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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by Myra Ellen on March 6, 2001, at 19:15:13
I was recently prescribed Klonapin to replace my Xanax for anxiety. I am also already on Paxil. After reading all of these things I do not want to begin taking the Klonapin. I feel that I cannot mentally afford the risk of more depression or anxiety. I am already having a lot of problems as it is. Did anyone else have any doubts and tried it anyway and had success?
Posted by JohnX on March 7, 2001, at 3:56:22
In reply to Klonapin and it's Risks, posted by Myra Ellen on March 6, 2001, at 19:15:13
> I was recently prescribed Klonapin to replace my Xanax for anxiety. I am also already on Paxil. After reading all of these things I do not want to begin taking the Klonapin. I feel that I cannot mentally afford the risk of more depression or anxiety. I am already having a lot of problems as it is. Did anyone else have any doubts and tried it anyway and had success?
Hopefully the Paxil will be enough to reduce your anxiety standalone. How long have you been taking Paxil?
The main downside of the addictive nature of the benzos like Klonopin and Xanax should be considered carefully. I have taken both Xanax and Klonopin. I liked Klonopin better because it lasts longer, you only need to dose it 2-3 times a day. Both Xanax and Klonopin are quick acting and you can switch from one to the other really quickly, so I don't see the harm in giving the Klonopin a 1 or 2 day test run.
Hope this helps,
John
Posted by AmyM on March 7, 2001, at 7:48:47
In reply to Klonapin and it's Risks, posted by Myra Ellen on March 6, 2001, at 19:15:13
Hi Myra,
I've been suffering from Panic for about 18 of my 28 years. 2 1/2 years ago I tried Xanax and added Paxil(10mg/day)when I developed Depression one year ago. Xanax alone did not take away my panic, but the combination of the two did. About a month ago I went off the Paxil and my Panic returned, but my depression did not. A week ago I traded my Xanax (1.5mg/day) for Klonopin (1.5mg/day). Boy is there a difference. Klonopin has a longer half life, so you don't feel the effects wearing off, and for the first time I am Panic & anxiety free. I too have some reservations about being on it,ie:the addictive nature and the withdrawal symptoms, in fact, I'm seeing my pdoc today to discuss these issues. I'll let you know what I find out. My advice is if it works, why change it.
Best of luck, AmyM
> I was recently prescribed Klonapin to replace my Xanax for anxiety. I am also already on Paxil. After reading all of these things I do not want to begin taking the Klonapin. I feel that I cannot mentally afford the risk of more depression or anxiety. I am already having a lot of problems as it is. Did anyone else have any doubts and tried it anyway and had success?
Posted by JackD on March 9, 2001, at 0:28:04
In reply to Klonapin and it's Risks, posted by Myra Ellen on March 6, 2001, at 19:15:13
I think Klonopin is generally considered (by doctors) to be a safe and VERY effective drug against anxiety. It's fast acting, unlike the SSRI's which can take weeks to start working, and has a much better track record statistically. Of course, there is the whole debate about addiction but I think it's a little exaggerated. Don't be afraid to give it a shot. It's been helping me A LOT.
Posted by Brian F on March 9, 2001, at 15:40:27
In reply to Re: Klonapin and it's Risks, posted by JackD on March 9, 2001, at 0:28:04
> I think Klonopin is generally considered (by doctors) to be a safe and VERY effective drug against anxiety. It's fast acting, unlike the SSRI's which can take weeks to start working, and has a much better track record statistically. Of course, there is the whole debate about addiction but I think it's a little exaggerated. Don't be afraid to give it a shot. It's been helping me A LOT.
I totally agree with you, I think way too much is
being made about the addictive potential of this and many other benzo meds.
I live in NY where a triplicate has to be filled
out for these drugs to be prescribed. This makes the pdocs that I have seen even more reluctant to
prescribe these drugs,always pushing SSRI group when I and many others haven't responded to them. It's a shame when doctors have to constantly look over their shoulder instead of just treating the patient with what is most effective for him/her.
I'm sorry about rambling on,it just pisses me off.
Posted by JohnX on March 9, 2001, at 18:00:15
In reply to Re: Klonapin and it's Risks, posted by JackD on March 9, 2001, at 0:28:04
> I think Klonopin is generally considered (by doctors) to be a safe and VERY effective drug against anxiety. It's fast acting, unlike the SSRI's which can take weeks to start working, and has a much better track record statistically. Of course, there is the whole debate about addiction but I think it's a little exaggerated. Don't be afraid to give it a shot. It's been helping me A LOT.
Hi Jack,
I'm wondering how long you have been taking Klonopin and how you dose it? Do you take Klonopin vacations to prevent sensitization?
I took Klonopin for 8 months with no problem and then all of a sudden it stopped working without substantially increasing the dose and then it stopped working....and I've spent 3 months slowly tapering off. I've found that Neurontin, a non-addictive fast-acting anti-convulsant, is just as effective as Klonopin for releaving my anxiety. I do agree that everyone's experience will differ.
-John
Posted by Lorraine on March 10, 2001, at 10:48:07
In reply to Re: Klonapin and it's Risks » JackD, posted by JohnX on March 9, 2001, at 18:00:15
John: I'm on Neurontin--one week titrated up from 100 mg to 300--as a mood stabilizer (not clear that I'm bipolar tho) and an anti-anxiety med. I still have tightness in the chest and difficulty taking a deep breath. How long would you expect before I those symptoms go away? I only have physical anxiety, not mental. Also do you feel like it's "dummying you down?"
Posted by JackD on March 10, 2001, at 19:04:51
In reply to Re: Klonapin and it's Risks » JackD, posted by JohnX on March 9, 2001, at 18:00:15
I've been taking Klonopin 2mg a day since early January this year. So far it still feels like it's working. I take 1 mg in the morning, and 1 mg at night. I don't take drug vacations, but I'm sure eventually I will. That's interesting that Neurontin works just as well for you. Did you at any point change your dosing or change to a generic version of the drug? Did you add any other drugs in combination with the Klonopin?
Posted by JohnX on March 11, 2001, at 5:52:57
In reply to Re: Klonapin and it's Risks, posted by Lorraine on March 10, 2001, at 10:48:07
> John: I'm on Neurontin--one week titrated up from 100 mg to 300--as a mood stabilizer (not clear that I'm bipolar tho) and an anti-anxiety med. I still have tightness in the chest and difficulty taking a deep breath. How long would you expect before I those symptoms go away? I only have physical anxiety, not mental. Also do you feel like it's "dummying you down?"
Lorraine,
What is your dosing schedule for Neurontin?
At first my Pdoc had me taking 100 mg BID (twice a day), but I found that it only lasted about 8 hrs, and I would have start-up/stop side effects. I increased the dose to 300 mg TID (three times day) and at that dose I don't have the side effect up/down + much less anxiety. I had excruciating tension headaches and bruxism (tightning in jaw/teeth grinding) earlier last year, and by accident found out that Klonopin wiped out the symptoms. At the time my pdoc dosed me at 1 mg morning, 1 mg afternoon, 2 mg night (to help me sleep). I found this was too strong and made me too drowsy, but miraculously rid me of the pain I had been in for 3 months. By the end of the year 10 mg had no effect. I have taken 3 months to reduce the dose to Klonpin 1 mg twice a day + 300 mg Lamictal (for best mood stabilization) + 300 mg Neurontin TID (for anxiety withdrawl).
As you may fully now, its possible to not feel anxious mentally, but for the symptoms to manifest themself in a physical way such as tingling in extremeties, headaches, muscle tension, stomach pain, high blood pressure, etc. This seems to be what you are referring to. I will say that as I have tapered the Klonopin down these last few weeks to the lowest dose, I have been having to avoid stress as much as possible to avoid the headaches and jaw pain. I did find that increasing the Neurontin dose was quite helpful.
The dose you are referring too 300 mg even at three times a day can be increased if you feel it is helping and any side-effects are minimal but you require more punch. I can't really predict how the med would help your chest pain as everyone responds differently. Stick with it and if it is not helping as much as you need, ask your doc to bump the dose. The med works quickly, so if it is not achieving your goals you will know in a few days. Also, get a thorough physical if you haven't already to rule out any other causes of your pain (I hope your doc has done enough testing to rule out any other causes).
Hope this help,
John
Posted by JohnX on March 11, 2001, at 6:07:07
In reply to Re: Klonapin and it's Risks, posted by JackD on March 10, 2001, at 19:04:51
> I've been taking Klonopin 2mg a day since early January this year. So far it still feels like it's working. I take 1 mg in the morning, and 1 mg at night. I don't take drug vacations, but I'm sure eventually I will. That's interesting that Neurontin works just as well for you. Did you at any point change your dosing or change to a generic version of the drug? Did you add any other drugs in combination with the Klonopin?
JackD,
While I was taking Klonopin, I did switch between generics at some times depending on what the pharmacy had in stock. But the generics chemically are identical as far as I know, so I wouldn't expect this to have made an impact. If I am wrong please let me know.
I went through many anti-depressants last year with varying success. But Klonopin acted quickly and stabilized my mood and fixed my physical pain. I thought it was the best thing since sliced bread at the time, but was aware of the addiction potential. I did get off Klonopin twice during the year with no big problems while trying Depakote and Buspar as a substitute, but unfortunately they did not help me, so it was back to Klonopin. Serzone was the only AD that relieved my pain, but it left me too drowsy and I got into a car accident, so I dumped it. If I could do it again, I would take Serzone or Trazodone at night to help sleep and Klonopin only during the day. This I believe may have helped to prevent addiction to Klonopin since it would be in my system for only part of the day. I have also been taking Adderall on/off to help with the drowsiness and anhedonia I experience while on the anti-convulsants or Klonopin. I recently made a stressfull job change and move, and I'm sure that didn't help the Klonopin situation any.
Hope you continue to do well. I know many people have taken med benzo holidays to help prevent sensitization, and its probably not a bad idea.
As always, I'm describing my experience, and everyone may differ....
-John
Posted by Lorraine on March 11, 2001, at 10:22:16
In reply to Re: Klonapin and it's Risks » Lorraine, posted by JohnX on March 11, 2001, at 5:52:57
> > John: >
Also, get a thorough physical if you haven't already to rule out any other causes of your pain (I hope your doc has done enough testing to rule out any other causes).
>
> Hope this help,Thanks John. I am getting a physical--beginning of next month. Cardiovascular is what I think needs to be checked out. Apparently, Mitral Valve Prolapse is associated with these symptoms (tightness in chest, difficulty taking deep breath). It is also associated with Panic Attacks. Was there anything else you were thinking I should have checked out? I'm making a list.
Posted by JackD on March 11, 2001, at 13:49:43
In reply to Re: Klonapin and it's Risks » JackD, posted by JohnX on March 11, 2001, at 6:07:07
Thanks John, I hope the best for you as well. If the pain you describe is physical, have you ever considered taking Vicadin (spelling?) or other narcotics?
Posted by JohnX on March 11, 2001, at 22:21:59
In reply to Re: Klonapin and it's Risks John, posted by Lorraine on March 11, 2001, at 10:22:16
> > > John: >
> Also, get a thorough physical if you haven't already to rule out any other causes of your pain (I hope your doc has done enough testing to rule out any other causes).
> >
> > Hope this help,
>
> Thanks John. I am getting a physical--beginning of next month. Cardiovascular is what I think needs to be checked out. Apparently, Mitral Valve Prolapse is associated with these symptoms (tightness in chest, difficulty taking deep breath). It is also associated with Panic Attacks. Was there anything else you were thinking I should have checked out? I'm making a list.I think you are on the right track. Get a thorough physical to rule out any serious conditions. Another option I didn't mention which may help quickly is to take a beta-blocker (a blood pressure med) like Inderal (propranolol). The beta blocker dampens the effects of adrenaline (flight or fight chemical). Adrenaline release can result in panic attacks, tightness of chest, difficulty breathing. It does sound like your symptoms are similar to those in a panic attack, which is often mastaken for feeling like a heart attach or stroke (I know personally). A beta-blocker should help for chest pain and especially if you experience a racing heart. But I wouldn't take any BP meds without having the physical to check out your cardiovascular system for any critical abnormalities.
Good luck.
-John
Posted by JohnX on March 11, 2001, at 22:35:19
In reply to Re: Klonapin and it's Risks, posted by JackD on March 11, 2001, at 13:49:43
> Thanks John, I hope the best for you as well. If the pain you describe is physical, have you ever considered taking Vicadin (spelling?) or other narcotics?
I haven't considered taken any narcotics for the pain, mainly because I believe it would be a band-aid solution for my case not really attacking the root of my problem. My main pain symptoms are generally a really bad tension headache and tension in my jaw. I also get occasional tingling in the extremeties. The pain symptoms seem to be directly correlated with my mood problems. When my depressions lift completely or if I go the other way into a manic state, then the muscle tension resolves itself. This plus my responses to meds indicates a lack of dopamine in an area of the brain where dopamine counteracts another chemical acetylcholine which causes muscle contractions in the face/head. When the dopamine is increased (as correlated to my mood) the muscle clenching wears off quickly. So I'm looking for solutions that cleanly alleviate my mood disorder as I believe it should also alleviate my physical pain. The tingling in the extremeties can be effectively treated with anti-convulsants which as you may or may not know are also 1st line treatment for manic-depression too.
Klonopin has anti-convulsant activity as well as anti-anxiety activity.Thanks for your ideas. I hope everyone finds a good solution tailored to their needs.
-John
Posted by jb on March 12, 2001, at 19:32:16
In reply to Klonapin and it's Risks, posted by Myra Ellen on March 6, 2001, at 19:15:13
Hi, Myra. I've had tremendous success with Klonopin for about the last 8 years. It's much longer lasting than Xanax and some of the others and, therefore, is supposed to have less addictive potential and well as not give you the ups and downs of a short-term acting benzo whose levels constantly vary within your system. My current dosage is 3 mg/day. I take it in addition to Nardil. I've tried Valium, and have notice little or no effect. Lastly, I've gone off of Klonopin for about 4 months, and did not experience any withdrawal systems. I'm very happy with Klonopin, as you might tell.
John
Posted by JohnX on March 13, 2001, at 2:34:38
In reply to Re: Klonopin and it's Risks - Myra, posted by jb on March 12, 2001, at 19:32:16
> Hi, Myra. I've had tremendous success with Klonopin for about the last 8 years. It's much longer lasting than Xanax and some of the others and, therefore, is supposed to have less addictive potential and well as not give you the ups and downs of a short-term acting benzo whose levels constantly vary within your system. My current dosage is 3 mg/day. I take it in addition to Nardil. I've tried Valium, and have notice little or no effect. Lastly, I've gone off of Klonopin for about 4 months, and did not experience any withdrawal systems. I'm very happy with Klonopin, as you might tell.
>
> JohnJohn,
Do you take the 3 mg once a day?
This would greatly reduce the potential for
addiction vs. taking the med 3x a day (which I did). From I've read the anti-convulsant effect of Klonopin is much more likely to wear off than the anti-anxiety effect. When studied for epilepsy usage, it usually lost its effect after 3-6 months.-Another John ;)
Posted by Myra Ellen on March 13, 2001, at 12:07:53
In reply to Re: Klonopin and it's Risks - Myra » jb, posted by JohnX on March 13, 2001, at 2:34:38
I am also having a tremendous problem with my sexual drive. I believe it is due to the Paxil. i know that some of you are on it as well and I know that losing your sexual desore is a side effect of this medication. Do you have any suggestions or maybe another medication that is for Anxiety AND depression that does not have this same effect......
-M.E.-
Posted by jb on March 13, 2001, at 12:35:58
In reply to Re: Klonopin and it's Risks - Myra » jb, posted by JohnX on March 13, 2001, at 2:34:38
> Do you take the 3 mg once a day?
> This would greatly reduce the potential for
> addiction vs. taking the med 3x a day (which I did). From I've read the anti-convulsant effect of Klonopin is much more likely to wear off than the anti-anxiety effect. When studied for epilepsy usage, it usually lost its effect after 3-6 months.
>
> -Another John ;)
Hi, John. No, I take 1 mg 3 times a day: morning, noon, and night. My psychdoc mentioned that this will better maintain the steady-state plasma levels of klonopin, minimizing some of the cognitive side effects which occur when levels rise and fall, such as with the shorter-acting benzo's.See you.
JohnB
Posted by jb on March 13, 2001, at 12:41:55
In reply to An Off the subject Question...., posted by Myra Ellen on March 13, 2001, at 12:07:53
> I am also having a tremendous problem with my sexual drive. I believe it is due to the Paxil. i know that some of you are on it as well and I know that losing your sexual desore is a side effect of this medication. Do you have any suggestions or maybe another medication that is for Anxiety AND depression that does not have this same effect......
> -M.E.-Hi, Myra. You'll find that most of the AD's which affect the serotonin receptor 5HT2 will negatively impact one of the aspects of your sexual functioning: libido, arousal, or orgasm. By the way, those are the three levels to which psychdocs refer. There are just a few non-SSRI's which are supposed to have little or no effect upon sexual function. I believe they are Bupropion, Celexa, and Remeron.
Also, your psychdoc may want to augment your Anti-depressant with Selegiline, which does tremendous things for sexual desire, sensation, and orgasm. Very tremendous things!
Hope this helps.
JohnB
Posted by dove on March 13, 2001, at 15:00:06
In reply to Re: An Off the subject Question Myra, posted by jb on March 13, 2001, at 12:41:55
>
> Hi, Myra. You'll find that most of the AD's which affect the serotonin receptor 5HT2 will negatively impact one of the aspects of your sexual functioning: libido, arousal, or orgasm. By the way, those are the three levels to which psychdocs refer. There are just a few non-SSRI's which are supposed to have little or no effect upon sexual function. I believe they are Bupropion, Celexa, and Remeron.
>Nefazodone (Serzone) is another med considered to be a SSRI that has few negative effects on Libido, arousal, and/or orgasm.
dove
Posted by Joe Schmoe on July 22, 2001, at 23:16:54
In reply to Re: Klonopin and it's Risks - Myra » jb, posted by JohnX on March 13, 2001, at 2:34:38
> Do you take the 3 mg once a day?
> This would greatly reduce the potential for
> addiction vs. taking the med 3x a day (which I did).Is this true? I mean is this anecdotal or is this supported by studies? Since Klonopin only seems to last (for me) for about six hours in terms of social phobia protection, I would find it hard to believe taking it once a day is optimal. Also taking this large a dose at once I would think would really dope me out.
I am new to Klonopin and trying to fumble my way toward discovering an effective dosage for me. Since I am also starting Wellbutrin (third week) this has been a challenge. I see my doc this week, wondering what to tell her. My dosage now is 1.5 mg a day, which I take 1 mg in the morning and .5 mg around 2 PM, although tonight for some reason I had to take an extra .5 in the evening - maybe the Wellbutrin is starting to kick in and make me more anxious. It is all so confusing. I think I will ask for more Clonopin when I see her.
Posted by Mitch on July 23, 2001, at 10:18:45
In reply to Re: Klonopin and it's Risks - Myra, posted by Joe Schmoe on July 22, 2001, at 23:16:54
Joe, How much Wellbutrin are you taking? I also take Klonopin for SP and when I was taking Wellbutrin with it I only took 25mg twice-three times a day and work up very slowly (I was quartering 100mg SR tabs). You may be titrating the dose upwards too quick or got started out with too high a dose. I found that just 75-150mg total in a day was plenty (divided up). I also think it worked better (from what I can remember) by splitting up my Klonopin with it. I think I was taking 25mg WB+.5mg Klonopin with each WB dose. The WB peaks fast and is quite buzzy, and the Klonopin works best the first few hours after you take it because you are getting the "parent" drug first-then it metabolizes in your body I think into desmethyl-clonazepam which is active, but not as active as the parent. Interestingly, the WB has active metabolites as well (with longer half-lives)which may explain your insomnia. I would suggest taking Klonopin together with the WB and don't take any WB later than say 4-6pm (to help with the insomnia).
Mitch
> Is this true? I mean is this anecdotal or is this supported by studies? Since Klonopin only seems to last (for me) for about six hours in terms of social phobia protection, I would find it hard to believe taking it once a day is optimal. Also taking this large a dose at once I would think would really dope me out.
>
> I am new to Klonopin and trying to fumble my way toward discovering an effective dosage for me. Since I am also starting Wellbutrin (third week) this has been a challenge. I see my doc this week, wondering what to tell her. My dosage now is 1.5 mg a day, which I take 1 mg in the morning and .5 mg around 2 PM, although tonight for some reason I had to take an extra .5 in the evening - maybe the Wellbutrin is starting to kick in and make me more anxious. It is all so confusing. I think I will ask for more Clonopin when I see her.
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