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Dr. Bob is Robert Hsiung, MD,
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Posted by HelenInCalif on May 24, 2004, at 22:11:25
I'm taking Klonopin (clonazepam) for anxiety. My new pdoc- first met today- wants me to add Celexa. She said it will help the anxiety, with a potential goal of eventually replacing klonopin when its time to go off of it.
Is Celexa a useful addition to Klonopin for anxiety (no depression, no panic, just anxiety due to a very stressful life situation)? I'm trying to do a cost-benefit analysis of starting the Celexa for anxiety. I've already got the Klonopin and it works without noticible side effects so far. How much more will the Celexa give me vs. the potential side effects it could have?
Also, why prescribe Celexa instead of Lexapro? From what I read Lexapro is faster and has slightly less side-effect incidence. As I have to pay full price for either anyways (because there is no generic and its not on Kaiser's formulary), why not Lexapro? Is it much more expensive? (my new celexa cost $89 for 30 x 20mg pills. I'd take 10mg / day).
In the past 2 months a relative was hospitalized and nearly died, and because I took time off for that I lost my job. This gave me strong anxiety. I'd never had strong anxiety before, so my gp prescribed Klonopin. (Also Trazadone for insomnia, but I rarely need it now). Just now, 1 1/2 months later, I've finally been able to see a pdoc.
She wants to add celexa- she says it will help with the anxiety and can essentially "take over the job" when its time for me to go off of Klonopin. I've been reading here and elsewhere, and am not yet seeing to much about Celexa as an anxiety treatment. I'm not depressed, nor am I having panic attacks: just a very high stress level from dealing with ICUs and watching hospital near-deaths and being fired.
She said that Celexa, like Klonopin, would have as a secondary benefit the reduction of mild social anxiety I have (i.e. I'm shy: not enough to make me skip events, but enought to make me nervous about "working the room"). I do like that Klonopin has helped me with that the past few weeks.
I've had SSRIs before for depression (I'm not depressed currently, although if/when my dad dies it'd certainly be possible). I hated their side effects (drymouth, sexual effects, and with paxil the severe withdrawal symptoms). Everything I'm reading here suggests that Celexa won't be that different as a SSRI. I don't remember those earlier SSRIs helping me with social situations- they just worked on the depression, as far as I can tell.
My other prescriptions are ritalin for ADD- taken the same dose for years, and the BCP. (I also take omega 3, Tyrosine or LD-Phenylalanine, and complete vitamins as nonprescriptions)
I feel like I don't have time to deal with nausea or changes to my "female cycle" or the sexual side effects I've been reading about here and elsewhere. Thanks for any thoughts on this: I'm still staring at my first 1/2 pill (for 10 mg) trying to decide when to take it.
Posted by Sad Panda on May 24, 2004, at 22:54:39
In reply to help! add Celexa to Klonopin for anxiety: useful?, posted by HelenInCalif on May 24, 2004, at 22:11:25
> I'm taking Klonopin (clonazepam) for anxiety. My new pdoc- first met today- wants me to add Celexa. She said it will help the anxiety, with a potential goal of eventually replacing klonopin when its time to go off of it.
>
> Is Celexa a useful addition to Klonopin for anxiety (no depression, no panic, just anxiety due to a very stressful life situation)? I'm trying to do a cost-benefit analysis of starting the Celexa for anxiety. I've already got the Klonopin and it works without noticible side effects so far. How much more will the Celexa give me vs. the potential side effects it could have?
>
> Also, why prescribe Celexa instead of Lexapro? From what I read Lexapro is faster and has slightly less side-effect incidence. As I have to pay full price for either anyways (because there is no generic and its not on Kaiser's formulary), why not Lexapro? Is it much more expensive? (my new celexa cost $89 for 30 x 20mg pills. I'd take 10mg / day).
>
> In the past 2 months a relative was hospitalized and nearly died, and because I took time off for that I lost my job. This gave me strong anxiety. I'd never had strong anxiety before, so my gp prescribed Klonopin. (Also Trazadone for insomnia, but I rarely need it now). Just now, 1 1/2 months later, I've finally been able to see a pdoc.
>
> She wants to add celexa- she says it will help with the anxiety and can essentially "take over the job" when its time for me to go off of Klonopin. I've been reading here and elsewhere, and am not yet seeing to much about Celexa as an anxiety treatment. I'm not depressed, nor am I having panic attacks: just a very high stress level from dealing with ICUs and watching hospital near-deaths and being fired.
>
> She said that Celexa, like Klonopin, would have as a secondary benefit the reduction of mild social anxiety I have (i.e. I'm shy: not enough to make me skip events, but enought to make me nervous about "working the room"). I do like that Klonopin has helped me with that the past few weeks.
>
> I've had SSRIs before for depression (I'm not depressed currently, although if/when my dad dies it'd certainly be possible). I hated their side effects (drymouth, sexual effects, and with paxil the severe withdrawal symptoms). Everything I'm reading here suggests that Celexa won't be that different as a SSRI. I don't remember those earlier SSRIs helping me with social situations- they just worked on the depression, as far as I can tell.
>
> My other prescriptions are ritalin for ADD- taken the same dose for years, and the BCP. (I also take omega 3, Tyrosine or LD-Phenylalanine, and complete vitamins as nonprescriptions)
>
> I feel like I don't have time to deal with nausea or changes to my "female cycle" or the sexual side effects I've been reading about here and elsewhere. Thanks for any thoughts on this: I'm still staring at my first 1/2 pill (for 10 mg) trying to decide when to take it.
>
>How often do you take Klonopin? If you only take it occasionally then stay with it. If you have to take it every day, then an SSRI might be a good idea. I would not take an antidepressant to help you through a rough patch.
Cheers,
Panda.
Posted by HelenInCalif on May 25, 2004, at 0:31:31
In reply to Re: help! add Celexa to Klonopin for anxiety: useful? » HelenInCalif, posted by Sad Panda on May 24, 2004, at 22:54:39
.5mg taken 3 times a day.
I've been taking the Klonopin every day since the family health emergency started: so thats been about 1 1/2 months now. The pdoc didn't think I needed to go off of it yet, but that I should add the Celexa to the mix.
I'm just very wary of SSRIs as I don't like the side- effects. As mentioned, I'm not currently depressed (and I've been depressed before, so I'd know if I was now- or if I was sliding into one. Not this time). I'd certainly take it for depression: not being depressed outweighs the side-effects. But are the potential side-effects worth having Celexa as a second (back up?) anxiety medicine? That I'd like to research more on.
Posted by MGOLDW on May 25, 2004, at 9:32:02
In reply to .5mg 3xday... add Celexa to Klonopin for anxiety? » Sad Panda, posted by HelenInCalif on May 25, 2004, at 0:31:31
Hi! When I became depressed, back in 2001, I suffered from severe anxiety attacks. I was given Xanax by my doc before I went to see a pdoc. I was prescribed Celexa and was forbidden to take any more Xanax. After 3 very rough weeks, dealing with the SE, I started to feel better. My anxiety was under control and never had the need to take the Xanax anymore.
In October 2003 I was feeling so good that I decided to go off the Celexa. I was taking 40mg. My pdoc told me to reduce the dose by 10mg every 2 weeks. No withdrawl effects.
8 weeks ago, I started to have severe anxiety due to some stressful situations in my life, so I went back to my pdoc and asked him to put me back on Celexa. He prescribed me Lexapro 10mg. Same SE as Celexa and my anxiety went trough the roof. I had to take some Xanax, against my pdoc's advice to cope with the first 3 weeks.
After 8 weeks, I feel very good, only mild anxiety in the mornings.
Good luck
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