Posted by Viridis on October 29, 2003, at 2:35:24
In reply to Re: Agitated depression; anxiety bad in morning, posted by dannen on October 28, 2003, at 12:37:49
Hi Dannen,
I don't have any experience with TCAs, so can't help there. Re: Klonopin: I've been taking 1 mg Klonopin per day for 2 1/2 years and haven't changed the dosage except for very rarely taking an extra mg later in the day (only for really intense stress, maybe once a month).
There are no guarantees, but my pdoc says he has many patients who have been on the same dose for years and are doing well. He's offered to increase my dose (1 mg is at the very low end for serious anxiety/panic) but I've had no need so far and don't want to increase it unless I absolutely have to. Generally, I use Xanax for "breakthrough" anxiety, but given my sudden tolerance to Xanax I keep its use to a minimum. It is very helpful as a backup, though, and normally Klonopin is enough anyway.
BTW, Klonopin was originally used for epilepsy, and up to 20 mg/day was/is a pretty common dose for that condition. I can't imagine taking that much! No matter how much you take, though, if you take it for long, you need to diminish the dose gradually should you decide to quit it. This seems to be the case for almost all of these psychiatric meds (and lots of others too, like some blood pressure drugs etc.).
If I were you, I'd give Klonopin a trial for a couple of weeks -- I suspect it will help a lot, especially together with nortriptyline. The morning anxiety syndrome is awful, and I've had plenty of experience with it. I never want to go back there, and will stick with the meds for life if necessary.
poster:Viridis
thread:271647
URL: http://www.dr-bob.org/babble/20031025/msgs/274531.html