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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by JaneB on May 7, 2002, at 22:53:43
I have been taking 10-20 mg Celexa and .5 mg klonopin for 2 years. What would happen if I stopped both cold turkey. I would switch to Ambien so that I could get to sleep. What about danger of seizures from stopping the K? Would I just be uncomfortable for a while or in physical danger? Thanks for any input.
JaneB
Posted by judy1 on May 7, 2002, at 23:51:02
In reply to What if I stop Klonopin?, posted by JaneB on May 7, 2002, at 22:53:43
Hi,
I don't think you'll be in any physical danger (0.5mg of klonopin is a VERY low dose), but you'll probably have a week or so of insomnia, agitation, etc. Personally when I'm at that low a dose, I like to quit rather than prolong any withdrawal symptoms. Best of luck- Judy
Posted by JohnX2 on May 8, 2002, at 1:17:19
In reply to What if I stop Klonopin?, posted by JaneB on May 7, 2002, at 22:53:43
> I have been taking 10-20 mg Celexa and .5 mg klonopin for 2 years. What would happen if I stopped both cold turkey. I would switch to Ambien so that I could get to sleep. What about danger of seizures from stopping the K? Would I just be uncomfortable for a while or in physical danger? Thanks for any input.
> JaneBJMO, I'm not a big fan of cold-turkey stops.
I would taper the Celexa down at least over 1-2 weeks,
and maybe do the same for Klonopin (switch to 0.25 then
to 0). Although the Klonopin dose is pretty low as noted.Some people are very sensitive to Klonopin however, and
there can be some rebound seizure like activity. It seems
people have been taking and stopping stroger doses than
0.5 mg when the significant rebound effects occured ...John
Posted by Rathrbfishn on May 8, 2002, at 3:00:56
In reply to Re: What if I stop Klonopin? » JaneB, posted by JohnX2 on May 8, 2002, at 1:17:19
It is not wise to stop either of these meds cold turkey after using them for two years. I would consult your doctor and discuss a tapering schedule and withdraw under medical supervision. There is really no way of knowing what would happen if you stopped both cold turkey. You may not have too much difficulty, but then again you may find it extremely uncomfortable, or anywhere in between. I personally would want my doctors advice and would want him/her aware of what I was doing in the event problems/difficulties arose.
Also, I would have a plan B ready if you have reemergence of your symptoms after you've completed the withdrawals. All the more reason to discuss this with your doctor. Good luck.
Posted by Rathrbfishn on May 8, 2002, at 3:36:35
In reply to Re: What if I stop Klonopin? » JohnX2, posted by Rathrbfishn on May 8, 2002, at 3:00:56
Sorry, not quite awake yet. Unless there is some medical reason to stop both at the same time, I would withdraw from the celexa first, using the klonopin to help with any potential problems. Then tackle the klonopin. If you withdraw from both at the same time and have problems you won't have any idea which drug is causing them. Again, please discuss these issues with your doctor before you do anything. Polytherapy creates interesting issues, doesn't it. Best of luck with your decision.
Posted by JaneB on May 8, 2002, at 7:02:03
In reply to Why not stop one at a time? » Rathrbfishn, posted by Rathrbfishn on May 8, 2002, at 3:36:35
> Sorry, not quite awake yet. Unless there is some medical reason to stop both at the same time, I would withdraw from the celexa first, using the klonopin to help with any potential problems. Then tackle the klonopin. If you withdraw from both at the same time and have problems you won't have any idea which drug is causing them. Again, please discuss these issues with your doctor before you do anything. Polytherapy creates interesting issues, doesn't it. Best of luck with your decision.
My reasoning for stopping both at once is this: Celexa is activating, K is not. if I just stop the Celexa wouldn't the k make me feel a little sluggish and perhaps depressed? then I would think I couldn't go off the Celexa when, in fact, it could be the K making me start to feel depressed. If I go off the K alone the Celexa would make me feel to anxious and I would think I needed the K when, in fact, it could be the Celexa causing the problems.
This could be very faulty thinking and I will discuss with pdoc at next appt. but you all have such widespread knowledge and understanding i wanted to run it by PB first. I wouldn't have made it through the last few years without PB! Thanks, Dr. Bob and all.
JaneB
Posted by wendy b. on May 8, 2002, at 8:07:39
In reply to Re: Why not stop one at a time?, posted by JaneB on May 8, 2002, at 7:02:03
> > Sorry, not quite awake yet. Unless there is some medical reason to stop both at the same time, I would withdraw from the celexa first, using the klonopin to help with any potential problems. Then tackle the klonopin. If you withdraw from both at the same time and have problems you won't have any idea which drug is causing them. Again, please discuss these issues with your doctor before you do anything. Polytherapy creates interesting issues, doesn't it. Best of luck with your decision.
>
> My reasoning for stopping both at once is this: Celexa is activating, K is not. if I just stop the Celexa wouldn't the k make me feel a little sluggish and perhaps depressed?I believe it wouldn't cause you to be MORE sluggish or depressed than you are now with it... Withdrawing from the Celexa would be the culprit, if that did indeed happen...
>then I would think I couldn't go off the Celexa when, in fact, it could be the K making me start to feel depressed. If I go off the K alone the Celexa would make me feel to anxious and I would think I needed the K when, in fact, it could be the Celexa causing the problems.
I think the other way is right, I agree with Rathbfishn: go off the Celexa 1st, if you must go off anything at all, IMHO. At least you will have the Klonopin to help you sleep and help with anxiety... Then when you feel alright, try easing off the Klonopin...
> This could be very faulty thinking and I will discuss with pdoc at next appt. but you all have such widespread knowledge and understanding i wanted to run it by PB first. I wouldn't have made it through the last few years without PB! Thanks, Dr. Bob and all.
> JaneBJane, I wonder why you are doing this? Is there a v. good reason you are quitting the medicines? (i.e. -wanting to get pregnant, etc.) Even if that were the case, you can be on SOME meds while you are pregnant, but a dr could help you with that. Please don't go off the meds because you feel beter now, cuz the meds are probably helping you... I'm just concerned you will crash. If you don't like your current cocktail, you could discuss with your dr and try a change. I'm a little worried about this...
with respect,
Wendy
Posted by JaneB on May 8, 2002, at 9:53:52
In reply to Re: Why not stop one at a time? - worried » JaneB, posted by wendy b. on May 8, 2002, at 8:07:39
Jane, I wonder why you are doing this? Is there a v. good reason you are quitting the medicines? (i.e. -wanting to get pregnant, etc.) Even if that were the case, you can be on SOME meds while you are pregnant, but a dr could help you with that. Please don't go off the meds because you feel beter now, cuz the meds are probably helping you... I'm just concerned you will crash. If you don't like your current cocktail, you could discuss with your dr and try a change. I'm a little worried about this...
with respect,
Wendy
No I won't get pregnant. Too old. Husband just became disabled. I need more energy! Have been having lack of energy problem for 2 years. Pdoc tried adding WB but I could not tolerate it. Great at first but I would get agitated and that is just not me. Either K or Celexa is making me too lethargic and unmotivated. I must get more energy. The more Celexa I take the less energy I have and I can't sleep without the Klonopin. Oh me, oh my. What to do? Thanks for your concern. I will ponder and keep searching.
JaneB
Posted by Ritch on May 8, 2002, at 11:10:49
In reply to Thanks Wendy, I quesiton myself also, posted by JaneB on May 8, 2002, at 9:53:52
> Jane, I wonder why you are doing this? Is there a v. good reason you are quitting the medicines? (i.e. -wanting to get pregnant, etc.) Even if that were the case, you can be on SOME meds while you are pregnant, but a dr could help you with that. Please don't go off the meds because you feel beter now, cuz the meds are probably helping you... I'm just concerned you will crash. If you don't like your current cocktail, you could discuss with your dr and try a change. I'm a little worried about this...
>
> with respect,
>
> Wendy
>
> No I won't get pregnant. Too old. Husband just became disabled. I need more energy! Have been having lack of energy problem for 2 years. Pdoc tried adding WB but I could not tolerate it. Great at first but I would get agitated and that is just not me. Either K or Celexa is making me too lethargic and unmotivated. I must get more energy. The more Celexa I take the less energy I have and I can't sleep without the Klonopin. Oh me, oh my. What to do? Thanks for your concern. I will ponder and keep searching.
> JaneBJane,
You might try taking *all* your Klonopin at bedtime (if you don't already do so). Then, try cutting your Celexa dose down and see what happens. If you are taking 20mg/day, try 10mg/day for a while and see if that helps. Oh, another thing-you might try taking your Celexa dose in the evening instead of first thing in the morning. Or...you might switch the Celexa to a more activating SSRI like Zoloft or Prozac.
hope this helps some,
Mitch
Posted by Krazy Kat on May 8, 2002, at 11:21:56
In reply to Thanks Wendy, I quesiton myself also, posted by JaneB on May 8, 2002, at 9:53:52
Jane:
I haven't followed this thread too closely, so please forgive me if I'm repeating anything...
the energy issue is a BIG one for me, as well. I am Bipolar, and all stabilizers I tried made me tired. Beyond the tired I was already experiencing from the depressive side of it. I also could not tolerate Wellbutrin AT ALL. Pdoc has not been as concerned about the lack of energy as I have over the last two years, until I finally told him that I was going to stop all meds unless it could be "fixed".
I'm doing a trial of Ritalin right now - there's a thread above. I'm really tired today, not sure why, but it had seemed to improve both my energy and focus the last couple of days. The best thing is stimulants work quickly or not at all.
I cannot tolerate Anti-Depressants but this seems to have very minimal side effects.
What about adding a stimulant? I hope that you at least will consider this - I don't know your background, but the two times I stopped my med (Depakote) I went into serious suicidal depressions recently.
Take care.
- KK
Posted by JaneB on May 8, 2002, at 15:48:08
In reply to Re: Thanks Wendy, I quesiton myself also » JaneB, posted by Ritch on May 8, 2002, at 11:10:49
> Jane,
>
> You might try taking *all* your Klonopin at bedtime (if you don't already do so). Then, try cutting your Celexa dose down and see what happens. If you are taking 20mg/day, try 10mg/day for a while and see if that helps. Oh, another thing-you might try taking your Celexa dose in the evening instead of first thing in the morning. Or...you might switch the Celexa to a more activating SSRI like Zoloft or Prozac.
>
> hope this helps some,
>
> MitchI have been taking it all at night. I get energetic just when it is time to take it at bedtime. I have tried taking it in am and get real tired. I have gone down to 10 mg of Celexa. More makes my mood unstable. Sometimes I take 20 when really stressed (ex. grief or husband's irritability.) I don't want to crash. What about a drug holiday? 2 days off, 5 days on type of thing. Has anyone ever tried this. then i would at least get some things done. Once a pdoc said that the extra energy when stopping an ad was "discontinuation syndrome". Have you ever heard of such a thing? He was changing me from Zoloft to Effexor XR. This new pdoc put me on celexa and thought i would not need klonopin but that did not make sense to me. klonopin keeps me more stable.
So thanks for your input and my question is about drug holidays and discontinuation syndrome and whether or not I am setting myself up for a crash.
JaneB
Posted by Krazy Kat on May 8, 2002, at 17:42:17
In reply to Mitch, Wendy and all: Drug holidays?, posted by JaneB on May 8, 2002, at 15:48:08
Jane:
This really set off my radar -- i think our goal is to get as "stable" as possible. taking drug holidays is not going to do that.
celexa's half life is about 35 hours from what i've read. so you'll have it in you for a good day or so anyhow.
can you try a different ad?
i, personally, and with no research on hand to back me up, think drug holidays are a big mistake. try to fix the problem first.
i think our bodies thrive on consistency. just mho.
take care and good luck.
- kk
Posted by Krazy Kat on May 8, 2002, at 17:44:05
In reply to Mitch, Wendy and all: Drug holidays?, posted by JaneB on May 8, 2002, at 15:48:08
this is a recent development in my thinking, per many sessions with my pdoc. he kept telling me i could not change my depakote dose continually and expect "stability" - i have found that to be true.
Posted by JaneB on May 8, 2002, at 18:24:11
In reply to by the way » JaneB, posted by Krazy Kat on May 8, 2002, at 17:44:05
Very interesting! My old pdoc tried me on Ritalin but when I called the office to get a refill because I was going to be out of town when I ran out the receptionist acted like I was taking a "very controlled substance" and I got scared and quit. I don't know what my new pdoc would think of Ritalin. He suggested I take Wellbutrin intermittently to counteract the side effects of Celexa quite a while ago and I have lots of samples. I'm just afraid of it because of the agitation. But that was when I was trying to take it consistently. I wish I still lived near my old pdoc.
The reason I was switched from Xanax to Klonopin was to maintain a more consistent level of antianxiety and it is supposed to have some mood stabilizing properties. I started thinking about stopping all meds after seeing a family doctor who thought it horrible that I was on Klonopin. I am rambling. sorry. I read your other posts and will be very interested in your outcome. Thanks for sharing.
JaneB
Posted by Rathrbfishn on May 8, 2002, at 19:40:19
In reply to Re: by the way » Krazy Kat, posted by JaneB on May 8, 2002, at 18:24:11
Jane...glad you posted originally. After reading about why you were considering stopping all the meds, advice is easier to give. I think you received several good responses. Your reasoning for wanting more energy is sound and rational. Your pdoc is the best source for an answer to your situation. I want to comment on your family doctors reaction to your use of klonopin. Klonopin is an anxiolitic, some use it as a mood stabalizer, some for epilepsy, some for sleep, and some for a few other reasons. Point is that Klonopin is a pshych drug. Family physicians don't specialize in psychiatric conditions, Pdocs do. Would you rely on your family doctor to treat you for a heart condition? Probably not. You would get better treatment from a cardiologist. If you had cancer, I'm sure you would rather have an oncologist treat it than your family doctor. The same applies to psychiatric conditions and meds. I'm not implying that family docs don't have a working knowledge of these conditions and the meds to treat them, they just aren't specialists. Let the psychiatrist who has specialized training in psychiatric conditions and meds treat that aspect of your health. You have a miriad of options available that you haven't tried, your best source for imput and new cocktails is the pdoc. Great thing about all this is that you are not on high doses of either drug, so switching cocktails should be easier than if you were on high doses. See your pdoc about this situation at the first opportunity, for your sake and your husbands. All my best. Robin
Posted by wendy b. on May 8, 2002, at 22:17:45
In reply to Re: by the way » JaneB, posted by Rathrbfishn on May 8, 2002, at 19:40:19
Posted by Ritch on May 8, 2002, at 23:46:48
In reply to Mitch, Wendy and all: Drug holidays?, posted by JaneB on May 8, 2002, at 15:48:08
>
> > Jane,
> >
> > You might try taking *all* your Klonopin at bedtime (if you don't already do so). Then, try cutting your Celexa dose down and see what happens. If you are taking 20mg/day, try 10mg/day for a while and see if that helps. Oh, another thing-you might try taking your Celexa dose in the evening instead of first thing in the morning. Or...you might switch the Celexa to a more activating SSRI like Zoloft or Prozac.
> >
> > hope this helps some,
> >
> > Mitch
>
> I have been taking it all at night. I get energetic just when it is time to take it at bedtime. I have tried taking it in am and get real tired. I have gone down to 10 mg of Celexa. More makes my mood unstable. Sometimes I take 20 when really stressed (ex. grief or husband's irritability.) I don't want to crash. What about a drug holiday? 2 days off, 5 days on type of thing. Has anyone ever tried this. then i would at least get some things done. Once a pdoc said that the extra energy when stopping an ad was "discontinuation syndrome". Have you ever heard of such a thing? He was changing me from Zoloft to Effexor XR. This new pdoc put me on celexa and thought i would not need klonopin but that did not make sense to me. klonopin keeps me more stable.
>
> So thanks for your input and my question is about drug holidays and discontinuation syndrome and whether or not I am setting myself up for a crash.
> JaneB
Jane,Celexa has a fairly long half-life (approx. 36 hrs), try taking your 10mg tab at bedtime every other day. A pdoc told me that once when I was having gastrointestinal problems with it.
Mitch
Posted by Rathrbfishn on May 9, 2002, at 0:38:40
In reply to Re: Mitch, Wendy and all: Drug holidays? » JaneB, posted by Ritch on May 8, 2002, at 23:46:48
Thanx wendy, just trying to give a little back of what so many taught me over the years.
Jane...I will try to keep this short. I get upset when I hear the term, discontinuation syndrome.
Basically it is a term used by the drug co. who make AD's that implies there may be withdrawal problems for some people. It is a nice way of avoiding the word ADDICTIVE like symtoms may accure in some people when they stop their drug.
The symptoms can vary from increased energy as you experienced to flu like symptoms, headaches, insomnia, night sweats, etc. The way to avoid this is when discontinueing a psych drug, taper it slowly under medical supervision.
Thus far in the US, the makers of paxil and prozac(both ssri's, as is celexa) have lost law suits for not disclosing the full information about their initial drug trials showing/proving that some people have addictive like symptoms upon discontinueing their drug.
I don't want to get people upset because these drugs do help many people with depression and panic/anxiety problems. But the potential exists and is very real for people to have addictive type withdrawals upon cessation of these drugs. Some people have spent years trying to get off the ssri's.
I could go on forever about this...but it's late and get's somewhat complicated.
Hope all goes well for you.
Posted by JaneB on May 9, 2002, at 9:02:22
In reply to Jane, discontinuation syndrome, posted by Rathrbfishn on May 9, 2002, at 0:38:40
This is the end of the thread.
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