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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 25. This is the beginning of the thread.
Posted by freedom2001 on March 3, 2003, at 3:55:29
Hi,
I'm taking 80 mg prozac and 1 mg of clonopin (clonazepam) for OCD, as well as 5000mg of EPA+DHA fish oil and 50 mg trazodone for sleeping at night.
Please tell me what EFFECTIVE DOSAGE of Klonopin should I take since 1 mg doesn't seem to help much.....
BTW, I went to my pentecostal power Jesus Healing Night and after the laying of hands by a minister, that night, my OCD decreases by 99-100%.
By the next morning, my obsessions and compulsions
decreases by at least 85% or more.But I'm SCARED that they will come back so I need to know how MUCH klonopin should I take to maintain my 85% improvement.
Thanks!
Posted by Phil on March 3, 2003, at 8:03:20
In reply to CLONAZEPAM AND OCD. PLS HELP!!!!!!! URGENT HELP!!!, posted by freedom2001 on March 3, 2003, at 3:55:29
That's a question for your doctor.
Everyone is different and it would be irresponsible for us to set your med levels. Tell your doc your syptoms.P
Posted by dave1 on March 3, 2003, at 12:23:55
In reply to CLONAZEPAM AND OCD. PLS HELP!!!!!!! URGENT HELP!!!, posted by freedom2001 on March 3, 2003, at 3:55:29
Hi,
I looked in a book and it says the daily dose is between .5mg-4mg. You probably would divide that into several doses during the day. But, certainly consult your doctor and tell him you read about the doses in a book if there is a problem.
Usually when you reduce stress or anxiety it reduces your OCD symptoms. I don't think the clonazepam directly reduces it but reduces your anxiety which reduces your OCD. When you do your religious stuff it probably makes you less anxious and that, not the medicine, reduces your OCD.
Dave
Posted by freedom2001 on March 3, 2003, at 19:18:14
In reply to Re: CLONAZEPAM AND OCD. PLS HELP!!!!!!! URGENT HELP!!!, posted by dave1 on March 3, 2003, at 12:23:55
> Hi,
>
> I looked in a book and it says the daily dose is between .5mg-4mg. You probably would divide that into several doses during the day. But, certainly consult your doctor and tell him you read about the doses in a book if there is a problem.
>
> Usually when you reduce stress or anxiety it reduces your OCD symptoms. I don't think the clonazepam directly reduces it but reduces your anxiety which reduces your OCD. When you do your religious stuff it probably makes you less anxious and that, not the medicine, reduces your OCD.
>
> DaveHi,
which book are you referring to?My dosage is as follows:
morning 8 am
40 mg generic prozac
0.5 mg klonopin
2000mg EPA+DHA fish oilsafternoon 12 pm
40 mg generic prozac
0.5 mg klonopin
2000mg EPA+DHA fish oils3pm
1000mg EPA+DHA fish oils
ADD 0.5mg Klonopin(?????)Any suggestions or opinions on whether to add 0.5mg of klonopin at 3pm would be most appreciated.
OR what about upping the generic prozac to 100mg a day?
I also read that TOO MUCH klonopin renders CBT ineffective!!??? Is that true???
Sometimes there are so many conflicting data on the internet.
Posted by dave1 on March 3, 2003, at 22:03:43
In reply to Re: CLONAZEPAM AND OCD. PLS HELP!!!!!!! URGENT HELP!!! » dave1, posted by freedom2001 on March 3, 2003, at 19:18:14
Hi,
I guess I don't know too much about your situation, and not being your pdoc, shouldn't make specific dosage recommendations. In my case I take about 4mg ativan a day which my pdoc knows about. The book says I should take between 2-6mg a day. I try to take only 1 mg at a time but if I feel really freaked out I might take 1.5mg or 2mg just once during the day. I certainly wouldn't go over 6mg a day total since that is the maximum listed. By the way, most pdocs I've talked to would say 6mg a day is too much. In your case with klonopin, which I haven't taken in years, you have to convert the dosage so like me taking 1 mg ativan 3 times a day would be like you taking .5mg klonopin 3 times a day. So if you took 1mg klonopin once during the day and .5mg at other times maybe that would be okay. You have experiment a little, but tell your pdoc, you don't want to self medicate. Also, remember that I take ativan more for general anxiety, then for OCD.
Regarding Prozac, isn't 80mg a day the maximum. Probably the best source of dosages other than your pdoc is the physician's desk reference - PDR. They have an internet site which I'm sure you can find and maybe look up Prozac.
Maybe a helpful chat room for you would be -
http://groups.yahoo.com/group/ocd-support/
It has OCD sufferers and more importantly a psychologist and psychiatrist answering posts. The psychiatrist is probably the best known OCD doctor in the world.
The book I was refering to is called 'MANUAL OF PSYCHIATRIC THERAPEUTICS' edited by Richard I. Shader. I think it is a decent book, but I really don't know.
Luck,
Dave
Posted by exbenzouser on March 3, 2003, at 22:09:55
In reply to Re: CLONAZEPAM AND OCD. PLS HELP!!!!!!! URGENT HELP!!! » dave1, posted by freedom2001 on March 3, 2003, at 19:18:14
> Any suggestions or opinions on whether to add 0.5mg of klonopin at 3pm would be most appreciated.
When I was on it, I took a morning and evening dose which is probably best as far as keeping the blood level fairly constant. Klonopin has an elimination half life of 30-40 hours.
Larry
Posted by dave1 on March 3, 2003, at 22:33:01
In reply to Re: CLONAZEPAM AND OCD. PLS HELP!!!!!!! URGENT HELP!!!, posted by exbenzouser on March 3, 2003, at 22:09:55
I agree with Larry. Ativan is much shorter acting so I have to take it more often and it doesn't build up as much
Dave
Posted by freedom2001 on March 3, 2003, at 23:21:56
In reply to Re: CLONAZEPAM AND OCD. PLS HELP!!!!!!! URGENT HELP!!!, posted by dave1 on March 3, 2003, at 22:33:01
> I agree with Larry. Ativan is much shorter acting so I have to take it more often and it doesn't build up as much
>
> Davewhat you guys think of these reports? I counted 13 success stories in here....
As of 1994 there are reports of six adults for whom clonazepam successfully treated their OCD. In five of these cases clonazepam was used alone. In the sixth it was used as an augmentation agent. In 1987 Cohen and Rosenbaum reported a patient with OCD, and no other anxiety disorder, who responded partially to imipramine. This patient improved significantly with clonazepam augmentation. This response discontinued after the clonazepam was stopped, and returned once the augmentation had begun again. A second patient, with both OCD and panic disorder, experienced a total remission of symptoms while on clonazepam, according to Bodkin and White in 1989. In 1990 Bacher reported the successful use of clonazepam in a 60-year old man for whom other benzodiazepines had been ineffective. Hewlett studied 3 OCD patients who responded to clonazepam in 1990. When two of these patients discontinued the drug treatment they experienced significant relapse of the OCD symptoms.
In 1993 Ross and Piggott reported using clonazepam in the successful treatment of a 14-year old male OCD patient. The boy had previously failed trials of clomipramine, thioridazine, diazepam, and fluoxetine. "To our knowledge, this current case study represents the youngest individual to receive clonazepam augmentation of serotonin reuptake blocking medications. It is also the first report of the long-term outcome of a patient receiving such augmentation. In addition, the patient in this study had complete remission of his obsessive-compulsive symptoms after an overdose of fluoxetine, which raises interesting questions about therapeutic mechanisms.(Allen, p.793.)" He was symptom free for 1 month after the overdose but slowly his OCD symptoms began to return to their previous severity. This patient was then started on fluoxetine therapy, then on fluvoxamine, and finally concurrently with fluoxetine and buspirone. None of these medication regiments were successful in effectively alleviating his OCD symptoms. At the age of 20 the patient's buspirone was discontinued, and clonazepam was instituted as the augmenting agent. Within 1 month he noticed a 75% reduction in the severity of his symptoms. The results of this case indicate that clonazepam may be considered as an augmentation agent to the serotonin reuptake inhibitor medications for treating OCD.
Posted by ace on March 4, 2003, at 0:36:00
In reply to CLONAZEPAM AND OCD. PLS HELP!!!!!!! URGENT HELP!!!, posted by freedom2001 on March 3, 2003, at 3:55:29
> Hi,
>
> I'm taking 80 mg prozac and 1 mg of clonopin (clonazepam) for OCD, as well as 5000mg of EPA+DHA fish oil and 50 mg trazodone for sleeping at night.
>
> Please tell me what EFFECTIVE DOSAGE of Klonopin should I take since 1 mg doesn't seem to help much.....
>
> BTW, I went to my pentecostal power Jesus Healing Night and after the laying of hands by a minister, that night, my OCD decreases by 99-100%.
>
> By the next morning, my obsessions and compulsions
> decreases by at least 85% or more.
>
> But I'm SCARED that they will come back so I need to know how MUCH klonopin should I take to maintain my 85% improvement.
>
> Thanks!
I wouldn't really be on clonazepam for OCD, freedom. Maybe you need to consider Anafranil. This wipes out OCD cold in a lot of people. Also, how about augmenting your prozac with zyprexa or risperidone? As far as I know Clonazepam is a benzo used as a anti-convulsant.But do you really think it helps? I might try it.
Be Safe,
Ace.
Posted by dave1 on March 4, 2003, at 0:50:15
In reply to Re: CLONAZEPAM AND OCD. PLS HELP!!!!!!! URGENT HELP!!! » dave1, posted by freedom2001 on March 3, 2003, at 23:21:56
Hi,
I will have to look into this more. I usually use PUBMED or put a post on that other website.
Dave
Posted by dave1 on March 4, 2003, at 1:07:55
In reply to Re: CLONAZEPAM AND OCD. PLS HELP!!!!!!! URGENT HELP!!!, posted by dave1 on March 4, 2003, at 0:50:15
" We usually go to 80mg per day and i have gone as high as 120mg per day
without problems. For OCD, higher dosages are usually required.Best wishes! "
I stumbled on this from the other website and wanted to post it before I forgot
Dave
Posted by dave1 on March 4, 2003, at 1:27:14
In reply to Re: CLONAZEPAM AND OCD. PLS HELP!!!!!!! URGENT HELP!!!, posted by dave1 on March 4, 2003, at 1:07:55
HI again,
I can't sleep so I keep doing research and posting what I find (you shouldn't have got me started - ha, ha). Here's what I found on augmentation from www.ocfoundation.org in the drug section.
" Other drugs are sometimes combined with ongoing SRI medications. Some that have commonly been used include the following: buspirone (Buspar), lithium carbonate (Eskalith), clonazepam (Klonopin), methylphenidate (Ritalin), fenfluramine (Pondamin), and other antidepressants (e.g., trazodone, bupropion, desipramine, etc.). The controlled trials that have been done with these augmenting agents have been largely disappointing, but since occasional patients respond to the addition of a second drug, clinicians frequently try this technique. "Dave
Posted by Dr. Bob on March 4, 2003, at 8:46:35
In reply to Re: CLONAZEPAM AND OCD. PLS HELP!!!!!!! URGENT HELP!!!, posted by dave1 on March 3, 2003, at 22:03:43
> The book I was refering to is called 'MANUAL OF PSYCHIATRIC THERAPEUTICS' edited by Richard I. Shader. I think it is a decent book, but I really don't know.
I'd just like to plug the double double quotes feature:
http://www.dr-bob.org/babble/faq.html#amazon
But I don't mean to be pushy. Did you deliberately not use it to link to Amazon? If so, I'd be interested in why, over at Psycho-Babble Administration:
http://www.dr-bob.org/babble/admin/20020918/msgs/7717.html
Thanks!
Bob
Posted by freedom2001 on March 4, 2003, at 20:10:03
In reply to Re: CLONAZEPAM AND OCD. PLS HELP!!!!!!! URGENT HELP!!! » freedom2001, posted by ace on March 4, 2003, at 0:36:00
> > Hi,
> >
> > I'm taking 80 mg prozac and 1 mg of clonopin (clonazepam) for OCD, as well as 5000mg of EPA+DHA fish oil and 50 mg trazodone for sleeping at night.
> >
> > Please tell me what EFFECTIVE DOSAGE of Klonopin should I take since 1 mg doesn't seem to help much.....
> >
> > BTW, I went to my pentecostal power Jesus Healing Night and after the laying of hands by a minister, that night, my OCD decreases by 99-100%.
> >
> > By the next morning, my obsessions and compulsions
> > decreases by at least 85% or more.
> >
> > But I'm SCARED that they will come back so I need to know how MUCH klonopin should I take to maintain my 85% improvement.
> >
> > Thanks!
>
>
>
Hi
>
> I wouldn't really be on clonazepam for OCD, freedom. Maybe you need to consider Anafranil. This wipes out OCD cold in a lot of people.I've tried anafranil 200mg for 2 months in the past, no results.
Also, how about augmenting your prozac with zyprexa or risperidone?
risperidone almost "killed" me, in a sense. I took the lowest dosage and suddenly I found myself on the bed, unable to get up at all for the next 1 hour, with wicked shaking of my hands. It was horrible and I have to stop immediately.
As far as I know Clonazepam is a benzo used as a anti-convulsant.
It appears that clonazepam is slightly different from other bezos as it acts on the serotogenic system as well in a different way compared to prozac.
>
> But do you really think it helps? I might try it.Based on the 13 success stories I've listed in this thread, I think it will help.
>
> Be Safe,
> Ace.Thanks.
Posted by freedom2001 on March 4, 2003, at 20:15:08
In reply to Re: CLONAZEPAM AND OCD. PLS HELP!!!!!!! URGENT HELP!!!, posted by dave1 on March 4, 2003, at 1:07:55
> " We usually go to 80mg per day and i have gone as high as 120mg per day
> without problems. For OCD, higher dosages are usually required.
>
> Best wishes! "
>
> I stumbled on this from the other website and wanted to post it before I forgot
Hmm.....so maybe I should take
at 8 am,
40 mg generic prozac
0.5mg clonazepam
2000 EPA/DHA fish oilat 12 pm
40 mg generic prozac
0.5 mg clonazepam
2000 EPA/DHA fish oilat 3pm
EXTRA 20 MG generic prozac (??)
EXTRA 0.5 mg clonazepam (??)
1000 EPA/DHA fish oilSo the total amount of prozac I will be taking per day would be 100 mg.
I wonder whether I should up my prozac to 100mg/day.
What do you think?
>
> Dave
Posted by ace on March 4, 2003, at 23:12:42
In reply to Re: CLONAZEPAM AND OCD. PLS HELP!!!!!!! URGENT HELP!!! » freedom2001 » ace, posted by freedom2001 on March 4, 2003, at 20:10:03
> > > Hi,
> > >
> > > I'm taking 80 mg prozac and 1 mg of clonopin (clonazepam) for OCD, as well as 5000mg of EPA+DHA fish oil and 50 mg trazodone for sleeping at night.
> > >
> > > Please tell me what EFFECTIVE DOSAGE of Klonopin should I take since 1 mg doesn't seem to help much.....
> > >
> > > BTW, I went to my pentecostal power Jesus Healing Night and after the laying of hands by a minister, that night, my OCD decreases by 99-100%.
> > >
> > > By the next morning, my obsessions and compulsions
> > > decreases by at least 85% or more.
> > >
> > > But I'm SCARED that they will come back so I need to know how MUCH klonopin should I take to maintain my 85% improvement.
> > >
> > > Thanks!
> >
> >
> >
> Hi
> >
> > I wouldn't really be on clonazepam for OCD, freedom. Maybe you need to consider Anafranil. This wipes out OCD cold in a lot of people.
>
> I've tried anafranil 200mg for 2 months in the past, no results.
>
> Also, how about augmenting your prozac with zyprexa or risperidone?
>
> risperidone almost "killed" me, in a sense. I took the lowest dosage and suddenly I found myself on the bed, unable to get up at all for the next 1 hour, with wicked shaking of my hands. It was horrible and I have to stop immediately.
>
> As far as I know Clonazepam is a benzo used as a anti-convulsant.
>
> It appears that clonazepam is slightly different from other bezos as it acts on the serotogenic system as well in a different way compared to prozac.
> >
> > But do you really think it helps? I might try it.
>
> Based on the 13 success stories I've listed in this thread, I think it will help.
> >
> > Be Safe,
> > Ace.
>
> Thanks.I'm in a huge hurry now and I will answer your qstn better but 8 weeks on 200 mg Clomipramine (Anafranil) is simply not long enough. You need at least 10-12 weeks.
Ace.
Posted by Dave1 on March 5, 2003, at 3:19:03
In reply to Re: CLONAZEPAM AND OCD. PLS HELP!!!!!!! URGENT HELP!!! » dave1, posted by freedom2001 on March 4, 2003, at 20:15:08
Hi,
Gee I don't know. You should really consult with your pdoc about this. One pdoc did tell me that going 20% higher than the PDR maximum is generally acceptable.
What does your pdoc think about all this. How often do you see him? I hope you are not doing all this on your own (self-medicating).
Also, it seemed like your fish oil was high. A pdoc from Stanford told me to take 1000mg twice a day, but I really don't know much about it.
Dave
Posted by Dave1 on March 5, 2003, at 3:24:30
In reply to Re: CLONAZEPAM AND OCD. PLS HELP!!!!!!! URGENT HELP!!! » freedom2001, posted by ace on March 4, 2003, at 23:12:42
Hi,
Why is that you have try these AD's for 3 months when the therapeutic level is reached with one month?
Thanks,
Dave
Posted by ace on March 5, 2003, at 20:51:54
In reply to Re: CLONAZEPAM AND OCD. PLS HELP!!!!!!! URGENT HELP!!! » ace, posted by Dave1 on March 5, 2003, at 3:24:30
> Hi,
>
> Why is that you have try these AD's for 3 months when the therapeutic level is reached with one month?
>
> Thanks,
>
> Dave
As Far as i remeber this chap was refering to OCD. Depression is 2-6 weeks. OCD is 12 weeks+ I don't really know why but it is scattered everywher in the medical literature.Ace.
Posted by dave1 on March 5, 2003, at 22:38:17
In reply to Re: CLONAZEPAM AND OCD. PLS HELP!!!!!!! URGENT HELP!!! » Dave1, posted by ace on March 5, 2003, at 20:51:54
Thanks,
Its amazing how much I learn from these chat rooms that my pdoc either never told me or never bothered to apply. I was recently on effexor for a month and then stopped it because it didn't help my depression. Now, I have to go back and try it for 3 months to see if it clears up my OCD (its supposed to have an ssri component/action).
By the way, do you know the normal test time for the antipsychotics?
Bye,
Dave
Posted by ace on March 6, 2003, at 1:27:40
In reply to Re: CLONAZEPAM AND OCD. PLS HELP!!!!!!! URGENT HELP!!! » ace, posted by dave1 on March 5, 2003, at 22:38:17
> Thanks,
>
> Its amazing how much I learn from these chat rooms that my pdoc either never told me or never bothered to apply. I was recently on effexor for a month and then stopped it because it didn't help my depression. Now, I have to go back and try it for 3 months to see if it clears up my OCD (its supposed to have an ssri component/action).
>
> By the way, do you know the normal test time for the antipsychotics?
>
> Bye,
>
> DaveI've read EXTENSIVELY on OCD -- thousands and thousands of pages. I don't care if this sounds egotistical, but I know a lot more than your average pdoc on OCD. Antipsychotics kick in faster but still need a trial.
But seriously, 8 weeks on Anafranil...you pulled out weigh to early...you need at least 10-12 weeks. I've heard cases in the literature where it takes longer. But when it works...boy, let's just say you won't have OCD at all.
ANY drug used for OCD which is an antidepressent NEEDS 10-12 weeks. I am on my 13 week of Nardil and it is still clearing up. Each day it does more. In 4 more weeks at 120mg I doubt there will be ANY OCD. Also remember high dose is needed i.e. 300mg of Anafranil for 10-12 weeks.
Any more qstns welcome...
Ace.
Posted by freedom2001 on March 6, 2003, at 1:56:16
In reply to Re: CLONAZEPAM AND OCD. PLS HELP!!!!!!! URGENT HELP!!! » dave1, posted by ace on March 6, 2003, at 1:27:40
> > Thanks,
> >
> > Its amazing how much I learn from these chat rooms that my pdoc either never told me or never bothered to apply. I was recently on effexor for a month and then stopped it because it didn't help my depression. Now, I have to go back and try it for 3 months to see if it clears up my OCD (its supposed to have an ssri component/action).
> >
> > By the way, do you know the normal test time for the antipsychotics?
> >
> > Bye,
> >
> > Dave
>
> I've read EXTENSIVELY on OCD -- thousands and thousands of pages. I don't care if this sounds egotistical, but I know a lot more than your average pdoc on OCD. Antipsychotics kick in faster but still need a trial.
>
> But seriously, 8 weeks on Anafranil...you pulled out weigh to early...you need at least 10-12 weeks. I've heard cases in the literature where it takes longer. But when it works...boy, let's just say you won't have OCD at all.
>
> ANY drug used for OCD which is an antidepressent NEEDS 10-12 weeks. I am on my 13 week of Nardil and it is still clearing up. Each day it does more. In 4 more weeks at 120mg I doubt there will be ANY OCD. Also remember high dose is needed i.e. 300mg of Anafranil for 10-12 weeks.
>
> Any more qstns welcome...
>
> Ace.Hi, I'm on 80 mg generic Prozac, 1 mg clonazepam and 50mg trazodone at night. Shall I up the prozac, clonazepam and trazodone dose? cos sometimes the OCD get bad, then it get better..... If yes, by how much?
or shall I add a small dose of Anafranil to my prozac??????
Posted by Dave1 on March 6, 2003, at 9:55:24
In reply to Re: CLONAZEPAM AND OCD. PLS HELP!!!!!!! URGENT HELP!!! » ace, posted by freedom2001 on March 6, 2003, at 1:56:16
HI,
It sound like you are obsessing about your medications. Maybe you should see your pdoc, decide on dosages and then try to think of something else.
Dave
Posted by freedom2001 on March 6, 2003, at 20:59:25
In reply to Re: CLONAZEPAM AND OCD. PLS HELP!!!!!!! URGENT HELP!!!, posted by Dave1 on March 6, 2003, at 9:55:24
> HI,
>
> It sound like you are obsessing about your medications. Maybe you should see your pdoc, decide on dosages and then try to think of something else.
>
> Dave
Hi,I just ran out of clonazepam. So I'm taking 3 xanax (0.75mg total) a day to replace my 2 clonazepam (1 mg) a day until I see my doc 5 days later...I hope everything will be okay....
Posted by Dav e1 on March 7, 2003, at 9:26:25
In reply to Re: CLONAZEPAM AND OCD. PLS HELP!!!!!!! URGENT HELP!!! » Dave1, posted by freedom2001 on March 6, 2003, at 20:59:25
I think everything will be fine. I looked in my book and the XANAX dosage looked good. You probably will feel it faster and stronger than the klonopin since it is shorter acting.
Luck,
Dave
This is the end of the thread.
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