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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Simcha on October 13, 2002, at 12:49:12
The pdoc that I'm considering working with seems to think that Neurontin or Topamax would be better meds for fighting Bruxism than the Klonopin that has worked for almost 8 months.
I understand his reasoning that Klonopin can cause depression and that it interrupts sleep cycles. Klonopin also can mess with the liver after long-term use and possibly cause renal problems. The literature on Klonopin supports these claims.
Yet............
I've been doing my research on Neurontin and Topamax.
Topamax seems to come with a host of another set of issues. Glaucoma, being the most obvious. Also it may cause severe cognitive problems. There is also a tendancy to develop kidney stones on the stuff. Is this med better than Klonopin? Also, there might be some evidence to suggest that it might be mildly carcinogenic. Oh, great....cancer... Oh, and there is that odd incidence of sudden death too.
Neurontin has been shown to cause pancreatic cancer in lab animals. This is almost always fatal. Also neurontin may cause one to stagger interfering with motor skills. Neurontin also seems to be universally sedating and might cause weight gain.
OK, all three meds have side-effects. I'm on Klonopin. I know that it works for me. I do understand that something else might work better. I'm optimistic enough to be hopeful that there is a better med to fight bruxism. I do know that this pdoc cares. He has shown me that he cares even with seeing him for just one session. I know that he has my best interest in mind.
I'm just nervous about experimenting with a med change especially when it has not been shown to me that Topamax or Neurontin is any safer than Klonopin.
Please comment if you resonate and you could offer any guidance.
Thanks,
Simcha
Posted by Dinah on October 13, 2002, at 12:59:33
In reply to PDoc wants me off Klonopin -- Neurontin or Topamax, posted by Simcha on October 13, 2002, at 12:49:12
Sorry, Simcha, but my only advice is to find a new doctor. Benzophobia is a deal killer for me, and I wouldn't choose as my doctor a benzophobe.
Does he prescribe Klonopin in situations where it would be the medication of choice? Are there any disorders that he believes benzos can help?
If not, he doesn't sound like a doctor I would deal with.
Posted by BarbaraCat on October 13, 2002, at 16:57:08
In reply to PDoc wants me off Klonopin -- Neurontin or Topamax, posted by Simcha on October 13, 2002, at 12:49:12
Dear Simcha,
Your docs reasoning for choosing Topamax eludes me. It caused anxiety and a clenching throughout my body. I resumed bruxism while on it. Neurontin has helped somewhat. I don't always get the yummy relaxed state - seems I have to lay off it for a few days and then it will kick in. Lacmictal has become my drug of choice recently because it's helping so much with the depression. But there aren't any meds I've found that will provide that sweet blissful relaxation many of us are seeking. A good meditation will do it, but finding time is hard.I have a well gaurded secret I'm ready to share on this board. I take tryptophan at night. Yes, the dreaded, fatal, pharmaceutical grade amino acid tryptophan. I have no qualms whatsoever about taking it because the problems were traced to a bad batch from Japana few years ago. This stuff has worked wonders for me. It puts me to sleep, relaxes me, and works better than a benzo and much much better than 5-HTP. It's hard to find, but I got it at a pharmaceutical outfit that is a veterinary provider, but can procure people things too. I also like it because it seems to be addressing a basic serotonin imbalance.
Posted by Alan on October 13, 2002, at 17:20:44
In reply to Re: PDoc wants me off Klonopin -- Neurontin or Topamax » Simcha, posted by Dinah on October 13, 2002, at 12:59:33
Posted by Simcha on October 13, 2002, at 17:30:35
In reply to Re: PDoc wants me off Klonopin -- Neurontin or Topamax » Simcha, posted by Dinah on October 13, 2002, at 12:59:33
Dinah,
Thanks for your concern. I'm concerned too.
I do have to say that I've been sleeping almost the entire day away. It's nice outside and I just don't feel like going out there. I had a good night's sleep.
I do have to say that my job takes a lot of my energy and I do have 3 classes this quarter at grad school. Weekends are my only time where I can just let go and do nothing. I think that this is what my body is doing.
Anyway, back to the Klonopin...
I really hate the idea of having to search for another pdoc. Dang, this is not fun. Something tells me to stay away from Neurontin and Topamax. Basically it's the old addage of, "if it ain't broke, don't fix it." I really think that Klonopin is much safer than the other two drugs. The profile is safer. It's been used longer and people who have been on it long-term seem to have no problems with it.
I have not had to increase my dosage at all for eight months to get the relief from the bruxism. Personally after researching all of this I think this pdoc is full of (well, something brown and slimy that would be naughty to say on this board). Perhaps it is time to go back to the drawing board and get look at another pdoc. There is an anxiety clinic here and perhaps they might have some suggestions of benzo-friendly physicians.
Please comment and give me some assurances that I might be on the right track. This is all so new to me. The last pdoc just wrote the script, no questions asked and thought that it was doing wonders for me.....
Take Care,
Simcha
Posted by Simcha on October 13, 2002, at 17:31:35
In reply to Re: off Klonopin..here, here! (nm) » Dinah, posted by Alan on October 13, 2002, at 17:20:44
Posted by Alan on October 13, 2002, at 18:41:55
In reply to R:off Klonopin..here, here! Why?..Give me a reason (nm) » Alan, posted by Simcha on October 13, 2002, at 17:31:35
Posted by Dinah on October 13, 2002, at 19:22:45
In reply to Re: PDoc wants me off Klonopin -- Neurontin or Topamax » Dinah, posted by Simcha on October 13, 2002, at 17:30:35
>
> Please comment and give me some assurances that I might be on the right track. This is all so new to me. The last pdoc just wrote the script, no questions asked and thought that it was doing wonders for me.....
>
Well of course, I can't comment on your specific circumstances. But in general, I just can't imagine going to a pdoc who doesn't try to find the best "fit" of medication for each patient. I left a pdoc who kept pushing higher doses of a medication he must have approved of, but that didn't work at all well for me. And I would leave one that wouldn't prescribe a widely accepted medication that worked very well for me.Fortunately I haven't run into any benzo-phobic pdocs and I still have trouble believing there are so many of them. Klonopin clearly has a place in my medication regimen and not one of the three pdocs I've seen has even questioned that.
Good luck, Simcha.
Dinah
Posted by Simcha on October 13, 2002, at 21:28:46
In reply to Re: PDoc wants me off Klonopin -- Neurontin or Topamax, posted by Dinah on October 13, 2002, at 19:22:45
Dinah,
I think I'm going to bring this up in our next session. I do need to see if he does see Klonopin as good for something. I guess that he has some reservations because of the sleep interruption and perhaps he also wants to do something about my weight. I guess Topomax can help with that. He also said something about a thyroid test.
I want to see where this goes when I bring in my research and my concerns to him. I want to see how he responds. He did tell me to research Topamax and Neurontin because he wants me to be a large part of the decision making process. He did not really sound alarmist. He claimed that there were better meds to treat SSRI induced Bruxism and that he is concerned abut my weight.
I'm gonna wait and see. If I don't feel comfortable with his answers I will not hesitate to find another pdoc even though I hate the interviewing process.
Take Care &
Thanks,
Simcha
Posted by Dinah on October 14, 2002, at 6:57:19
In reply to Re: PDoc wants me off Klonopin -- Neurontin or Topamax » Dinah, posted by Simcha on October 13, 2002, at 21:28:46
Sounds like a sensible and well-reasoned response. I hope it goes well.
Dinah
Posted by Willow on October 14, 2002, at 12:33:43
In reply to Re: PDoc wants me off Klonopin -- Neurontin or Topamax » Dinah, posted by Simcha on October 13, 2002, at 21:28:46
I think we've discussed baclofen before concering this but I can't remember where it led. Has your doc mentioned it? I take 5-10mg at bedtime and it really helps me with muscle problems along the jaw area.
Willow
Posted by Simcha on October 15, 2002, at 0:33:47
In reply to Simcha?, posted by Willow on October 14, 2002, at 12:33:43
Willow,
I don't remember discussing Baclofen with you. I'm not even sure what it is. I guess I have more research to do.. Thanks for the information.
Simcha
This is the end of the thread.
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