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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 17 to 41 of 47. Go back in thread:
Posted by Viridis on June 15, 2003, at 0:37:23
In reply to Re: valium vs klonopin? » avid abulia, posted by Chloe on June 14, 2003, at 17:20:24
Hi again Chloe,
I'm very prone to mixed states -- intense depression coupled with severe, obsessive anxiety. The anxiety usually comes first, then the depression spiral. During these times, I am almost completely unable to eat or sleep. I used to experience this several times a year (since I was a child, so we're talking 30+ years). Others in my family have similar problems.
Although things aren't perfect, I haven't had a major episode of this kind since starting Klonopin. My pdoc says it has some mood-stabilizing effects, and is impressed with how much it's helped me at what he considers a very low dose. He'd like me to stay with it indefinitely, and considers it very safe when used responsibly.
I find that K is a great antidepressant for anxiety-induced depression/agitation. Xanax is also a mood elevator for me, but more than about 0.5 mg makes me very sleepy, so its dosage is self-limiting in my case, and I use it only as an occasional adjunct.
BTW, fish oil also seems to help; I take about 6-8 g/day, for about 1.2 g EPA (which appears to be the most important component). It's a healthy thing to do anyway, for many reasons (e.g., cardiovascular benefits etc.), so you might consider adding this. I do not find it substitutes for the meds, but does seem to provide a bit of additional stability.
Posted by Ritch on June 15, 2003, at 9:39:23
In reply to Re: valium vs klonopin? » Ritch, posted by Chloe on June 14, 2003, at 17:17:06
> Hi Mitch,
> It's funny you mention Ativan and Xanax. They didn't bring me down! I had a paradoxical reaction to ativan, and Xanax made me feel like I could (safely) jump out of my college 8th floor window. I was so sure I could make it!...
>
> Yes, I am sure there are some benzo's that have less of a depressive effect. But it seems that Klonopin could perhaps put the brakes on a mixed state episode? Valium doesn't touch mixed states or severe agitation. However, I wonder if my pdoc is just going to tell me to take more Valium? Can a benzo poop out after decades? I have taken it for so long, do you think switching will be difficul? I feel so anxious already. I don't want to make it worse!
>
> I don't understand it. I was sleeping GREAT, and feeling really calm, with little distorted thinking and agitation until about a month ago. Now things have shifted in a really negative way.
> Ugh, sorry to bore you. I guess I really don't like summer...(even though the weather has been extremely cool and raw).
> Take care,
> Chloe
>
>
Hi Chloe, when you had your "paradoxical reaction" to Ativan-what exactly happened? Did you get hypo on it? Just wondering because I might ask my pdoc at some point about switching from Klon to Ativan. I was just given a few tabs of Ativan as samples for panic related to flying. It worked really well, but I took my baggage to an obviously wrong place (to MOST people) at the airport and the baggage dudes all laughed at me-it WAS pretty funny.I think you are right about Klonopin "putting the brakes on a mixed-state episode". If I get like that usually 1.0mg/day (up from .5mg/day) for a couple of days will take care of it-just feel a little tired. You might just ask your pdoc for a trial script of clonazepam (and try to get the dose equivalence to your valium right) and swap it out for a while and see how it goes-if it gets worse-switch back. Let us know what happens---take care--- Mitch
Posted by Chloe on June 15, 2003, at 22:05:19
In reply to Re: valium vs klonopin? » Chloe, posted by Ritch on June 15, 2003, at 9:39:23
> Hi Chloe, when you had your "paradoxical reaction" to Ativan-what exactly happened? Did you get hypo on it? Just wondering because I might ask my pdoc at some point about switching from Klon to Ativan. I was just given a few tabs of Ativan as samples for panic related to flying. It worked really well, but I took my baggage to an obviously wrong place (to MOST people) at the airport and the baggage dudes all laughed at me-it WAS pretty funny.
Hi Mitch,
That airport story is funny! Maybe your next trial could be in a less stressful environment.
My Ativan trial (I looked it up) was in 1990. I wrote that I had severe anxiety and activation. I couldn't be still, pacing, etc. It does have a shorter half life than klonopin. So you might notice when it's wearing off if you don't take it regularly.
> I think you are right about Klonopin "putting the brakes on a mixed-state episode". If I get like that usually 1.0mg/day (up from .5mg/day) for a couple of days will take care of it-just feel a little tired. You might just ask your pdoc for a trial script of clonazepam (and try to get the dose equivalence to your valium right) and swap it out for a while and see how it goes-if it gets worse-switch back. Let us know what happens---take care--- MitchThanks-I have an appointment this thursday. So we will see how it goes. I am impressed though, that upping my Valium by 5mgs/day has had little effect on anxiety and mixed states. I am not sedated at all, like I have feared if I am at work, and I still feel so keyed up, like my heart is racing a bit. I wonder if that is related to the thyroid stuff that I can't seem to get an endo appt for! Hopefully thursday I can get a slip to get labs drawn too.
Chloe
Posted by Chloe on June 15, 2003, at 22:17:54
In reply to Re: valium vs klonopin -- mixed states » Chloe, posted by Viridis on June 15, 2003, at 0:37:23
> Hi again Chloe,
>
> I'm very prone to mixed states -- intense depression coupled with severe, obsessive anxiety. The anxiety usually comes first, then the depression spiral. During these times, I am almost completely unable to eat or sleep. I used to experience this several times a year (since I was a child, so we're talking 30+ years). Others in my family have similar problems.
>
> Although things aren't perfect, I haven't had a major episode of this kind since starting Klonopin. My pdoc says it has some mood-stabilizing effects, and is impressed with how much it's helped me at what he considers a very low dose. He'd like me to stay with it indefinitely, and considers it very safe when used responsibly.
>
> I find that K is a great antidepressant for anxiety-induced depression/agitation. Xanax is also a mood elevator for me, but more than about 0.5 mg makes me very sleepy, so its dosage is self-limiting in my case, and I use it only as an occasional adjunct.
>
> BTW, fish oil also seems to help; I take about 6-8 g/day, for about 1.2 g EPA (which appears to be the most important component). It's a healthy thing to do anyway, for many reasons (e.g., cardiovascular benefits etc.), so you might consider adding this. I do not find it substitutes for the meds, but does seem to provide a bit of additional stability.Thanks this is very useful. I am so glad to see a benzo used when an AP might be prescribed. K is much safer and much less side effects.
Wow, that is alot of fish oil. I did take 1 or 2 capsules for a while, but couldn't stand the "fish burps"! Yack! I do take a tbs of flaxseed oil day, however, I know that has alot of the omega 3-6-9, but I am unsure if it has any EPA. Flaxseed oil is quite palatable, and heart healthy too. Not sure if it helps mood. I hope so, I love it!
Take care,
Chloe
Posted by Viridis on June 16, 2003, at 2:01:28
In reply to Re: valium vs klonopin -- mixed states » Viridis, posted by Chloe on June 15, 2003, at 22:17:54
Hi Chloe,
Another oil that I really like is hemp oil. It has a nice, nutty taste, and is the closest to fish oil you can get from a vegetable source. It's great in salad dressing (can't be heated, so no good for cooking). The best prices I've found are at www.iherb.com (but it is still kind of expensive).
Re: real meds; give Klonopin a try -- at least for a couple of weeks, because you will probably need to get used to it (then no side effects at all, for me at least). Avoid the APs if you can; my impression is that these carry risks that don't occur with benzos. Benzos are great, because despite all the nonsense you see, they're extremely safe,clean meds. It's just that they're off-patent, so too inxpensive to warrant promotion.
Posted by Ritch on June 16, 2003, at 9:43:12
In reply to Re: valium vs klonopin? » Ritch, posted by Chloe on June 15, 2003, at 22:05:19
> > Hi Chloe, when you had your "paradoxical reaction" to Ativan-what exactly happened? Did you get hypo on it? Just wondering because I might ask my pdoc at some point about switching from Klon to Ativan. I was just given a few tabs of Ativan as samples for panic related to flying. It worked really well, but I took my baggage to an obviously wrong place (to MOST people) at the airport and the baggage dudes all laughed at me-it WAS pretty funny.
>
> Hi Mitch,
> That airport story is funny! Maybe your next trial could be in a less stressful environment.
> My Ativan trial (I looked it up) was in 1990. I wrote that I had severe anxiety and activation. I couldn't be still, pacing, etc. It does have a shorter half life than klonopin. So you might notice when it's wearing off if you don't take it regularly.
>
> > I think you are right about Klonopin "putting the brakes on a mixed-state episode". If I get like that usually 1.0mg/day (up from .5mg/day) for a couple of days will take care of it-just feel a little tired. You might just ask your pdoc for a trial script of clonazepam (and try to get the dose equivalence to your valium right) and swap it out for a while and see how it goes-if it gets worse-switch back. Let us know what happens---take care--- Mitch
>
> Thanks-I have an appointment this thursday. So we will see how it goes. I am impressed though, that upping my Valium by 5mgs/day has had little effect on anxiety and mixed states. I am not sedated at all, like I have feared if I am at work, and I still feel so keyed up, like my heart is racing a bit. I wonder if that is related to the thyroid stuff that I can't seem to get an endo appt for! Hopefully thursday I can get a slip to get labs drawn too.
> Chloe
>
>Chloe, the short half-life (12 hrs?) of Ativan (lorazepam) might be a problem for sure. The only other benzos I've taken chronically previously were chlordiazepoxide (Librium) and Valium and they both last much longer. OTOH, if I just take it at bedtime for sleep, and don't find the rebound anxiety (or rebound hypomania) annoying during the day that would suit me find. Too bad you had that paradoxical reaction-interesting that you didn't have that trouble with *others*. I am wondering about your thyroid situation as well. You may need to get an endocrinologist involved with your pdoc to straighten those out. Let us know how your appt. goes with the pdoc about the Klonopin----good luck---Mitch
Posted by chloe on June 16, 2003, at 11:21:41
In reply to Re: valium vs klonopin -- mixed states, posted by Viridis on June 16, 2003, at 2:01:28
>
> Another oil that I really like is hemp oil. It has a nice, nutty taste, and is the closest to fish oil you can get from a vegetable source. It's great in salad dressing (can't be heated, so no good for cooking). The best prices I've found are at www.iherb.com (but it is still kind of expensive).Hi,
Hemp oil sounds alot like faxseed oil, nutty flavor and you can't heat it. I am assuming it has EPA where FS Oil doesnt? I will look into it. I use Barlean's Flax seed oil. It's unbelievable expensive so I buy 32oz size and store unused in the freezer. I will give you the link if you are interested, though I don't think they sell hemp oil... :http://www.barleans.com/products/oils.html
>
> Re: real meds; give Klonopin a try -- at least for a couple of weeks, because you will probably need to get used to it (then no side effects at all, for me at least). Avoid the APs if you can; my impression is that these carry risks that don't occur with benzos. Benzos are great, because despite all the nonsense you see, they're extremely safe,clean meds. It's just that they're off-patent, so too inxpensive to warrant promotion.Your last sentence is interesting...
Yes, I try to avoid AP's at all costs. I take them only when necessary, about once a week when the suicadal thoughts get out of control or my thinking is so skewed, I can't understand people. I can get very paranoid. But I also have permanent tongue movements and bruxism from use of APs over the years. SOO, I am hoping a "better" benzo might keep me from going up or down so much that I end up in a scary mixed state. I bet my pdoc goes for it and I can give K a try...I'll know on thursday.
Thanks alot,
Chloe>
Posted by chloe on June 16, 2003, at 11:36:04
In reply to Re: valium vs klonopin? » Chloe, posted by Ritch on June 16, 2003, at 9:43:12
> Chloe, the short half-life (12 hrs?) of Ativan (lorazepam) might be a problem for sure. The only other benzos I've taken chronically previously were chlordiazepoxide (Librium) and Valium and they both last much longer. OTOH, if I just take it at bedtime for sleep, and don't find the rebound anxiety (or rebound hypomania) annoying during the day that would suit me find. Too bad you had that paradoxical reaction-interesting that you didn't have that trouble with *others*. I am wondering about your thyroid situation as well. You may need to get an endocrinologist involved with your pdoc to straighten those out. Let us know how your appt. goes with the pdoc about the Klonopin----good luck---Mitch
Hi Mitch,
I think Lorazapam has a half life of about 8-24 hours, depending on how you metabolize it. It also peaks in 3-4 hours. So, like you said, perhaps taking it at night, you could avoid any rebound or crash. I believe, for the "average" user!, it is far less sedating and depressive than librium, valium or klonopin.Do you see you med person soon? I know you are thinking about also adding some lamictal (eventually) to the mix too...
Chloe
Posted by Ritch on June 16, 2003, at 13:16:57
In reply to Re: valium vs klonopin? » Ritch, posted by chloe on June 16, 2003, at 11:36:04
> > Chloe, the short half-life (12 hrs?) of Ativan (lorazepam) might be a problem for sure. The only other benzos I've taken chronically previously were chlordiazepoxide (Librium) and Valium and they both last much longer. OTOH, if I just take it at bedtime for sleep, and don't find the rebound anxiety (or rebound hypomania) annoying during the day that would suit me find. Too bad you had that paradoxical reaction-interesting that you didn't have that trouble with *others*. I am wondering about your thyroid situation as well. You may need to get an endocrinologist involved with your pdoc to straighten those out. Let us know how your appt. goes with the pdoc about the Klonopin----good luck---Mitch
>
> Hi Mitch,
> I think Lorazapam has a half life of about 8-24 hours, depending on how you metabolize it. It also peaks in 3-4 hours. So, like you said, perhaps taking it at night, you could avoid any rebound or crash. I believe, for the "average" user!, it is far less sedating and depressive than librium, valium or klonopin.
>
> Do you see you med person soon? I know you are thinking about also adding some lamictal (eventually) to the mix too...
> Chloe
Chloe, I'm holding with Depakote 250mg ER + Klonopin .5mg HS, and a microdose of Effexor in the AM, and added 3.75mg buspirone last visit as an experiment for GAD sx and to boost the Effexor (without needing to increase it). It made my early morning awakening WORSE when I took it at bedtime. Switched to taking it only first thing in the AM. That has helped some. I will give it a full two-three weeks and if there isn't a clear trend towards improving sleep (startup effects?), it is going to get ditched. Then perhaps we'll talk about the possible lorazepam switch. I have a feeling that using low-dose lorazepam as a sleeper will work better than the clon. and I will have more energy the next day. Lamictal? I don't want to tinker with that idea until this upcoming spell is fully over with (when I'm stable in the fall). I'm already gaining weight and having carb craving, YUCK!
Posted by chloe on June 16, 2003, at 20:13:21
In reply to Re: valium vs klonopin? » chloe, posted by Ritch on June 16, 2003, at 13:16:57
> Chloe, I'm holding with Depakote 250mg ER + Klonopin .5mg HS, and a microdose of Effexor in the AM, and added 3.75mg buspirone last visit as an experiment for GAD sx and to boost the Effexor (without needing to increase it). It made my early morning awakening WORSE when I took it at bedtime. Switched to taking it only first thing in the AM. That has helped some. I will give it a full two-three weeks and if there isn't a clear trend towards improving sleep (startup effects?), it is going to get ditched. Then perhaps we'll talk about the possible lorazepam switch. I have a feeling that using low-dose lorazepam as a sleeper will work better than the clon. and I will have more energy the next day. Lamictal? I don't want to tinker with that idea until this upcoming spell is fully over with (when I'm stable in the fall). I'm already gaining weight and having carb craving, YUCK!
Hi Mitch,
It seems all the rules that held true during the spring, emotionally, no longer apply, at least for me. Could some of the increased E.M waking also have to do with the increased amount of daylight? I awaken as soon as the sun emerges over the horizon, and now that's about 4:58 am UUGH! In the winter I can sleep til 10 am without stirring once. That is a gift!Yes, I would wait on the lamictal too. Lamictal is a biggy. You have to wait a long to hit therapeutic dose, and you do have to be on the look out for major side effects.
Hey one K question: How long does it take to kick in? I took 5 mg Valium prn yesterday (6pm) and felt nothing at all, no help. But today I have felt so fluish and tired, hard to move. I do have terrible hayfever, so it could be that...Or do you think it could be hangover effect? How long does Klonopin take to work generally? Any hangover effects?
Thanks
Chloe
Posted by Ritch on June 16, 2003, at 23:43:42
In reply to Re: valium vs klonopin? » Ritch, posted by chloe on June 16, 2003, at 20:13:21
> Hi Mitch,
> It seems all the rules that held true during the spring, emotionally, no longer apply, at least for me. Could some of the increased E.M waking also have to do with the increased amount of daylight? I awaken as soon as the sun emerges over the horizon, and now that's about 4:58 am UUGH! In the winter I can sleep til 10 am without stirring once. That is a gift!OK, I always used to have trouble with the sun waking me up too early as well in late Spring and early Summer. So, I got blackout material and put it over my windows and set my alarm clock for the same time every day (9AM). I think it has helped somewhat. But I think it just makes it easier AFTER an early-morning awakening to get BACK to sleep to get another hour or two in so I'm not as sleep deprived. I don't think it *prevents* an EMA. When I get an EMA, it is nearly a full hour before the light is increased. The birds start in early as they can. I remember when I was in college the first time and didn't have an air conditioner (so windows were open all the time with fans running), and the birds would start doing their thing just before the sun came up. I can hear them now through closed windows in the mornings-do you think the *sound* of the birds chirping (crickets-whatever) is filtering in while I am tring to sleep, maybe triggering a subconscious wake reaction?
> Hey one K question: How long does it take to kick in? I took 5 mg Valium prn yesterday (6pm) and felt nothing at all, no help. But today I have felt so fluish and tired, hard to move. I do have terrible hayfever, so it could be that...Or do you think it could be hangover effect? How long does Klonopin take to work generally? Any hangover effects?
> Thanks
> Chloe
>
Benzos always "kicked-in" right away for me-no matter which ones they were. It might take more or less depending on the symptoms that were being treated. I wonder if your troubles have to do with your thyroid status and that until you get that figured/straightened out the BZD's are a secondary issue??
Posted by chloe on June 17, 2003, at 14:29:07
In reply to Re: valium vs klonopin? » chloe, posted by Ritch on June 16, 2003, at 23:43:42
> > Hi Mitch,
> > It seems all the rules that held true during the spring, emotionally, no longer apply, at least for me. Could some of the increased E.M waking also have to do with the increased amount of daylight? I awaken as soon as the sun emerges over the horizon, and now that's about 4:58 am UUGH! In the winter I can sleep til 10 am without stirring once. That is a gift!
>
> OK, I always used to have trouble with the sun waking me up too early as well in late Spring and early Summer. So, I got blackout material and put it over my windows and set my alarm clock for the same time every day (9AM). I think it has helped somewhat. But I think it just makes it easier AFTER an early-morning awakening to get BACK to sleep to get another hour or two in so I'm not as sleep deprived. I don't think it *prevents* an EMA. When I get an EMA, it is nearly a full hour before the light is increased. The birds start in early as they can. I remember when I was in college the first time and didn't have an air conditioner (so windows were open all the time with fans running), and the birds would start doing their thing just before the sun came up. I can hear them now through closed windows in the mornings-do you think the *sound* of the birds chirping (crickets-whatever) is filtering in while I am tring to sleep, maybe triggering a subconscious wake reaction?Hi Mitch,
I have no idea what is that makes up awaken for no good reason. I just blame it on this time of year. Perhaps it more complicated...
>
>
> > Hey one K question: How long does it take to kick in? I took 5 mg Valium prn yesterday (6pm) and felt nothing at all, no help. But today I have felt so fluish and tired, hard to move. I do have terrible hayfever, so it could be that...Or do you think it could be hangover effect? How long does Klonopin take to work generally? Any hangover effects?
> > Thanks
> > Chloe
> >
>
>
> Benzos always "kicked-in" right away for me-no matter which ones they were. It might take more or less depending on the symptoms that were being treated. I wonder if your troubles have to do with your thyroid status and that until you get that figured/straightened out the BZD's are a secondary issue??Yes, thyroid definitely has to be addressed too. I think my pdoc will get an earful about that from me on thursday. I am so angry that she continues me on a med (T3) that she doesn't even monitor..GRRR. But that seems like SOP for checking labs. Monitoring Li once a year or less seems to be the norm now. I remember when it was once a month! I know my thryoid should be checked more than every 8 months, esp. when the values are off!! I am going to get this worked out...thanks for the reminder.
Chloe
>
Posted by Ritch on June 17, 2003, at 23:24:58
In reply to Re: valium vs klonopin? » Ritch, posted by chloe on June 17, 2003, at 14:29:07
Posted by chloe on June 19, 2003, at 17:37:58
In reply to Let us know how your appt. goes.... (nm) » chloe, posted by Ritch on June 17, 2003, at 23:24:58
Hi
The appointment went ok. My pdoc agreed that a trial of clonazapam would be good. She said there are lots of studies proving Klonopin useful for anxiety, mixed states, rage, but little with Valium (probably because it can be so abused). So it was hard for her to truly know which works better. But she said if I were try a benzo for the first time now, Klonopin would probably the first choice. So I am trying 1 mgs clonaz. in place of my 5 of valium tonight, then after a week switch my am dose of V to clonaz, etc. She said a goal of 2-3 mgs seemed reasonable.
I am glad she was willing to make a change.She did NOT want to change my 5mcgs T3 until I see the endo she has lined up for me. Though she has not been able to get me an appointment for over 2 months, and my pdoc is the chief of psych. in the hospital. I don't see why I can't see someone else...But apparently this endo is very good with thyroid and female hormone issue (which maybe alot of my problem. I have amazing irregular and difficult period cycles). So I have to stick it out with the T3, but I do have a lab slip to get Li, TSH, T3 and T4 checked, yeah! So at least we won't be in the dark where I stand physically.
My pdoc didn't really have any other ideas of how to calm my cycling. Though she does hope TMS will be FDA approved, and will be available soon. She says since ECT was so useful for me, TMS maybe something helpful to me. It's worth investing, I guess... So, I have to just keep taking the lithium, and specks of doxepin and T3 and hope that the clonazapam has a more powerful effect of agitation and irritability without making me too depressed! Any thoughts Mitch?
Well, I guess that is it in a nut shell
Chloe
Posted by pseudonym on June 20, 2003, at 0:53:58
In reply to My med appointment-not alot of options, posted by chloe on June 19, 2003, at 17:37:58
Lets do some math here. You're quadrupling your benzo dose by going from 5mg V to 1mg K.
5mg Valium is equal to .25mg K, and you're doing directly to 1 on your way to 2 or 3? Perhaps a lateral move would be more advised, such as going to .25 mg K twice a day, which would only be doubling your dose.
Posted by Chloe on June 20, 2003, at 12:27:20
In reply to Re: My med appointment-not alot of options, posted by pseudonym on June 20, 2003, at 0:53:58
> Lets do some math here. You're quadrupling your benzo dose by going from 5mg V to 1mg K.
>
> 5mg Valium is equal to .25mg K, and you're doing directly to 1 on your way to 2 or 3? Perhaps a lateral move would be more advised, such as going to .25 mg K twice a day, which would only be doubling your dose.Hi,
My pdoc didn't think that .25 mgs of K was going to be equal to 5 V since I have been on V for 15 or more years. She thought since I was well habituated to V, that I could easily switch 5 V for 1 K. Perhaps this is too much, but I took 1 K last night and I am not zonked or hungover. My only minor complaint is a mild headache.
Bottomline, I believe my pdoc thinks the crossover charts for V and K are too low. Maybe because of their long halflives? I don't know. But thanks for pointing this out. And if it's I start feeling zoned out or crumby I will have a good idea why!
Chloe
Posted by Maxime on June 20, 2003, at 16:49:02
In reply to Re: My med appointment-not alot of options » pseudonym, posted by Chloe on June 20, 2003, at 12:27:20
Other than Lithium, have you tried any of the other mood stabilisers out there?
Max
Posted by Chloe on June 20, 2003, at 17:01:19
In reply to Re: My med appointment-not alot of options-Chloe, posted by Maxime on June 20, 2003, at 16:49:02
> Other than Lithium, have you tried any of the other mood stabilisers out there?
>
> MaxYes, literally all--depakote, tegratol, trileptal, topamax, Lamictal, neurontin...blah, blah on it goes. Most stabilizers give me terrible skin and scalp pain-like I am on fire. Some worked ok, but the side effects are just intolerable. Lithium is the best so far...But it's "pooping out" a bit in the cycling area which is very difficult.
I hope Klonopin can settle things down a bit. Perhaps it's unlikely. But as I said, I have few options left.
Chloe
Posted by Maxime on June 20, 2003, at 17:35:18
In reply to Re: My med appointment-not alot of options-Chloe » Maxime, posted by Chloe on June 20, 2003, at 17:01:19
Never say never! Who knows, Klonopin may be the one.
I have been on every mood stabiliser and anti-psychotic. I am trying Lamictal now and if doesn't work then I am left with Trileptal. It's scary when you feel like you have are running out of things to try.
Also, maybe when pregabalin comes out it would be worth you trying.
Hang in there.
Max
Posted by Emme on June 20, 2003, at 22:12:26
In reply to My med appointment-not alot of options, posted by chloe on June 19, 2003, at 17:37:58
Posted by Chloe on June 20, 2003, at 23:36:20
In reply to Re: My med appointment-not alot of options-Chloe, posted by Maxime on June 20, 2003, at 17:35:18
Thank you Max and Emme.
Your support and encouragement means so much. It's easy to get discouraged and forget you are not alone.
Thanks again
Chloe
Posted by Ritch on June 21, 2003, at 17:57:12
In reply to My med appointment-not alot of options, posted by chloe on June 19, 2003, at 17:37:58
> Hi
> The appointment went ok. My pdoc agreed that a trial of clonazapam would be good. She said there are lots of studies proving Klonopin useful for anxiety, mixed states, rage, but little with Valium (probably because it can be so abused). So it was hard for her to truly know which works better. But she said if I were try a benzo for the first time now, Klonopin would probably the first choice. So I am trying 1 mgs clonaz. in place of my 5 of valium tonight, then after a week switch my am dose of V to clonaz, etc. She said a goal of 2-3 mgs seemed reasonable.
> I am glad she was willing to make a change.
>
> She did NOT want to change my 5mcgs T3 until I see the endo she has lined up for me. Though she has not been able to get me an appointment for over 2 months, and my pdoc is the chief of psych. in the hospital. I don't see why I can't see someone else...But apparently this endo is very good with thyroid and female hormone issue (which maybe alot of my problem. I have amazing irregular and difficult period cycles). So I have to stick it out with the T3, but I do have a lab slip to get Li, TSH, T3 and T4 checked, yeah! So at least we won't be in the dark where I stand physically.
>
> My pdoc didn't really have any other ideas of how to calm my cycling. Though she does hope TMS will be FDA approved, and will be available soon. She says since ECT was so useful for me, TMS maybe something helpful to me. It's worth investing, I guess... So, I have to just keep taking the lithium, and specks of doxepin and T3 and hope that the clonazapam has a more powerful effect of agitation and irritability without making me too depressed! Any thoughts Mitch?
> Well, I guess that is it in a nut shell
> ChloeWhoa! I missed your post entirely! I just now saw it-sorry. I am hopeful that you will find the clonazepam more helpful to settle your irritability. It works better than any other BZD I've tried for that particular problem. So, the equivalence (per your pdoc) is 5mg diazepam=1.0mg clonazepam? When I was on valium I was taking 2.5-5.0mg once-twice daily. As far as the depressogenic aspects go I found valium far more depressing than clonazepam. I think your next best bright spot will be when you get in to see your endo. and get that thyroid hassle all straightened out, IMO. TMS sounds interesting. I think that vagal nerve stimulator (they use for epilepsy) might be valuable for some people. Hang in there while you wait on your endo!--Mitch
Posted by chloe on June 21, 2003, at 21:46:44
In reply to Re: My med appointment-not alot of options » chloe, posted by Ritch on June 21, 2003, at 17:57:12
Hi Mitch
So far I really like the clonazapam. I have less of a hair trigger, I think...Pdoc wanted me to take 1mg for every 5mgs of Valium, but I took just .5 clonaz. and that was plenty. I want to slowly work my way up. I tend to have nasty reactions to new meds. And I couldn't find any conversions close to 1K=5V! As psuedonym pointed out that is quadrupelling the dose... I guess it all how it makes me feel. .5K seems to be equal to 5 V for me so far. Do you take a total of .5/day?
Yeah, I can't wait for the endo appointment. It sure can't hurt.
Hope you are doing ok
Chloe
Posted by Simcha on June 21, 2003, at 23:36:28
In reply to Re: My med appointment-not alot of options » Ritch, posted by chloe on June 21, 2003, at 21:46:44
>And I couldn't find any conversions close to 1K=5V! As psuedonym pointed out that is quadrupelling the dose... I guess it all how it makes me feel. .5K seems to be equal to 5 V for me so far.
According to this link there are differing opinions on the equivalence of benzos.
http://www.dr-bob.org/tips/bzd.html
The second chart on that link shows that 10mg of Diazepam(Valium) is equal to 2mg of Clonazepam(Klonopin)
Just thought I'd interject with this.
Posted by Ritch on June 22, 2003, at 10:56:02
In reply to Re: My med appointment-not alot of options » Ritch, posted by chloe on June 21, 2003, at 21:46:44
> Hi Mitch
> So far I really like the clonazapam. I have less of a hair trigger, I think...Pdoc wanted me to take 1mg for every 5mgs of Valium, but I took just .5 clonaz. and that was plenty. I want to slowly work my way up. I tend to have nasty reactions to new meds. And I couldn't find any conversions close to 1K=5V! As psuedonym pointed out that is quadrupelling the dose... I guess it all how it makes me feel. .5K seems to be equal to 5 V for me so far. Do you take a total of .5/day?
> Yeah, I can't wait for the endo appointment. It sure can't hurt.
> Hope you are doing ok
> ChloeYep, .5mg at bedtime (occasionally more). I'm really accustomed to taking it and don't feel much sedation from it anymore. If I'm needing to sleep-it doesn't help much to increase it. However, it still provides a definite antipanic effect despite other things wearing off. Yeah.. I think .5mg of Klon is more equivalent to 5mg of Valium.. from my experience with both anyhow (although at different times). Hey, the colors of the tabs match too! ;0) Valium would make me paradoxically hostile at times-never had that with clonazepam... perhaps at worst a "grumbly sullenness" if I was already depressed (not from the clon), but not sparky hostile. Oh... right now I've been having non-stop night after night sleep disruption since I started a little Buspar (I suggested it to my pdoc of course) a couple of weeks ago. I thought it might start to fade, but it is getting worse-I'm dropping the stuff as of today and return to what I was on before I added it-Depakote ER 250mg+Klon .5mg + tiny Effexor. It (buspirone) seemed to add a little energy during the day and I could pick out words better, but on balance it just seemed to make me a little shorter fused and sleep-deprived. I'm carefully logging all of this stuff one step at a time. I'll probably end up trying Lamictal (with the Depakote), OR adding some verapamil. I think I would like to try the verapamil first-because I seem to respond well to meds that affect Calcium channels for some reason. I'm already starting to switch gears mood-wise. It is a slow change from bubbly to tired-mixed-wired feelings. Maybe returning to my last combo (slight change) will fix this. I think if you can get an endo that will aggressively work with you on your thyroid stuff you'll feel much better. I would be interested to see if he adds T4 or switches to T4 instead. Let us know--take care----- Mitch
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