Posted by viridis on November 6, 2002, at 3:57:43
In reply to Re: Benzodiazepines and depressionviridis, posted by Tepiaca on November 5, 2002, at 15:50:15
Hi Tepiaca,
I'm not sure if Xanax really is more likely to produce dependency than Klonopin, but the idea that benzos with short half-lives (like Xanax) are most likely to do so seems pretty widespread. If you can, why not try Klonopin with the Wellbutrin and see how you react? Wellbutrin is often very activating, so maybe the two together could work well for you. But if Xanax helps you more, I'd stick with it. Again, this is something to discuss with your doctor.
I've taken K and WB together, but for me, the WB was mainly irritating, and didn't help with my remaining depression, whereas Adderall, an amphetamine mixture, has been very helpful (but I take that primarily for ADD). WB alone (without K) was intolerable, causing me severe anxiety and various side effects. It can be a good antidepressant for some, but is notorious for increasing anxiety. On the positive side, WB rarely has sexual side effects and is sometimes used to offset the sexual side effects of other antidepressants. It had no sexual side effects for me, just lots of others that I couldn't stand.
Antidepressants that are especially well known for sexual side effects are the SSRIs (selective serotonin reuptake inhibitors -- Prozac, Paxil, Zoloft, Celexa, Luvox, etc.), and Effexor, which has SSRI-like effects and also affects norepinephrine reuptake. I haven't taken all of these, but Prozac and especially Zoloft were terrible for me in terms of side effects, including near-complete loss of libido. My psychiatrist estimates that sexual side effects from SSRIs occur in at least 60% of patients. But, others do very well with them.
Another antidepressant that some people here recommend is Remeron (mirtazipine). I've never taken it (although many others on this board could comment). Apparently, it rarely has sexual side effects, but is known for causing weight gain in some people. Then there's Serzone (Nefazodone), which works well for some people and (apparently) can reduce agitation. Again, I'm sure others here could comment.
There are lots of possibilities, and even though it may take time, you're very likely to find a medication strategy that will work for you. The nice thing about benzos is that they can help to stabilize you quickly, and you'll know how you react quite soon, whereas most of the antidepressants can take weeks or longer to be effective. If you can tolerate Wellbutrin, I'd give it a reasonable trial (a few weeks) and maybe see how Xanax vs. Klonopin work together with it. If it doesn't work, then I'd try some of the other antidepressants, under a doctor's supervision.
Having the benzos available can be a great help during the adjustment periods for ADs, and you may find (like I did) that benzos are the drugs that provide primary relief. If Xanax is most helpful for you, then I'd keep it on hand in case the other treatments don't work or cause intolerable side effects. It can be a great help to have something available that you know will calm you down, and you might find after trying various ADs that benzos are a better alternative for you.
Remember that most of the ADs can cause dependency, sometimes worse than that caused by benzos. If you have a serious mental condition and find a medication that treats it, there's a good chance that you'll become dependent on it. But I still think that this is better than being anxious and/or depressed most of the time.
poster:viridis
thread:126091
URL: http://www.dr-bob.org/babble/20021101/msgs/126640.html