no with Anafranil !
>
>
> >
> > Jeff (I think I'm hooked) Jeff
Posted by Steve on May 28, 1999, at 21:18:22
In reply to Re: Anafranil/Klonopin -- Correction & P.S., posted by JD on May 26, 1999, at 6:28:46
Jeff, I know exactly what you mean! I was on Anafranil and Klonopin for about a year. It was a very useful comination for me at that time of my life, but three side effects made the combination intolerable after a while:
1. Weight Gain
2. Sexual problems
3. "lazy"What made these problems so aggravating, was that they seemed to get worse over time. My solution was to switch to a different antidepressant (Prozac for many years, noe Celexea). As for your Klonopin dosage, I don't think it's very high (but these things vary so much from person to person). I am still on Klonopin to this day. I tried other benzos in the past: ativan, xanax & buspar. My personal opinion is that klonopin is the best. And as far as "addiction" -- well, I've been on bezos for 7 years now, and have managed to finish professional school, so I can't be on that of a track! Additionally, I am a firm believer that to really conquer anxiety/panic seretonin is the answer (increasing it of course). Hope this helps!
Posted by JD on May 29, 1999, at 7:12:11
In reply to Re: Anafranil/Klonopin , posted by Steve on May 28, 1999, at 21:18:22
Sounds like Steve has more personal experience with some of these meds than I do, but I just want to note that Buspar is an entirely different ballgame compared to benzos like Klonopin and Xanax-- it specifically effects serotonin receptors, yet in a different way than reuptake inhibitors like Zoloft or Prozac. (In other words, it doesn't have benzo-like side effects and usually needs to be taken for a while before it has much effect...)
--JD
>
> What made these problems so aggravating, was that they seemed to get worse over time. My solution was to switch to a different antidepressant (Prozac for many years, noe Celexea). As for your Klonopin dosage, I don't think it's very high (but these things vary so much from person to person). I am still on Klonopin to this day. I tried other benzos in the past: ativan, xanax & buspar. My personal opinion is that klonopin is the best. And as far as "addiction" -- well, I've been on bezos for 7 years now, and have managed to finish professional school, so I can't be on that of a track! Additionally, I am a firm believer that to really conquer anxiety/panic seretonin is the answer (increasing it of course). Hope this helps!
Posted by Steve on May 31, 1999, at 14:47:14
In reply to Re: Anafranil/Klonopin -- Buspar, posted by JD on May 29, 1999, at 7:12:11
> Sounds like Steve has more personal experience with some of these meds than I do, but I just want to note that Buspar is an entirely different ballgame compared to benzos like Klonopin and Xanax-- it specifically effects serotonin receptors, yet in a different way than reuptake inhibitors like Zoloft or Prozac. (In other words, it doesn't have benzo-like side effects and usually needs to be taken for a while before it has much effect...)
> --JD
> >
> > What made these problems so aggravating, was that they seemed to get worse over time. My solution was to switch to a different antidepressant (Prozac for many years, noe Celexea). As for your Klonopin dosage, I don't think it's very high (but these things vary so much from person to person). I am still on Klonopin to this day. I tried other benzos in the past: ativan, xanax & buspar. My personal opinion is that klonopin is the best. And as far as "addiction" -- well, I've been on bezos for 7 years now, and have managed to finish professional school, so I can't be on that of a track! Additionally, I am a firm believer that to really conquer anxiety/panic seretonin is the answer (increasing it of course). Hope this helps!Indeed, Buspar is in a different ballpark than the benzo's. It has been said that once someone takes benzo's then will usually never benifit from Buspar. I'm not sure of this is exactly true. Porbably for panic it is (although it is interesting that the SSRI's work well for panic via sertonin, whereas the benzo's do via the chloride channles... a mystery I suppose!)
Posted by Elizabeth on May 31, 1999, at 18:20:22
In reply to Re: Anafranil/Klonopin -- Buspar, posted by Steve on May 31, 1999, at 14:47:14
> Indeed, Buspar is in a different ballpark than the benzo's. It has been said that once someone takes benzo's then will usually never benifit from Buspar. I'm not sure of this is exactly true. Porbably for panic it is (although it is interesting that the SSRI's work well for panic via sertonin, whereas the benzo's do via the chloride channles... a mystery I suppose!)BuSpar doesn't work for panic in general, regardless of whether the person is a "benzo virgin."
It is true that people who've used benzos seem to be less likely to benefit from BuSpar. It's not clear why this is.
I think BuSpar is a better antidepressant than anxiolytic and should have been marketed as an antidepressant in the first place. Takes high doses, but it still ends up having few if any side effects. (I also think the doses used for anxiety probably aren't high enough, but that's just speculation.)
Posted by Steve on May 31, 1999, at 23:12:57
In reply to Re: Buspar, posted by Elizabeth on May 31, 1999, at 18:20:22
Elizabeth,
Do you think that someone who is having anxiety (but not panic) might benifit from startng Bupar or just increasing their SSRI? I find it curious that on the one hand, seritonin (depletion) is implicated in anxiety and panic (and thus the subsequent treament with SSRI's) and on the other, benzo's are used for anxiety as well which work mostly on chloride channels. So where do we stand as far as a hypothesis for anxiety? I know that the hippocampus has been implicated (and hence the calming effects of benzos), but as far as treatment goes, how does one decide?
> > Indeed, Buspar is in a different ballpark than the benzo's. It has been said that once someone takes benzo's then will usually never benifit from Buspar. I'm not sure of this is exactly true. Porbably for panic it is (although it is interesting that the SSRI's work well for panic via sertonin, whereas the benzo's do via the chloride channles... a mystery I suppose!)
>
> BuSpar doesn't work for panic in general, regardless of whether the person is a "benzo virgin."
>
> It is true that people who've used benzos seem to be less likely to benefit from BuSpar. It's not clear why this is.
>
> I think BuSpar is a better antidepressant than anxiolytic and should have been marketed as an antidepressant in the first place. Takes high doses, but it still ends up having few if any side effects. (I also think the doses used for anxiety probably aren't high enough, but that's just speculation.)
This is the end of the thread.
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