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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by banga on January 21, 2005, at 23:40:15
I have been on klonopin for 5 days now--1mg/day. I feel worse and worse--depressed, very teary; and it does little to help my anxiety.
Anyone experience this? I know some have commented that in the long run it may not help dep., but does anyone know of such an immediate (negative) response?
Posted by Ritch on January 22, 2005, at 9:27:39
In reply to adverse rxn to klonopin??, posted by banga on January 21, 2005, at 23:40:15
> I have been on klonopin for 5 days now--1mg/day. I feel worse and worse--depressed, very teary; and it does little to help my anxiety.
> Anyone experience this? I know some have commented that in the long run it may not help dep., but does anyone know of such an immediate (negative) response?I often get a negative reaction to a daytime dose of K just like you describe. It depends on what flavor of anxiety is present that I'm trying to control. When I am getting panicky or feeling intense social anx. I will feel better with a daytime dose (relief reaction). If the anxiety is the generalized, worrisome hand-wringing existential variety, or I'm just experiencing negative thoughts that make me worrisome the K will often give me that negative reaction when I take it. You might try cutting the dose back to .5mg/day for a while. It's got a really long half-life so if you just started it.. it is accumulating in your body and the level is rising. When I feel panic coming on I raise my .5mg dose to 1.0mg for just a day or two and then go back to .5mg.. if I don't I will start to get worsening depressive symptoms and thick-headedness.
Posted by ed_uk on January 23, 2005, at 8:55:36
In reply to Re: adverse rxn to klonopin?? » banga, posted by Ritch on January 22, 2005, at 9:27:39
I definately think it's time for you to try a different benzo! How about Ativan?
Ed.
Posted by banga on January 23, 2005, at 11:43:24
In reply to Re: adverse rxn to klonopin??, posted by ed_uk on January 23, 2005, at 8:55:36
I don't know. I had a small trial of Ativan once, it just made me tired. Granted, the dose may not have been much (I dont remember what it was) Same with Xanax-took it a couple of days, no effect, although I was drinking at the time, so that's no surprise.
I took Klonopin .5mg BID from Monday thru Friday, I have been on the verge of tears the whole time (or outright crying), I've felt more depressed than in a long time, felt nauseous...this has not been fun. I see my pdoc Monday, she said over the phone she is concerend that there is more serious depression under this (she's new, maybe I didn't tell her about the daily daydreams of sticking a knife in my heart...) and feels we need to be more aggressive...I am apprehensive, what could that mean? and I hope it doesn't mean we ignore the anxiety.
I want to go back on Geodon. I was a different person, even if my head was fogged. Maybe if I kept the dose very low I can have the antianxiety effect, but akathisia doesn't set in that in time nullifies the anxiolytic effect (that's my wishful theory right now).
Posted by ed_uk on January 23, 2005, at 12:28:12
In reply to Re: adverse rxn to klonopin??, posted by banga on January 23, 2005, at 11:43:24
Hi banga,
Have you ever tried chlordiazepoxide (Librium) or oxazepam (Serax)???
I think you should ask about trying a few different benzos to find out which you prefer. On the other hand, maybe benzos are just not for you.
Are you taking desipramine?
How long did you take Geodon for before the akathisia set in? Are you sure it was akathisia? Can you describe what it felt like and how it was different to your usual anxiety? Have you ever taken any other atypical antipsychotics?
Ed.
Posted by Phillipa on January 23, 2005, at 13:10:52
In reply to adverse rxn to klonopin??, posted by banga on January 21, 2005, at 23:40:15
K has been known to bring on a depression. I am going thru the same process of needing long term benzo properties w/o the depressive SE's. Ritch was right about the building up of levels in the body; it has a half-life of 18-50 hours.
Posted by banga on January 23, 2005, at 15:57:07
In reply to Re: adverse rxn to klonopin?? » banga, posted by ed_uk on January 23, 2005, at 12:28:12
Hi Ed,
No, I haven't tried any of the other meds you mentioned. In truth, this trial of Klonopin is the only true trial of a benzo, as neither Ativan nor Xanax were taken consistently; I in fact keep forgetting I tried them at all. I just don't know. I am scared, because I think in the back of my mind I always thought "well there's always benzos if the anxiety becomes dangerous"....and now there is a hint that my body might hate them.I am indeed taking desipramine. Too early for positive effects, but I seem to have more energy and my vision feels sharper. I don't think it makes me feel keyed up. I am hopeful about this one.
Oh and I still take 200mg lamictal, I think it is totally useless now.Today, two days off Klonopin and feeling a bit better--meaning I feel very depressed but am not crying. I see my pdoc tomorrow, I think there should at least be a discussion re: MAOIs
Oh! and the Geodon--these are symptoms I developed: sort of Parkinsonian feeling with my eyes--I could move them around and feel OK< but if I needed to make longer eye contact with someone, I couldòt do it-my eyes compulsively would twitch to the right, then I could have eye contact longer, then it would happen again.
I felt good, but agitated and pressured. Anxiety was gone, but approx. 8th week I quickly slid down into an odd state of being both agitated and yet paralyzed by anxiety, meaning I was too fearful (of nothing in particular) to get out of bed.
Risperidone did the same for my anxiety--BOOM it is simply gone. That was in the hospital, I would never have considered an AP on my own. That is why I keep longongly looking at the APs for relief of anxiety--SO dramatic and within 4 days.Do try to hang in there and finish school. I am only working part-time, but I know I would do better if I was busier, working on some kind of goal. Oh yeah there is the dissertation, but that is lonely busiess. If I had the money,I would take classes to get myself more among other people, even if I dont talk to them.
Push forward with what you are studying now, and start researching what related fields you may be happier with. Don't they do career, personality and interests testing there? It certainly isn't a life-changer necessarily, but it can help organize thoughts about career.
It makes me think back sadly how this anxiety has kept me back in life: I too wanted to go premed, but feared I could not take the pressure. I could have gone to any U in the US, my father would have paid, but instead I lived at home and went to a local college, too nervous to think going across the country where I know noone. Yes, I made it into a doctoral program, but it's been a struggle, I was supposed to finish 6 years ago....Anyway, I will bring up the idea of trying other benzos with my pdoc, as well as MAOIs. And Geodon vs Abilify. I may have to take one of these for the short-term goal of meeting my dissertation deadline, if nothing else...
Posted by banga on January 23, 2005, at 15:59:39
In reply to Re: adverse rxn to klonopin?? » banga, posted by Phillipa on January 23, 2005, at 13:10:52
I was simply taken aback at how suddenly and intensely the depression hit. I am worried that I wont find anything that lifts me from this anxiety. I am so tired, I just can't fight it at all--no intrnal resources to speak of.
Posted by ed_uk on January 23, 2005, at 16:29:38
In reply to Re: adverse rxn to klonopin??, posted by banga on January 23, 2005, at 15:57:07
Hi banga,
Akathisia is a state of intense physical restlessness combined with an urge to move and extreme difficulty in staying still- even for a few seconds in some cases. It can be very distressing. Does this sound like what you experienced?
Why don't you take Geodon for a few weeks... and then have a break for a couple of weeks... and then go back to it?? You could repeat this cycle for as long as you wanted. The Geodon should help you finish your dissertation!
If what you experienced with Geodon was akathisia, you may prefer Seroquel. Seroquel is probably less likely to cause akathisia than Geodon but it can be very sedating, I would suggest that you try a very low dose. I'm not sure whether or not you'd like Abilify.
>I am scared, because I think in the back of my mind I always thought "well there's always benzos if the anxiety becomes dangerous"....and now there is a hint that my body might hate them.
I know what you mean. I don't find benzos that effective myself. The last few times I took a benzo it made my anxiety worse because I needed to be able to concentrate and the drugs made me foggy. I was at work and felt so stupid because I made so many mistakes and couldn't remember anything. I would have been better off if I hadn't taken anything.
Don't worry- there are many other options if you don't do well on benzos. Ask your pdoc to let you have short trials on several different benzos. It is useful to find the benzo that is best for you.
>Don't they do career, personality and interests testing there?
No. I'm not even sure what that would involve!
Ed x
Posted by banga on January 23, 2005, at 17:20:35
In reply to Re: adverse rxn to klonopin?? » banga, posted by ed_uk on January 23, 2005, at 16:29:38
> Akathisia is a state of intense physical restlessness combined with an urge to move and extreme difficulty in staying still- even for a few seconds in some cases. It can be very distressing. Does this sound like what you experienced?
Not exactly..it was an agitated state-both mentally and physically, but not so bad I couldn't sit still. Somewhere I read a lengthier description, including that it can emerge as late as day 60--so I thought maybe these side effects were kicking in and counteracting the anxiolytic properties that I enjoyed days 3-59.
>
> Why don't you take Geodon for a few weeks... and then have a break for a couple of weeks... and then go back to it?? You could repeat this cycle for as long as you wanted. The Geodon should help you finish your dissertation!This certainly may be a logical option at this point.
>
> If what you experienced with Geodon was akathisia, you may prefer Seroquel. Seroquel is probably less likely to cause akathisia than Geodon but it can be very sedating, I would suggest that you try a very low dose. I'm not sure whether or not you'd like Abilify.
Yes. Id like to avoid sedating things if possible!
>
>
> >Don't they do career, personality and interests testing there?
>
> No. I'm not even sure what that would involve!In the US, any institute of higher education offers career counseling--and usually it involves taking tests that evaluate your personality, interests, values, abilities, and see what career routes could best fit you. It's sort of an idea generator. Developed by psychologists :) . Done through a university, it's usually cheap. Going to a specialized, independent career counseling service would be expensive.
If you've taken the MMPI, well, these are tests that look at how you are on, say, the manager scale instead of the mania scale.
Posted by Phillipa on January 24, 2005, at 0:33:27
In reply to Re: adverse rxn to klonopin?? » Phillipa, posted by banga on January 23, 2005, at 15:59:39
For what's it's worth, I'm going to suggest to the pdoc that he switch from the K and go back to what I first used years ago, Valium. I experience tightend neck and back muscles from anxiety that are addressed with V and is long acting like K.
Posted by denise1904 on January 24, 2005, at 8:29:09
In reply to adverse rxn to klonopin??, posted by banga on January 21, 2005, at 23:40:15
Hi Banga,
Can I suggest you try taking 10mg of zyprexa just when it gets too much and you don't think you can carry on more.
I found Zyprexa really helped me when nothing else would.
Denise
Posted by banga on January 24, 2005, at 8:55:46
In reply to Re: Banga - Try 10mg of Zyprexa, posted by denise1904 on January 24, 2005, at 8:29:09
Thanks Denise, I have noticed that some people use this prn if it is really bad. Truly that may not be a bad idea to have some around.
I still want to find something that can be helpful round the clock (we all know the weight gain and other effects of Zyprexa if used consistently), my daily anxiety keeps me from getting things done. Eventually if I get the depression under control I can try and use all kinds of relaxation techniques, etc. but for now these give me no relief.
Posted by ed_uk on January 24, 2005, at 9:28:22
In reply to Re: Banga - Try 10mg of Zyprexa » denise1904, posted by banga on January 24, 2005, at 8:55:46
Hi,
Have you ever tried using Geodon prn?
Ed.
Posted by banga on January 24, 2005, at 9:40:27
In reply to Re: Geodon prn » banga, posted by ed_uk on January 24, 2005, at 9:28:22
I haven't exactly, but my guess is it wouldn't work out well, as it takes ~3 days to kick in. That's why one idea I have is taking it at a very low dose--even every other day (it comes in 20mg capsules, hard to split to a smaller dose and it has such a long half-life). Or try Abilify--some say it increases, some say it decreases anxiety....
What is a typical dose of desipramine by the way?
Posted by ed_uk on January 24, 2005, at 10:08:38
In reply to Re: Geodon prn » ed_uk, posted by banga on January 24, 2005, at 9:40:27
Hi,
>I haven't exactly, but my guess is it wouldn't work out well, as it takes ~3 days to kick in.
It might work more quickly if you took a higher dose initially.
>That's why one idea I have is taking it at a very low dose--even every other day
You could certainly try taking 20mg every other day.
>What is a typical dose of desipramine by the way?
100-200mg/day would be a common maintenance dose.
Ed.
Posted by banga on January 24, 2005, at 11:42:07
In reply to Re: Geodon prn » banga, posted by ed_uk on January 24, 2005, at 10:08:38
This is the end of the thread.
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