Posted by Squiggles on September 2, 2006, at 8:36:37
In reply to Re: Clonazepam dosing » Squiggles, posted by Squiggles on September 2, 2006, at 8:17:20
My apologies for hitting the button twice
on my previous post.
i need more coffee - if Dr. Bob or his
assistants wich to remove it, please do
so.I found many article under the key words
clonazepam unique
in the PubMed selections - various reasons
from pharmacological structure to interaction
with benzo receptors are cited.This one is from a therapeutic point of view
and comes from Dr. G. Chouinard - Montreal
of all places (what a small world), discussing
the advantage of using clonazepam in bipolar
disorder and other psychiatric disorders,
as it seem to reduce the need for
neuroleptics. It is stated that even without
lithium, K (clonazepam) by itself can reduce
the manic state.I would like to cite my own experience not long
ago, when i took a corrupted (low, or counterfeit or whatever) dose of lithium. Over
six months the symptoms of manic depression
arose for the first time in 25 years. I was
able to correct this at the most suicidal and
agitated depression phase, by switching to another pharmacy and the old lithium.I would like to point out, that at the time of
this incident i had never stopped taking the
regular dose of clonazepam.You might consider the pharmacological import of that according to anyone understaning its
significance. Perhaps an increase in K would
have confirmed Dr. Chouinard's hypothesis.Here is the abstract:
The use of benzodiazepines in the treatment of manic-depressive illness.
* Chouinard G.
Clinical Psychopharmacology Unit, Allan Memorial Institute, Royal Victoria Hospital, Montreal, Canada.
The benzodiazepine clonazepam was approved for the treatment of epilepsy in 1976. To study its use in acute mania, the author compared clonazepam with lithium in a crossover trial. Clonazepam proved more effective than lithium in controlling the symptoms of mania and caused fewer manifestations of parkinsonism. Associated side effects included ataxia, drowsiness, and behavioral changes. No treatment-emergent depression was observed. Neither clonazepam nor any other benzodiazepine is recommended in schizoaffective or schizophrenic disorders because of the high risk of dependence in those patients, in contrast to manic-depressives. For the maintenance treatment of bipolar disorder, lithium is recommended as the initial agent, with L-tryptophan added if concomitant medication is needed. Clonazepam can then be added as the anticonvulsant, if necessary. In the treatment of acute mania, clonazepam is recommended for the first week of treatment, and lithium is added in the beginning of the second week, thus avoiding the use of neuroleptics.
PMID: 2903143 [PubMed - indexed for MEDLINE]
Squiggles
poster:Squiggles
thread:679936
URL: http://www.dr-bob.org/babble/20060901/msgs/682236.html