![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 88 to 112 of 251. Go back in thread:
Posted by Cam W. on March 22, 2000, at 22:35:04
In reply to Re: generic version of klonopin CAM W help, posted by Melissa on March 22, 2000, at 21:46:20
Amanda - Low dose Klonopin, used as needed to take the edge off of anxiety is safe and effective. Some of the alarmist descriptions above are tempered with success stories. Long term use can lead to tolerance to the motor effects (drowsiness, dizziness, etc.) but not to the anti-anxiety effects. When people don't feel these side effects they sometimes believe that the drug is no longer controlling the anxiety and they then increase the dose. This is where the trouble starts. It is harder to wean oneself from larger doses taken long term. If someone has taken Klonopin daily for a long period of time, tapering is a must. I have found that those who are taking Klonopin to get high or as a way to forget their problems (instead of just using it to take the edge off of anxiety) are the people who have the hardest time withdrawing from the drug.This said, there are methods to ease one's withdrawl from high dose, long term Klonopin. Tapering of the drug should be done slowly over a couple of months at least if one has been taking the drug on a daily basis for more than a year. One tapers to a point to where they can't taper anymore without getting withdrawl effects. Then, a low dose long-acting benzodiazepine (usually Valium) can ease the symptoms. The long half-life of Valium prevents the low blood levels of Klonopin from causing the withdrawl symptoms. After one can get off the Klonopin, then the Valium can be slowly withdrawn. Valiums long half life prevents the withdrawl symptoms from being much of a problem. The problem with Valium in the 1960's was the high doses given 3 or 4 times daily. The drug built up in the body (because of the long half life) until there were liver changes and a person became physically addicted. In the scenario above, one would be using 4 or 5 mg of Valium a day (dived doses) for about a month (not much chance to build up to the levels seen in the sixties).
Ultimately, the choice of taking Klonopin is yours. Have a talk with your doctor. Write down your concerns and take them with you next time you see him. Have him address your concerns point by point. Many times a drug will not work as well if the person taking it has fears about it. Many of the above posts against Klonopin were people lashing out (maybe out of frustration; maybe they felt betrayed by their doctor - I don't know). When discussing medication, it must be done in a rational way; emotions should be curbed. I'd actually like Paul to post again, after 2 years, to see if he is still as angry as when he first posted. I don't know if I have helped alleviate your fears and I won't tell you to take Klonopin or not. You have to ultimately make that decision, others can't. Sincerely Cam W.
Posted by Melissa on March 23, 2000, at 4:18:29
In reply to Re: generic version of klonopin CAM W help, posted by Cam W. on March 22, 2000, at 22:35:04
>
> Amanda - Low dose Klonopin, used as needed to take the edge off of anxiety is safe and effective. Some of the alarmist descriptions above are tempered with success stories. Long term use can lead to tolerance to the motor effects (drowsiness, dizziness, etc.) but not to the anti-anxiety effects. When people don't feel these side effects they sometimes believe that the drug is no longer controlling the anxiety and they then increase the dose. This is where the trouble starts. It is harder to wean oneself from larger doses taken long term. If someone has taken Klonopin daily for a long period of time, tapering is a must. I have found that those who are taking Klonopin to get high or as a way to forget their problems (instead of just using it to take the edge off of anxiety) are the people who have the hardest time withdrawing from the drug.
>
> This said, there are methods to ease one's withdrawl from high dose, long term Klonopin. Tapering of the drug should be done slowly over a couple of months at least if one has been taking the drug on a daily basis for more than a year. One tapers to a point to where they can't taper anymore without getting withdrawl effects. Then, a low dose long-acting benzodiazepine (usually Valium) can ease the symptoms. The long half-life of Valium prevents the low blood levels of Klonopin from causing the withdrawl symptoms. After one can get off the Klonopin, then the Valium can be slowly withdrawn. Valiums long half life prevents the withdrawl symptoms from being much of a problem. The problem with Valium in the 1960's was the high doses given 3 or 4 times daily. The drug built up in the body (because of the long half life) until there were liver changes and a person became physically addicted. In the scenario above, one would be using 4 or 5 mg of Valium a day (dived doses) for about a month (not much chance to build up to the levels seen in the sixties).
>
> Ultimately, the choice of taking Klonopin is yours. Have a talk with your doctor. Write down your concerns and take them with you next time you see him. Have him address your concerns point by point. Many times a drug will not work as well if the person taking it has fears about it. Many of the above posts against Klonopin were people lashing out (maybe out of frustration; maybe they felt betrayed by their doctor - I don't know). When discussing medication, it must be done in a rational way; emotions should be curbed. I'd actually like Paul to post again, after 2 years, to see if he is still as angry as when he first posted. I don't know if I have helped alleviate your fears and I won't tell you to take Klonopin or not. You have to ultimately make that decision, others can't. Sincerely Cam W.Cam
I just can not agree with you. 1 mg that I am taking is not exactly a large dosage. I have tried tapering off slowly. I have done this under the supervision of literally one of the world's leading pharmacological psychiatrists. His name is Dr. Charles Olsen and he is involved with many of the studies at NIH (National Institutes of Health.) You can look him up. I live in Baltimore near Johns Hopkins and near DC which fortumately for me gives me access to some of the leading medical people in the world.We tried reducing my dosage by 6 1/4% at a time. After two weeks the effect of even the first 6 1/4 % were intolerable for me. It led to extreme irritability, inability to sleep, hyper-activity and a complete incapacity to concentrate and barely function. It actually became unsafe for me to drive because I lost impulse control. It became impossible for me to function professionally and it became imperative that I return to my "normal" dosage of 1 mg. We have tried to find a substitute for me to be on while I was withdrawing with the intentions that I would be on some kind of blocker (I think the term was Beta Blocker) while I withdrew. But we could not find a drug that did not have intolerable side effects, the most serious being deep in my bone tiredness. In particular, we tried Celexa which is know for minimal side effects and Neurontin which is also an anti-convulsant as is klonopin and used for anxiety but known through serious medical research not to be physically addictive. Klonopin is known through serious medical reseach to be extremely physically addictive, becoming more so as one takes over time and very dangerous to get off if not done carefully. Some people never succeed getting off if they have been on it a long time.
Klonopin's anti-anxiety effects do wear off over time. It is a little insulting to the numerous reported observations by patients and doctors as to this result (not just those reported here on this list) to suggest that the patients are imagining its reduction in effectiveness due to missing the side-effects some people experience. I personally never had any side effects from klonopin while I was taking it and I know many high functioning high level professionals who report the same. It is also a little insulting to suggest that those who have been upset by what they have experienced as long term negative effects of trying to get off this drug as merely expressing frustration and taking it out on their doctors. I personally bear no ill-will towards the doctor who first put me on klonopin. He was very careful in his research (which is why I chose him) and he reported what was known at the time. He too acknowledges now, not only from the research but the large number of his clients who he put on klonopin that the research available at the time was wrong and he is dealing with a number of addicted clients. (He is no longer my doctor because I no longer live in that city but we stay in touch, having a somewhat more personal relationship than most clients and doctors do.) What you report about valium is what was reported about the advantages of klonopin over valium over 12 years ago. What you report is rather dated information. There is much more significant and more recent research on the effects of klonopin since then. I was put on klonopin the first time for exactly the reasons you cite. That it was not as addicitive as valium, which if you are familiar with valium's history was also believed to be non-addictive when it was first introduced. Klonopin was orignally believed to be non-addictive as well. It is now known otherwise.
Obviously I am not taking klonopin now for anti-anxiety reasons after ten years. It has no anti-anxiety effect on me any more. I am just physically hooked to it. At this point, unless I can go into a medical treatment center for at least one month to go through the early stages of withdrawal, my doctor and I have given up hope of my withdrawing from the drug. I do not have that time and at this point and it is not assured that one month for the early stages will be adequate. I have a fairly close friend who is 20 years younger than me, who became addicted to the klonopin quite severly after two years. She has been tapering off slowly. She was also on 1 mg. After over one year she is down to the last .25 mg and is finding it extremely difficult to tolerate the last stages of withdrawal from the drug. Apparantly, the last part is the hardest to physically tolerate. She also is under strict doctor supervision. And the risk of epileptic seizures from withdrawing are quite real and are reported side effects of the drug. Another woman I know and her sister both were put on klonopin after the sudden deth of their parents and after a number of years both went through withdrawal. They both suffered permanent damage to their hearing, a not uncommon effect of withdrawing from klonopin. When I was switched by my prescription plan to the generic of klonopin, not only did I suffer severe withdrawal symptoms but I too suffered damage to my hearing. I happened to have been tested for my hearing a couple of month before as a routine ENT check-up just before the switch to generics happened and my hearing was evaluated as above average for the population. Now I am struggling not to get a hearing aid. As my prescription plan does not cover the name brand any more, I must pay for the difference between the genric and the name brand out of my pocket, which is not inexpensive.
The conclusion by the medical profession that klonopin should only be used for short-term use is quite well known among more sophisticated medical circles. Even the manufacurer in its reports acknowledges that. Of course, I am sure one can come up with cases where there were no serious negative side effects from usage of the drug. But then so did the tobacco companies with regard to smoking cigarettes. The question is the risk one undertakes when choosing to take this drug. Whether, when the incidence of physical addiction over long term use is fairly certain, the reduction in the drug's effectiveness over time a known possible result, and the fairly high incidence of quite troublesome withdrawal from it, is worth the risk of even starting it. Particularly when there are more effective and less troublesome drugs out there, Neurontin being the most notable in functioning bio-medically the same as klonopin but without the addictive effects. I know that the reports here at this site tend to be a skewed sample, but I am reporting the results of well known research. These results are also known among the medical profession in Europe as well. (I happen to have colleagues in the medical profession in Europe as I go there to lecture in my field.) I would be careful reassuring someone that there are many success stories when there are so many that are not successful.
As I do not wish to get into a debate with you, Cam, I will not respond any further. Amanda has enough information from our exchange to be able to make an informed decision through her own efforts. There are quite a few other sites, some of which can be linked to through this site that also discuss the difficulties of taking klonopin.
Amanda, I wish you best of luck in your endeavors.
Melissa
Posted by Sherry on March 23, 2000, at 6:17:56
In reply to Re: generic version of klonopin CAM W help, posted by Melissa on March 23, 2000, at 4:18:29
I was under the impression that Klonopin had a very long half life. The longest of any of the anti-anxiety medications. I don't know about withdrawal though because I have never become dependent on it. However, I did become dependent on xanax, and it was very difficult to withdraw. ~Sherry
>
> > Amanda - Low dose Klonopin, used as needed to take the edge off of anxiety is safe and effective. Some of the alarmist descriptions above are tempered with success stories. Long term use can lead to tolerance to the motor effects (drowsiness, dizziness, etc.) but not to the anti-anxiety effects. When people don't feel these side effects they sometimes believe that the drug is no longer controlling the anxiety and they then increase the dose. This is where the trouble starts. It is harder to wean oneself from larger doses taken long term. If someone has taken Klonopin daily for a long period of time, tapering is a must. I have found that those who are taking Klonopin to get high or as a way to forget their problems (instead of just using it to take the edge off of anxiety) are the people who have the hardest time withdrawing from the drug.
> >
> > This said, there are methods to ease one's withdrawl from high dose, long term Klonopin. Tapering of the drug should be done slowly over a couple of months at least if one has been taking the drug on a daily basis for more than a year. One tapers to a point to where they can't taper anymore without getting withdrawl effects. Then, a low dose long-acting benzodiazepine (usually Valium) can ease the symptoms. The long half-life of Valium prevents the low blood levels of Klonopin from causing the withdrawl symptoms. After one can get off the Klonopin, then the Valium can be slowly withdrawn. Valiums long half life prevents the withdrawl symptoms from being much of a problem. The problem with Valium in the 1960's was the high doses given 3 or 4 times daily. The drug built up in the body (because of the long half life) until there were liver changes and a person became physically addicted. In the scenario above, one would be using 4 or 5 mg of Valium a day (dived doses) for about a month (not much chance to build up to the levels seen in the sixties).
> >
> > Ultimately, the choice of taking Klonopin is yours. Have a talk with your doctor. Write down your concerns and take them with you next time you see him. Have him address your concerns point by point. Many times a drug will not work as well if the person taking it has fears about it. Many of the above posts against Klonopin were people lashing out (maybe out of frustration; maybe they felt betrayed by their doctor - I don't know). When discussing medication, it must be done in a rational way; emotions should be curbed. I'd actually like Paul to post again, after 2 years, to see if he is still as angry as when he first posted. I don't know if I have helped alleviate your fears and I won't tell you to take Klonopin or not. You have to ultimately make that decision, others can't. Sincerely Cam W.
>
> Cam
> I just can not agree with you. 1 mg that I am taking is not exactly a large dosage. I have tried tapering off slowly. I have done this under the supervision of literally one of the world's leading pharmacological psychiatrists. His name is Dr. Charles Olsen and he is involved with many of the studies at NIH (National Institutes of Health.) You can look him up. I live in Baltimore near Johns Hopkins and near DC which fortumately for me gives me access to some of the leading medical people in the world.
>
> We tried reducing my dosage by 6 1/4% at a time. After two weeks the effect of even the first 6 1/4 % were intolerable for me. It led to extreme irritability, inability to sleep, hyper-activity and a complete incapacity to concentrate and barely function. It actually became unsafe for me to drive because I lost impulse control. It became impossible for me to function professionally and it became imperative that I return to my "normal" dosage of 1 mg. We have tried to find a substitute for me to be on while I was withdrawing with the intentions that I would be on some kind of blocker (I think the term was Beta Blocker) while I withdrew. But we could not find a drug that did not have intolerable side effects, the most serious being deep in my bone tiredness. In particular, we tried Celexa which is know for minimal side effects and Neurontin which is also an anti-convulsant as is klonopin and used for anxiety but known through serious medical research not to be physically addictive. Klonopin is known through serious medical reseach to be extremely physically addictive, becoming more so as one takes over time and very dangerous to get off if not done carefully. Some people never succeed getting off if they have been on it a long time.
>
> Klonopin's anti-anxiety effects do wear off over time. It is a little insulting to the numerous reported observations by patients and doctors as to this result (not just those reported here on this list) to suggest that the patients are imagining its reduction in effectiveness due to missing the side-effects some people experience. I personally never had any side effects from klonopin while I was taking it and I know many high functioning high level professionals who report the same. It is also a little insulting to suggest that those who have been upset by what they have experienced as long term negative effects of trying to get off this drug as merely expressing frustration and taking it out on their doctors. I personally bear no ill-will towards the doctor who first put me on klonopin. He was very careful in his research (which is why I chose him) and he reported what was known at the time. He too acknowledges now, not only from the research but the large number of his clients who he put on klonopin that the research available at the time was wrong and he is dealing with a number of addicted clients. (He is no longer my doctor because I no longer live in that city but we stay in touch, having a somewhat more personal relationship than most clients and doctors do.) What you report about valium is what was reported about the advantages of klonopin over valium over 12 years ago. What you report is rather dated information. There is much more significant and more recent research on the effects of klonopin since then. I was put on klonopin the first time for exactly the reasons you cite. That it was not as addicitive as valium, which if you are familiar with valium's history was also believed to be non-addictive when it was first introduced. Klonopin was orignally believed to be non-addictive as well. It is now known otherwise.
>
> Obviously I am not taking klonopin now for anti-anxiety reasons after ten years. It has no anti-anxiety effect on me any more. I am just physically hooked to it. At this point, unless I can go into a medical treatment center for at least one month to go through the early stages of withdrawal, my doctor and I have given up hope of my withdrawing from the drug. I do not have that time and at this point and it is not assured that one month for the early stages will be adequate. I have a fairly close friend who is 20 years younger than me, who became addicted to the klonopin quite severly after two years. She has been tapering off slowly. She was also on 1 mg. After over one year she is down to the last .25 mg and is finding it extremely difficult to tolerate the last stages of withdrawal from the drug. Apparantly, the last part is the hardest to physically tolerate. She also is under strict doctor supervision. And the risk of epileptic seizures from withdrawing are quite real and are reported side effects of the drug. Another woman I know and her sister both were put on klonopin after the sudden deth of their parents and after a number of years both went through withdrawal. They both suffered permanent damage to their hearing, a not uncommon effect of withdrawing from klonopin. When I was switched by my prescription plan to the generic of klonopin, not only did I suffer severe withdrawal symptoms but I too suffered damage to my hearing. I happened to have been tested for my hearing a couple of month before as a routine ENT check-up just before the switch to generics happened and my hearing was evaluated as above average for the population. Now I am struggling not to get a hearing aid. As my prescription plan does not cover the name brand any more, I must pay for the difference between the genric and the name brand out of my pocket, which is not inexpensive.
>
> The conclusion by the medical profession that klonopin should only be used for short-term use is quite well known among more sophisticated medical circles. Even the manufacurer in its reports acknowledges that. Of course, I am sure one can come up with cases where there were no serious negative side effects from usage of the drug. But then so did the tobacco companies with regard to smoking cigarettes. The question is the risk one undertakes when choosing to take this drug. Whether, when the incidence of physical addiction over long term use is fairly certain, the reduction in the drug's effectiveness over time a known possible result, and the fairly high incidence of quite troublesome withdrawal from it, is worth the risk of even starting it. Particularly when there are more effective and less troublesome drugs out there, Neurontin being the most notable in functioning bio-medically the same as klonopin but without the addictive effects. I know that the reports here at this site tend to be a skewed sample, but I am reporting the results of well known research. These results are also known among the medical profession in Europe as well. (I happen to have colleagues in the medical profession in Europe as I go there to lecture in my field.) I would be careful reassuring someone that there are many success stories when there are so many that are not successful.
>
> As I do not wish to get into a debate with you, Cam, I will not respond any further. Amanda has enough information from our exchange to be able to make an informed decision through her own efforts. There are quite a few other sites, some of which can be linked to through this site that also discuss the difficulties of taking klonopin.
>
> Amanda, I wish you best of luck in your endeavors.
>
> Melissa
Posted by Cam W. on March 23, 2000, at 7:17:17
In reply to Re: generic version of klonopin CAM W help, posted by Sherry on March 23, 2000, at 6:17:56
Sherry - Clonazepam (+ active metabolites) does have a longer half life than most benzodiazepines (18 - 72 h), but it is still half that of Diazepam (+ its metabolites). I would bet (but not much - I do not have proof) that many of the people who are having problems withdrawing from Clonazepam are of the faster metabolizing group. Yes, the books state that all benzodiazepines "should" be used short term, but in the real world this luxury is not practical. If we could find a non-addicting (esp psychologically), non-sedating, and effective anxiolytic, no one would be happier than me. But we do have to work with the tools that we are given. Unfortunately, everyone's body is physiologically different and if someone has significant aberations (eg easier downregulated or upregulated GABA receptors or changes in the GABA receptor complex) in the GABA-ergic system, yes, benzodiazepines can cause havoc in the bodys and minds of these people. The only way we can tell if someone is going to have a reaction is to have them take the drug and sometimes unfortunate incidents occur (this is true for any drug). That is the risks of medication. I will never say someone should or shouldn't take a certain medication. I believe that all options must be weighed and an informed choice made by the person taking the drug. I hope I haven't stepped on too many toes and I am sorry a number of people have had bad experiences with Clonazepam, but many, many others haven't. Sincerely - Cam W.
Posted by Amanda S on March 23, 2000, at 15:13:34
In reply to generic version of klonopin CAM W help, posted by Amanda S on March 22, 2000, at 19:05:06
I have tried almost every mood stabilizing drug and I have been very sensitive to them. Headaches,exhaustion,out to lunch,depressed,shakey,you name it. I am at my wits end. Lamictal and xanax .25mg at night. Don't have a problem going days without the xanax. All the horrible stories about the klonopin really bothers me, but it has a longer life than the zanax. I really need an anti-anxiety so I won't constantly think about dying. I tried some kind of drug that helps that, but I was out to lunch on that one. I took .25mg half pill of klonopin last night and I didn't think about dying. I certainately don't want to kill myself I am just preoccupied with how I may die, cancer, horrible car crash, hit on the head. These thoughts constantly are on my mind. I try to distract myself, but it just doesn't work. Just constant worry. My 15 year old is learning to drive and I don't think I will be able to live with the fact that he will be driving on his own soon, here I come Charter.
Posted by harry b. on March 23, 2000, at 20:38:27
In reply to Re: generic version of klonopin CAM W help, posted by Cam W. on March 22, 2000, at 20:49:23
>
>.25mg is a nice, low dose. Hope this helps - Cam W.
Whoa. I've been taking 2mg for 5yrs. My new dose
is 4mg.
Posted by Cam W. on March 23, 2000, at 21:08:59
In reply to Re: generic version of klonopin , posted by harry b. on March 23, 2000, at 20:38:27
> >
> >.25mg is a nice, low dose. Hope this helps - Cam W.
>
>
> Whoa. I've been taking 2mg for 5yrs. My new dose
> is 4mg.Harry - 4mg is not an unreasonable dose either, but some people cannot tolerate Clonazepam withdrawl and really do have trouble stopping the drug. Most people, though, do not have problems with Clonazepam. When stopping the drug, it must be tapered slowly, no matter what the dose. - Cam W.
Posted by JIll on March 24, 2000, at 10:05:58
In reply to Re: generic version of klonopin , posted by Cam W. on March 23, 2000, at 21:08:59
> > >
> > >.25mg is a nice, low dose. Hope this helps - Cam W.
> >
> >
> > Whoa. I've been taking 2mg for 5yrs. My new dose
> > is 4mg.
>
> Harry - 4mg is not an unreasonable dose either, but some people cannot tolerate Clonazepam withdrawl and really do have trouble stopping the drug. Most people, though, do not have problems with Clonazepam. When stopping the drug, it must be tapered slowly, no matter what the dose. - Cam W.I have a question is Clonazepam (The generic of Klonopin just as effective or is brand name better to take?
Posted by Cam W. on March 24, 2000, at 19:31:28
In reply to Re: generic version of klonopin , posted by JIll on March 24, 2000, at 10:05:58
Jill - In Canada, by law, the generic version must be within 5% of the pharmacokinetic parameters of the name brand product (eg within 5% in absorption, distribution, metabolism and excretion). This essentially means that the two are interchangeable. The generic companies sometimes use cheaper fillers and binders. I have seen some people with allergies have problems with some of the generic products. Also, for some reason, generic Valium doesn't seem to work as well as the name brand. Much of this may be due to the fact that the resale value on the street is much lower for the generic version, but some of my reputable customers have said the generic version of Valium doesn't work as well. I do take there word for it, as I have not done any informal studies myself. =^)In Alberta we have what is called the Drug Benefit List (has a new, more politically correct name now, but I forget what it is) which contains the maximum costs that the government will pay for medications for those covered by Social Services, Assured Income for the Severely Handicapped and for Seniors. Essentially, the costs allowed are for the generic versions, where available.
The name brand companies do not lower their prices because they are multinational companies selling to many countries. If these companies lowered their prices in Canada, they would have to do so in countries where generics are not allowed (damn lobby groups). This has included (until recently) the United States. In Canada, we have had generic versions of older drugs for about 20 years.
The name brand companies can get around this pricing problem by forming what are called "ultra-generic" companies (eg Altimed) that are at arms length from the parent companies. These ultra-generic companies essential buy the rights to sell exactly the same tablet that the brand name company markets and sell them at a generic price. The drug, binders and fillers are exactly the same as the name brand product. These generics actually come from the same lots (batches) and machines that the brand name drugs do. During the manufacturing process the dies (stamps) that press the tablets are changed from name brand to ultra-generic brand, using the very same batch of drug. The ultra-generic companies market by saying that they are made by using the same process, but are actually the same tablet. Slimy business practice, huh. All this is done so that the multinationals can charge you (in the United States) more than is charged in Canada for exactly the same product (but under a different name). Thought you'd like to know - Cam W.
Posted by bob on March 24, 2000, at 22:26:04
In reply to Re: generic version of klonopin - Jill , posted by Cam W. on March 24, 2000, at 19:31:28
Amanda, and anyone else interested in or worried about klonopin for that matter,
There are some watchwords a lot of us here in Babbleland use quite often -- Your Mileage May Vary.
That doesn't mean that people who say they've had great difficulty with a drug haven't had those problems -- it means that it may not happen to you. It *also* means that when people like me stand up and say things like "klonopin has been the single most effective psychotropic medication I have been on", no matter how true it is for me, that it will be the same blessing for you. As Cam has so articulately pointed out several times on this thread, different people have different responses to the same medication because while some of us may share symptoms, our underlying genetics and brain chemistry may be quite different.
I can't tell you how klonopin makes me feel, because that's not what it does for me. Klonopin makes me NOT feel the constant raw-edged nervous buzz that had been so omnipresent in my life that I wasn't really consciously aware of it until it was gone. Cam talks about how, sometimes, folks like me who have this "loss" of anxiety believe the med isn't working, expecting that they should be feeling something, anything.
I guess that's another way in which this med has been a blessing -- the change for me was subtle but profound and immediate. I cannot, to this day, describe well enough the way I **used** to feel ... but I am very aware that it is gone. And that's a Very Good Thing.
I've read through a couple of recent editions of "handbooks" on psychopharmacology to research the meds I've been taking forthe past few years, and I haven't found a single medication in any of them that is prescribed for depression and/or anxiety that DOES NOT say its supposed to be used for a fixed time, two years at the most, and then gradually stopped. The indication in these handbooks is that one to two years on an antidepressant should be sufficient to cure anyone of their depression.
So much for academic, scientific knowledge.
I would hazard a guess that those "lifetimes" for being on a medication have more to do with grant cycles and publication pressures than with the reality that people with neurological disorders have to face after the funding for the study dries up. At least that's my experience as an academic and a scientist (from a different field than clinical psych) who has dealt with getting funded and published.
Anyway, in making these sorts of decisions, having information from multiple perspectives is important. After spending some time around here reading, you can't help but get educated on the sorts of issues you should address when starting or changing meds. It's helped make me an informed, intelligent partner with my psychiatrist when it comes to decisions on my meds instead of someone who just sits down and takes whatever script is handed over. That sort of knowledge helped me convince my pdoc that I had shown over the course of 18 months that I don't respond to SSRIs, and so a different class of medications might be better (now, I'm on nortriptyline for my AD). When the nortrip needed a boost, I was able to go to my pdoc with three different strategies involving 6 or so different meds ... when he hit me with "let's increase your dose on the nortriptyline", I hit him with my research and my own perceptions of what might work. We decided on ritalin augmentation, and it's been a very promising month since that visit.
Whatever path you take, good luck with it!
my two cents,
bob
Posted by Susan on March 25, 2000, at 13:08:38
In reply to YMMV ... for me, klonopin's a godsend, posted by bob on March 24, 2000, at 22:26:04
Bob,
I could echo everything you have said about Klonopin. It has been working wonderfully for me for almost 3 months (to replace Xanax and Effexor XR. I asked my Pdoc about ritalin for the days I feel too tired to do anything and it seems to be working. Are you taking Ritalin on a prn basis and how much? Any side effects?
Posted by bob on March 26, 2000, at 2:17:57
In reply to Re: Bob's godsend and Ritalin, posted by Susan on March 25, 2000, at 13:08:38
> Are you taking Ritalin on a prn basis and how much? Any side effects?
Hi Susan!
Well, given that I need it all the time, yeah, you could say that ;^).
My pdoc started me at 20mg/day split 10 at breakfast, 10 at lunch, then moved me up to 20/10. At this level, it's had a very "light" touch on me -- nothing like tossing down a triple-shot espresso (not that caffeine ever did anything for me anyway). Still, it has improved my mood, my concentration, and has helped me set aside my OCD behaviors ... as long as I'm not stressed. No side effects at all. I think there's still quite a bit of room for improvement -- with my energy level at any time, or in general when I'm stressed out. But my mood hasn't been this good on a day to day basis in a long, long time. I see my pdoc again on Monday--hopefully, I'll be going to a little higher dose on it.
Between klonopin and ritalin, it makes me think of song by a friend:
"Little miracles will build a cornerstone
Next in line to debts of mine
Little miracles are all I own"Right now, I'll settle for the little ones
;^)
bob
Posted by Parker on August 21, 2000, at 18:58:37
In reply to Re: listen to YOUR body, posted by Patty on August 12, 1999, at 20:54:59
I am curious. I just happened to stumble onto this site while doing a web-search. I am on Neurontin for Peripheral Neuropathy. My Neurologist has me on 1200 MG, 3 times a day (which is 3600 MG per day). He has me on it for the pain. I have never had any side effects or seizures. I have been on this dose about a year. Should I be concerned? Is this the same medication that is causing so many problems for some of you? Is it the mixture of it with other medications to be cautious of? Thank you.
Posted by Dena C on August 23, 2000, at 22:56:53
In reply to Re: mood disorders/klonopin,depakote,neurontin etc, posted by Kate on December 14, 1998, at 12:51:11
OK heres my story, a few months ago I was diagnosed by my family physician as having anxiety disorder. She put me on Paxil and referred me to a psychiatrist. Paxil worked wonders until I started gaining weight! Got off the Paxil and on Wellbutrin for anxiety and Klonopin for sleep.
I am going through severe Paxil withdrawl which my pdoc thinks is all in my head, today he even called me hostile, childish, and uncivilized! He is a military psychiatrist by the way. Soooo, dont know what to do now. I have never felt this sick in my life, I cry for what seems hours at a time, chills and sweats, elecitric like zaps to my brain, face, and hands, dizziness to the point where I cant drive and I have a 4 year old to take care of by myself! (hubby is stationed in Korea) No family around to help since we are in a strange place and my DR. is just a big jerk! Any suggestions?
mix
Posted by shar on August 24, 2000, at 1:55:21
In reply to Paxil, Klonopin, Wellbutrin, posted by Dena C on August 23, 2000, at 22:57:14
I can't comment on Paxil withdrawal, but as a military brat I understand the dr. situation. Any chance you could get a new shrink? Because even if your behavior IS hostile, childish, or whatever he wants to call it, there is probably a reason for it (that is eluding him?).
Regarding the Paxil and withdrawal. It's not a good idea to cold turkey off a psych med. It may help if you actually get back on Paxil and go through a weaning process (reduce your dose over a period of weeks). There are other people here that can give you more info.
Good luck! And stay away from the military dentists!
Shar> OK heres my story, a few months ago I was diagnosed by my family physician as having anxiety disorder. She put me on Paxil and referred me to a psychiatrist. Paxil worked wonders until I started gaining weight! Got off the Paxil and on Wellbutrin for anxiety and Klonopin for sleep.
> I am going through severe Paxil withdrawl which my pdoc thinks is all in my head, today he even called me hostile, childish, and uncivilized! He is a military psychiatrist by the way. Soooo, dont know what to do now. I have never felt this sick in my life, I cry for what seems hours at a time, chills and sweats, elecitric like zaps to my brain, face, and hands, dizziness to the point where I cant drive and I have a 4 year old to take care of by myself! (hubby is stationed in Korea) No family around to help since we are in a strange place and my DR. is just a big jerk! Any suggestions?
> mix
Posted by adniL on August 24, 2000, at 20:38:47
In reply to Paxil, Klonopin, Wellbutrin, posted by Dena C on August 23, 2000, at 22:57:14
Gosh, I hope you're going off the Paxil slowly. The light flashes and diszziness are definitely Paxil withdrawal. I think my Dr. had me go off my 20mg over a period of a month. Wellbutrin did nothing for my anxiety. Just so you know. My shrink put me on Effexor once the Paxil weight gain kicked in. Try to get a different doctor. You need someone who takes your symptoms seriously.
> OK heres my story, a few months ago I was diagnosed by my family physician as having anxiety disorder. She put me on Paxil and referred me to a psychiatrist. Paxil worked wonders until I started gaining weight! Got off the Paxil and on Wellbutrin for anxiety and Klonopin for sleep.
> I am going through severe Paxil withdrawl which my pdoc thinks is all in my head, today he even called me hostile, childish, and uncivilized! He is a military psychiatrist by the way. Soooo, dont know what to do now. I have never felt this sick in my life, I cry for what seems hours at a time, chills and sweats, elecitric like zaps to my brain, face, and hands, dizziness to the point where I cant drive and I have a 4 year old to take care of by myself! (hubby is stationed in Korea) No family around to help since we are in a strange place and my DR. is just a big jerk! Any suggestions?
> mix
Posted by CraigF on August 25, 2000, at 14:57:19
In reply to Re: Paxil, Klonopin, Wellbutrin, posted by adniL on August 24, 2000, at 20:38:47
DEFINITELY get a new doctor, by all means!
I've never heard of anyone taking WB for anxiety problems. I had to stop taking it because it generated frustration and anxiety. The chills, etc., are from withdrawl. I had the same experience (horrible) after missing several consecutive doses of Serzone. The advice given in the above posts sounds sound. The first order of business, however, is to fire that doctor.
Posted by jim mcc on August 28, 2000, at 11:38:48
In reply to Re: Klonopin, posted by Melissa on March 20, 2000, at 1:04:58
> > > The only med for panic attacks is xanax, it restored me to sanity. The key to coming off any benzo is to use a beta blocker such as Inderal. Try it, it works. If the doctor tells you it wont tell him to try it him self and then begin counseling patients on these meds.
Good luck
> > My question isn't how to go off Klonopin, I need something to help my anxiety attacks that have gotten worse. My Dr suggested going up on my klonopin. I don't want to if I am going to get bad effects. I don't want to gain weight or have an increase of appetite. I binge already, I am always hungry, but I really am not, just think I need to eat. My Dr. also suggested neurontin, but I also have questions about side effects on that drug too. I wondered about Paxil also. I just want to get rid of these anxiety attacks and live my life again. HELP!!!!
>
> If you check my previous e-mail, I spoke about the issues of eating with Neurontin. I am also a compulsive overeater (amember of OA) and the Neurontin had no eating side effects. In fact, if anything, it relieved it and I started to lose weight gradually while I was on it. There is almost no reported weight gain side effect on Neurontin. The incidence in which it occurs is absolutely miniscule. Because I have eating issues I was very concerned about this. If there was ever a chance of weight gain on a drug no matter how small, I gained the weight. I did NOT on Neurontin. So give it a try. I also was put on klonopin because it was supposed to be not addictive as valium. ANd in fact it was. And the longer you are on it the more addicted you become. I could not even tolerate a reduction of my medication of klonopin of less than 5% . The effects on my physiologically were horrendous, extreme irratability and so forth, with in a matter of days. I have known several people who have tried to get off Klonopin after being on it for years. One woman has nearly succeedded after slowly reducing her dosage over a two year period. Another woman suffered permanent hearing damage. During one of my efforts to get off with the slightest reduction in the drug caused permnent hearing loss in me and I will now probably have to get a hearing aid. Klonopin is only supposed to be prescribed for extremely short term use. Unfortunately, many doctors are not informed of that and therefore misinform their patients. The short term use is precisely becaus of its increeasing addictive qualities over time, that can in fact induce epilepsy if one tries to get off it.
Posted by DianeD on August 28, 2000, at 12:34:18
In reply to Bad side effects of neurontin, posted by Melissa on March 3, 2000, at 9:06:59
> >But as the days progressed I started feeling an increased speedy effect, teeth....
When I took Neurontin alone it made me tired, I slept deeply. BUT when I took it with Wellbutrin and selegiline I got a weird sorta wired. I was at book store and had a heck of a time making my eyes alight long enough on a title to read it. I wasn't unable to control myself and nobody picked up on it but it was like nothing I've experienced before and I've done my share of speed. Two hours later I had a terrific headache. I think if you took Neurontin by it's self you'd be helped.
How to get off the Klonopin, I don't know. I've kicked heroin, methadone, speed, and klonopin cold. I had no problem withdrawing from Klonopin(5mg daily for about 3 months) I think because I didn't think of Klonopin as heavy drug. I was buying it off the street in an attempt to ease my withdraw symptoms from Methadone. Didn't work at all. So I just stopped taking it. A big part of any withdrawal is FEAR. If you can get your mind away from the fear some how some way you'll do much better.
And as for your " normal struggle not to overeat." I hear you there. I love food. I love to cook and unfortunately I like to eat. I have 25 lbs extra pounds I just can not loose. That Wellbutrin really cuts the appetite but I personally wasn't loosing any weight! As with drug withdrawal, the more I think and obsess about diets/calories the fatter I get. Cutting calories isn't the answer, unless you plan on eating a starvation diet the rest of your life. Getting active is the answer but I can't get up the motivation, drive, energy to do it.
I can do something once but to CONTINUE doing something (walking, lifting weights, WORKING) is my biggest problem. I don't/can't stick to anything.So much for my problems......Good luck with yours
Posted by mJim on September 3, 2000, at 7:05:07
In reply to Re: mood disorders/klonopin,depakote,neurontin etc...., posted by nancy on July 22, 1999, at 16:42:06
Hi,
I'm living with a wonderful girl who has been
taking klonopin for a couple of years now. I'm
real concerned with the amount of substances she
consumes each day, she starts the morning with a
coke to get going, often skipping breakfast. Throughout
the day she has several cokes, often skipping lunch too.
She ends her day at bedtime with 1-2mg of klonopin to knock
herself out. Also she smokes pot every day and more so on the
weekends. It saddens me to see her this way, and angers me that
the doctors prescribes these "quick fixes". She takes klonopin
mainly for occasional panic attacks which are usually due to
reactions to real external stressful circumstances at work
(a hospital). Also she takes Zoloft for depression, she lost her husband
to a car wreck a few years ago. It just seems to me that the collection
of substances she's consuming are just keeping her on a roller
coaster. I'm having a hard time watching her do this daily
ride and believe there must be some way to stop this routine.
I've attended an Al-Anon meeting but their approach is to "let
go and let God" I've read many of your postings and have seen
some success stories. I just think she needs a change of environment
away from work and stress for a while so she can break the pattern
but how do I convince her and others involved that the problem requires it?
Am I wrong to be this concerned?
Thanks,
Jim
Posted by stjames on September 4, 2000, at 0:56:23
In reply to mood disorders/klonopin,zoloft,pot,alcohol....., posted by mJim on September 3, 2000, at 7:05:07
Hmmm....
Breakfast in not the most important meal. Given the
length of time it takes your body to get nutrants
you dinner is still making nutrants in the AM, you really
don't need breakfast for more nutrants.The traditional breakfast is an overkill. Lunch or dinner is different.
Actually humans do best on 1 big meal and many snacks
during the day.Do keep in mind that Klonipin lasts for days in the body, so it is
treating the panic attacks even when taken at night. many find caffine
and effective psyco stimulant. I do think that instead of focusing
on what she is putting into her body, and anyones opinion that these are good or bad,
sugest she do some thearpy. She does sound like it would benifit from it. While in general
the less you have to take to function the better but some do need meds to function.
I always say "You take what you need to get by"Pot... I have posted B4 that I don't think, in general, it is bad but I always question
if someone is smoking it all the time to deal with some issue it does make sence
to see if there are other, legal ways to cope. Illicit drug use, to me, is not the cause but
can indicate a greater problem.Panic disorder and anxeity can have organic origins and need medical treatment.
james
Posted by Louis on September 21, 2000, at 12:37:26
In reply to mood disorders/klonopin,zoloft,pot,alcohol....., posted by mJim on September 3, 2000, at 7:05:07
I have bipolar disorder and have unsuccessfully tried the usual litany of meds. As a classical musician I especially cannot suffer the loss of coordination and tremors in my hands, which have been a side effect of far too many of the prescription drugs.
Though I am feeling quite well at the moment, a therapist recently suggested that I consider trying Neurontin. Of course, it would be written 'off label' as it is for diabetics.
In the past, I have used Marihuana for self-medication and only small amounts in the evening. I don't feel that I abused the drug, though it is illegal. I have spoken with a psychiatrist who has, in the past, prescribed Marinol to good effect for bipolar disorder. However, it would have to be written off label.
If I was an adult who had HIV, or even a child with cancer, I could use Marinol. However, currently, the Feds (Big Brother) pull licenses of doctors who write Marinol off label.
What I don't understand is: why would someone suggest neurontin off label for a bipolar disorder when they would not even consider my using Marinol off label for the same purpose?
I mean 'off label' is 'off label' isn't it?
Posted by Chris A. on September 21, 2000, at 20:00:38
In reply to Re: mood disorders/klonopin,zoloft,pot,alcohol..... » mJim, posted by Louis on September 21, 2000, at 12:37:26
>
> What I don't understand is: why would someone suggest neurontin off label for a bipolar disorder when they would not even consider my using Marinol off label for the same purpose?
>
> I mean 'off label' is 'off label' isn't it?
Using a controlled substance "off label" is a whole different ball game than using a noncontrolled substance, such as Neurontin (gabapentin) off label. It is totally illegal for your doc to use Marinol off label. He/she can not only lose their license and career for which they've worked their tail off for a minimum of eleven years, but go to jail for such an offense as well. Neurontin is actually an anticonvulsant, or more aptly put, a neuromodulatory med that has a number of beneficial "off label" uses. There is a fair amount of research in using a number of anticonvulsants in bipolar. Anticonvulsants are the top choice in treating bipolar other than lithuim. Lamictal (lamotrigine) is my all time favorite.
I wish you well in finding the right med for you.Chris A.
Posted by panicchic on November 16, 2000, at 0:38:10
In reply to Re: Klonopin, posted by Melissa on March 20, 2000, at 1:04:58
> > > Hi, I have been on klonopin 1.5 mg a day for approx 3 months now. It has definitely helped to stop my panic attacks. I am worried, however, of it's possible long-term effects. After being on Klonopin for a months, my Doc prescribed Effexor XR for depression and it is supposed to help a little w/anxiety, too. I really like the Effexor XR...It has improved my mood, I feel more motivated and I have lost weight while being on it. If you read this and have any questions / comments about Effexor XR or advice about Klonopin, please email me.
> > My question isn't how to go off Klonopin, I need something to help my anxiety attacks that have gotten worse. My Dr suggested going up on my klonopin. I don't want to if I am going to get bad effects. I don't want to gain weight or have an increase of appetite. I binge already, I am always hungry, but I really am not, just think I need to eat. My Dr. also suggested neurontin, but I also have questions about side effects on that drug too. I wondered about Paxil also. I just want to get rid of these anxiety attacks and live my life again. HELP!!!!
>
> If you check my previous e-mail, I spoke about the issues of eating with Neurontin. I am also a compulsive overeater (amember of OA) and the Neurontin had no eating side effects. In fact, if anything, it relieved it and I started to lose weight gradually while I was on it. There is almost no reported weight gain side effect on Neurontin. The incidence in which it occurs is absolutely miniscule. Because I have eating issues I was very concerned about this. If there was ever a chance of weight gain on a drug no matter how small, I gained the weight. I did NOT on Neurontin. So give it a try. I also was put on klonopin because it was supposed to be not addictive as valium. ANd in fact it was. And the longer you are on it the more addicted you become. I could not even tolerate a reduction of my medication of klonopin of less than 5% . The effects on my physiologically were horrendous, extreme irratability and so forth, with in a matter of days. I have known several people who have tried to get off Klonopin after being on it for years. One woman has nearly succeedded after slowly reducing her dosage over a two year period. Another woman suffered permanent hearing damage. During one of my efforts to get off with the slightest reduction in the drug caused permnent hearing loss in me and I will now probably have to get a hearing aid. Klonopin is only supposed to be prescribed for extremely short term use. Unfortunately, many doctors are not informed of that and therefore misinform their patients. The short term use is precisely becaus of its increeasing addictive qualities over time, that can in fact induce epilepsy if one tries to get off it.
Posted by Maniz on November 16, 2000, at 12:58:48
In reply to Re: Klonopin, posted by panicchic on November 16, 2000, at 0:38:10
Do you have any information about alprazolam (Xanax, ect) causing the same problems as klonopin (which I think is clonazepam) ?.
Which is the safest benzodiazepine for long term use ?.
Thanks
>Klonopin is only supposed to be prescribed for extremely short term use. Unfortunately, many doctors are not informed of that and therefore misinform their patients. The short term use is precisely becaus of its increeasing addictive qualities over time, that can in fact induce epilepsy if one tries to get off it.
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