Posted by Laurie1041 on April 16, 2011, at 1:27:05
History of Anxiety Disorder x 1 year, age 19 in 1979.
Started on Klonopin 1 mg. (for panic attacks induced by start-up of Effexor XR for depression) at age 40 in 2000 (bad marriage, stress at work).
Started Provigil for Shift Work Sleep Disorder (night shift) in 2007.Hospitalized at age 47 for supposed BP I, Mixed, after a huge spending spree and ensuing depression. Note that I had been started on Provigil. I had to leave my profession as a RN and have not worked since 2007.
Hospitalized x 2 at age 49 in 2009 for severe depression after death of my husband. I was in a manic state for 4 months after being discharged on Adderral XR 30 mg. BID.
Hospitalized x 3 at age 50 in 2010 for severe depression.
Started Cognitive Behavioral Therapy in 2010 and continuing.
All SSRI's/SNRI's do not work.
Lithium - well tolerated, no side effects. It has lost it's punch.
All atypical anti-psychotics give me EPS, with the exception of Seroquel. However, my pdoc is hesitant to keep me on Seroquel due to metabolic syndrome. Plus Seroquel XR 150 mg. BID makes me dumb as a rock.
Wellbutrin - major anxiety and mood lability
Nortryptaline- 50 mg. major oversedation
Tegretol - somnolence
Trileptal - depression
Current Meds:
Pristiq 100 mg. QD
Levothyroxine 0.112 mg. QD
Adderrall XR 30 mg. QAM
Lithium 900 mg. QHS
Klonopin 2 mg. QHS
Seroquel 25 mg. QHSMy theory is that I may be suffering from "Tolerance Withdrawals" from long-term "medically-dose" stable clonazepam use (11 years).
From what I have read "Tolerance Withdrawal" can result from a stable dose of benzodiazepines and can cause paradoxical symptoms of withdrawal, including, severe depression, suicidal ideation, anxiety, and panic, to name a few. I have had and continue to have all of these symptoms.My benzo use (1 mg. x 10 years, 2 mg. x 1 year) has never been addressed by the multitude of professionals I have consulted with. My pdoc listened very politely to my theory regarding my treatment resistant depression and said I could reduce my dose of clonazepam from 2 mg. to 1.75 mg. each night. I went into withdrawals after 5 days of tapering and after 3 weeks of hell, my pdoc instructed me to go back to 2 mg. at night. I can only assume that my pdoc does not agree with my benzo "tolerance withdrawal" theory and does not exude confidence when it comes to getting off long term benzodiazpines.
I consulted with a Internist who specializes in chemical dependency and he said he would have no problem in helping me to undergo a very slow taper except for the fact that I have a psych history. (?)
I consulted with a recommended pdoc today and brought my sister and step-mom with me for the consultation and he glided over getting off of clonazepam and said that his first goal for me would be to treat my depression. What a novel idea!! I said I had been on every class of meds and he recommended that I taper off of my SNRI, wait for 7 days and start on the Ensam patch. But what he really thought would be best would be to taper down to 1 mg. of clonazepam and then start rTMS (repetitive Transcranial Magnetic Stimulation) therapy at $8500.00 for 4 weeks and then $450.00 per session thereafter for a total of 6 weeks. This sounds like junk science to me.
Any suggestions? I need some hope!
poster:Laurie1041
thread:982992
URL: http://www.dr-bob.org/babble/20110406/msgs/982992.html