Psycho-Babble Medication Thread 1002238

Shown: posts 1 to 16 of 16. This is the beginning of the thread.

 

Increase/decrease Klonopin: fear of disinhibition

Posted by porkpiehat on November 11, 2011, at 0:28:22

After maybe 3 weeks on a very low dose of klonopin (<.5 mg daily divided into 2-3 doses), I am starting to experience increasing:

agitation and anger;
a significant spike in libido.

So the big question...

am I developing tolerance and therefore having the agitation as a drop in GABA regulation between doses? And therefore should I be increasing the dose? I don't want to increase sedation and I don't want to get more and more addicted to avoid this agitation.

OR am I experiencing a paradoxical effect called a "disinhibitory reaction" to the benzo. It is rare but symptoms include increased libido and agitation/anger? It seems to be more common in people with borderline and antisocial/impulse problems?

Here is an illuminating article on disinhibition: http://pb.rcpsych.org/content/26/12/460.full#SEC2

I have also experienced strong agitation effects with Buspar and risperdal after a week or more of dosing

My pdoc thinks this first example is likely and wants to increase my dose. I am skeptical and fear getting more agitated AND addicted by going up. I'm feel somewhat paralyzed. I have been waking very irritable and I don't want to kill my clients

For the first three weeks, however, the drug was working miraculously (in concert with 20 mgs of Celexa and 200 mgs of lamictal). Also of note, the agitation does seem to decrease with a full meal and occasionally caffeine, which reminds me of the problems I used to have lowering my lamictal or changing the manufacture of that drug.

Any advice would be VERY helpful and appreciated!

 

Re: Increase/decrease Klonopin: fear of disinhibition » porkpiehat

Posted by Chairman_MAO on November 11, 2011, at 8:06:53

In reply to Increase/decrease Klonopin: fear of disinhibition, posted by porkpiehat on November 11, 2011, at 0:28:22

Have you ever been evaluated for ADHD or tried a psychostimulant?

Just a hunch here ...

Given the other meds you are taking it's hard to say what is doing what. Don't just increase the dose as a matter of course, the more you take the longer it takes to get off of it should you want to.

 

Re: Increase/decrease Klonopin: fear of disinhibition

Posted by Phillipa on November 11, 2011, at 10:59:45

In reply to Re: Increase/decrease Klonopin: fear of disinhibition » porkpiehat, posted by Chairman_MAO on November 11, 2011, at 8:06:53

Klonopin depressed me paradoxical reactions? Phillipa

 

Re: Increase/decrease Klonopin: fear of disinhibition

Posted by porkpiehat on November 11, 2011, at 11:03:53

In reply to Re: Increase/decrease Klonopin: fear of disinhibition » porkpiehat, posted by Chairman_MAO on November 11, 2011, at 8:06:53

Chairman I'm curious what makes you ask about the stim...I'm taking the benzo partially for concentration, partially for social anxiety, and partially because it calms what I call in lay terms as hypomania from the SSRI and Lamictal.

I've taken stimulants recreationally. they seem to work but make me anxious if not taken with some kind of anxiolytic.

Thanks!

 

Re: Increase/decrease Klonopin: fear of disinhibition » porkpiehat

Posted by Chairman_MAO on November 11, 2011, at 12:54:06

In reply to Re: Increase/decrease Klonopin: fear of disinhibition, posted by porkpiehat on November 11, 2011, at 11:03:53

> Chairman I'm curious what makes you ask about the stim...I'm taking the benzo partially for concentration, partially for social anxiety, and partially because it calms what I call in lay terms as hypomania from the SSRI and Lamictal.

I ask because these are all really just drugs with effects; just because something is labelled something and conventionally used for that doesn't mean that the effect you're looking for is anything like what is going to happen.

I am not sure if "hypomania" is the right word.
Benzodiazepines can sometimes worsen agitation and anxiety in the long-term. You're already on three drugs so I'm not sure how you're supposed to tease apart the effects.

What is the Lamictal and the SSRI prescribed for?

>
> I've taken stimulants recreationally. they seem to work but make me anxious if not taken with some kind of anxiolytic.

Which stimulants, and at what doses? The dose is very important, and different stimulants have different effects. Also please tell me which medications you were taking, if any, when you tried them.

If you want any additional feedback from me, please tell me which drug you started taking first, then the rest in the order they were added and why.

Best of luck.

 

Re: Increase/decrease Klonopin: fear of disinhibition

Posted by jono_in_adelaide on November 11, 2011, at 17:58:43

In reply to Re: Increase/decrease Klonopin: fear of disinhibition » porkpiehat, posted by Chairman_MAO on November 11, 2011, at 12:54:06

You are on a very low dose - maybe try increasing to 0.5mg twice a day for a week and see what happens.

If you want to stop, it isnt difficult, you just need to taper the drug over a period of time (depending on how long you've been taking it and at what dose)

 

Re: Increase/decrease Klonopin: fear of disinhibition » jono_in_adelaide

Posted by gadchik on November 12, 2011, at 7:10:10

In reply to Re: Increase/decrease Klonopin: fear of disinhibition, posted by jono_in_adelaide on November 11, 2011, at 17:58:43

"If you want to stop, it isnt difficult, you just need to taper the drug over a period of time (depending on how long you've been taking it and at what dose)"

I love that sentence,makes me feel like if I want to taper klonopin,I can do it.

 

Re: Increase/decrease Klonopin: fear of disinhibition » Phillipa

Posted by gadchik on November 12, 2011, at 15:01:10

In reply to Re: Increase/decrease Klonopin: fear of disinhibition, posted by Phillipa on November 11, 2011, at 10:59:45

> Klonopin depressed me paradoxical reactions? Phillipa

What dose klonopin did you try? Ive heard that lower doses dont cause depression in most people.I only take .5mg a day.It makes me happy/carefree,helps also w/social anxiety-i take at night,lasts all day!

 

Re: Increase/decrease Klonopin: fear of disinhibition » gadchik

Posted by Phillipa on November 12, 2011, at 20:56:33

In reply to Re: Increase/decrease Klonopin: fear of disinhibition » Phillipa, posted by gadchik on November 12, 2011, at 15:01:10

It was a low dose don't remember? Sorry? Phillipa

 

Re: Increase/decrease Klonopin: fear of disinhibition

Posted by porkpiehat on November 13, 2011, at 10:42:10

In reply to Re: Increase/decrease Klonopin: fear of disinhibition » porkpiehat, posted by Chairman_MAO on November 11, 2011, at 12:54:06

> > Chairman I'm curious what makes you ask about the stim...I'm taking the benzo partially for concentration, partially for social anxiety, and partially because it calms what I call in lay terms as hypomania from the SSRI and Lamictal.
>
> I ask because these are all really just drugs with effects; just because something is labelled something and conventionally used for that doesn't mean that the effect you're looking for is anything like what is going to happen.
>
> I am not sure if "hypomania" is the right word.
> Benzodiazepines can sometimes worsen agitation and anxiety in the long-term. You're already on three drugs so I'm not sure how you're supposed to tease apart the effects.
>
> What is the Lamictal and the SSRI prescribed for?
>
> >
> > I've taken stimulants recreationally. they seem to work but make me anxious if not taken with some kind of anxiolytic.
>
> Which stimulants, and at what doses? The dose is very important, and different stimulants have different effects. Also please tell me which medications you were taking, if any, when you tried them.
>
> If you want any additional feedback from me, please tell me which drug you started taking first, then the rest in the order they were added and why.
>
> Best of luck.

Without getting into my entire profile, I've been taking SSRIs (first Prozac then Celexa) for depression and anxiety. I've stopped them 2-3 times because I felt manic-y (spending, drinking, drugs, hyper), blunted, and insensitive, no sex drive. I tried Serzone in the interim, which only sorta worked. Added Wellbutrin and risperdal (separately) before giving up on the serzone altoether and switching back to Celexa.

They added Lamictal to calm the hypomanic behavior that returned with the celexa (given the prevalence of BP in my family). It worked and also provided an excellent anti-depressive/pro-social, pro-motivational effect. I was always awash in new ideas and started my own business and became very successful professionally. However it can make me very racy and concentration/reading became very difficult. It allowed me to cut the Celexa to 20 mgs.

Increasing anxiety led us to add buspar a while back at low doses <mgs per day, but it ultimately made me sad and angry a lot. Dropped that after a year with the exception of 5mgs at night because I ruminations kept me from sharing a bed with my boyfriend and awake.

Docs/therapists now see my symptoms as more of PTSD from childhood and some trauma/borderline symptoms. The whole bipolar question is kind of up in the air.

moderate substance use since early teens.


 

Re: Increase/decrease Klonopin: fear of disinhibition

Posted by jono_in_adelaide on November 13, 2011, at 21:28:49

In reply to Re: Increase/decrease Klonopin: fear of disinhibition » jono_in_adelaide, posted by gadchik on November 12, 2011, at 7:10:10

I love that sentence,makes me feel like if I want to taper klonopin,I can do it.
--------------------------------------------------------------------------------

You can, anyone can...... all you do is transfer your self from your current benzo to an equivalent dose of diazepam, then reduce this dose by 1mg every 1-2 weeks. It might take a year to give up, but it will be painless.

Having said that, the original symptoms for which you took a benzo might still be there when you stop.... same as if took aspirin for your arthritis, and then stopped, its quite likely the arthritic pain would come back.

 

Re: Increase/decrease Klonopin: fear of disinhibition » jono_in_adelaide

Posted by Phillipa on November 13, 2011, at 21:37:28

In reply to Re: Increase/decrease Klonopin: fear of disinhibition, posted by jono_in_adelaide on November 13, 2011, at 21:28:49

Jono I like that corrolation fits perfectly to me. Phillipa

 

Re: Increase/decrease Klonopin: fear of disinhibition » porkpiehat

Posted by Chairman_MAO on November 15, 2011, at 6:09:08

In reply to Re: Increase/decrease Klonopin: fear of disinhibition, posted by porkpiehat on November 13, 2011, at 10:42:10


> Without getting into my entire profile, I've been taking SSRIs (first Prozac then Celexa) for depression and anxiety. I've stopped them 2-3 times because I felt manic-y (spending, drinking, drugs, hyper), blunted, and insensitive, no sex drive. I tried Serzone in the interim, which only sorta worked. Added Wellbutrin and risperdal (separately) before giving up on the serzone altoether and switching back to Celexa.
>
So you take the SSRIs for depression? Have you ever tried a TCA or an MAOI? SSRIs are the most likely to induce mania. I see why you're taking the benzo now.

> They added Lamictal to calm the hypomanic behavior that returned with the celexa (given the prevalence of BP in my family). It worked and also provided an excellent anti-depressive/pro-social, pro-motivational effect. I was always awash in new ideas and started my own business and became very successful professionally. However it can make me very racy and concentration/reading became very difficult. It allowed me to cut the Celexa to 20 mgs.
>

It can be difficult dealing with these multi-drug cocktails. Unfortunately, I do not have clinical experience so I cannot really recommend anything here in good faith over anything else. I have some unconventional ideas, but it seems as if the SSRI is the culprit.

> Increasing anxiety led us to add buspar a while back at low doses <mgs per day, but it ultimately made me sad and angry a lot. Dropped that after a year with the exception of 5mgs at night because I ruminations kept me from sharing a bed with my boyfriend and awake.
>
Buspar wouldn't work in this case anyway.

> Docs/therapists now see my symptoms as more of PTSD from childhood and some trauma/borderline symptoms. The whole bipolar question is kind of up in the air.
>

How much do you need the SSRI? Seems like perhaps you might consider something else besides Lamictal or otherwise evaluate the need for SSRI? I know Lamictal can be very good, but it sounds like it might be too agitating for you. You could talk to your doctor about increasing clonazepam, but that comes with its own drawbacks at higher doses, such as risk of depression, gait disturbance, cognitive impairment, etc. Still worthy of discussing.

> moderate substance use since early teens.
>
Are you still using now? If not, how long have you been "clean" (or mostly clean)? If you are still using, what are you using and how often?

I'm unclear on one thing: are you still taking an antipsychotic now or not?

 

Re: Increase/decrease Klonopin: fear of disinhibition

Posted by ron1953 on November 15, 2011, at 12:05:11

In reply to Increase/decrease Klonopin: fear of disinhibition, posted by porkpiehat on November 11, 2011, at 0:28:22

I am one of the few who experienced the disinhibition effect of Klonopin, and without going into detail, it pretty much destroyed my life, or at least a big piece of it. I STRONGLY advise that you discontinue use ASAP.

 

Re: Increase/decrease Klonopin: fear of disinhibition » porkpiehat

Posted by Phidippus on November 15, 2011, at 19:40:20

In reply to Increase/decrease Klonopin: fear of disinhibition, posted by porkpiehat on November 11, 2011, at 0:28:22

Fear of addiction is a common fear among benzodiazapine users. If you're not addicted thus far, an increase in dosage is not likely to put you at a higher risk.

As far as disinhibition goes, I have experienced it myself on Klonopin. A higher dose did not result in increased disinhibition for me, nor did it resolve the issue. Try a couple of days at the higher dose and if you remain agitated/horny then you might want to reconsider the medication.

Eric

 

Re: Increase/decrease Klonopin: fear of disinhibition

Posted by porkpiehat on November 20, 2011, at 12:15:03

In reply to Re: Increase/decrease Klonopin: fear of disinhibition » porkpiehat, posted by Phidippus on November 15, 2011, at 19:40:20

The agitation thing only lasted a few days...glad that's over!

If only now I could stop obsessing over it all.

I miss the increase in libido. Right now I can't muster anything more than mild interest in anything...and I'm taking less than .5 mgs per day. Now I'm wondering if an increase in dose will get me past the sedated feeling, but I can't see how that's possible.


This is the end of the thread.


Show another thread

URL of post in thread:


Psycho-Babble Medication | Extras | FAQ


[dr. bob] Dr. Bob is Robert Hsiung, MD, bob@dr-bob.org

Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.