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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Nic on August 12, 2001, at 16:42:29
I have been on Celexa (60mg/day) and Klonopin (3-6mg/day) for several months now, and the combination seems to help me allot with both my depression and severe panic/anxiety attacks.
My question is that I have a hard time getting too motivated, so I dink allot of caffeine, and that makes my panic/anxiety just worse.
Would I be better off adding Wellbutrin to this combo at a low dosage and reduce my Celexa dosage (so I can get of of my sex drive back also.)
Any comments or experience with any of these medicattions would be much appreciated.
Kindest Regards,
Nic
Posted by Joe Schmoe on August 12, 2001, at 17:48:36
In reply to Celexa + Klonopin question??????????, posted by Nic on August 12, 2001, at 16:42:29
Well I am on Klonopin 2 mg/day and Wellbutrin 100 mg SR/day and just started Celexa 20 mg/day so I wish I had some answers for you but after only three days, I don't! Each day has been totally different so far, I have no idea how it will shake out.
While on just Wellbutrin and Klonopin I no longer needed caffeine, so the Wellbutrin definitely energized me, but since adding Celexa I am yawning, napping and drinking Cokes again to stay awake. This may be a transient effect though. I am also on a fairly low dose of Wellbutrin which may change if/when the chest pains it causes go away.
Posted by Amy Blue on August 13, 2001, at 10:49:17
In reply to Celexa + Klonopin question??????????, posted by Nic on August 12, 2001, at 16:42:29
I would recommend reducing your Klonopin. If you've been on Celexa for a few months that should be long enough to help the anxiety. That is a large dose of Klonopin to be taking daily, in my totally medically uneducated opinion.
Posted by Nic on August 13, 2001, at 11:45:21
In reply to Re: Celexa + Klonopin question??????????, posted by Amy Blue on August 13, 2001, at 10:49:17
> I would recommend reducing your Klonopin. If you've been on Celexa for a few months that should be long enough to help the anxiety. That is a large dose of Klonopin to be taking daily, in my totally medically uneducated opinion.
Amy,
I wish I could reduce the Klonopin dosage, but that is the only dosage that will control my panic attacks.
Posted by Rick on August 13, 2001, at 17:52:19
In reply to Re: Celexa + Klonopin question??????????, posted by Nic on August 13, 2001, at 11:45:21
> > I would recommend reducing your Klonopin. If you've been on Celexa for a few months that should be long enough to help the anxiety. That is a large dose of Klonopin to be taking daily, in my totally medically uneducated opinion.
>
> Amy,
>
> I wish I could reduce the Klonopin dosage, but that is the only dosage that will control my panic attacks.A lot of Babblers aren't full of praise for Provigil, but it's the only stimulant I've taken that actually reduces anxiety rather than increases it, at least in combo with more sedating meds and in reasonable amounts. I'm guessing that it might help you, too, but I could see being a bit more cautious with panic than with the non-depressive Social Phobia I use it for. For me, Provigil reduces anxiety by building my confidence and enthusiasm. It adds a welcome "proactivity" dimension to my treatment, let alone eliminating most fatigue without causing insomnia.
Backing up a bit, I was taking Klonopin alone with lots of benefit, but added Celexa in an attempt to "go for the gold." It may have helped a bit, but mainly made me lethargic and apathetic, and this only got worse as my twelve-week Celexa trial wore on. (The sexual dysfunction was annoying, too.) Adding Wellbutrin caused some anxiety to come back and didn't really provide as much activation as I had hoped.
Sticking with Klonopin 1.75 mg/day (now down to 1.0), I quit the Celexa, but added the even more sedating Serzone at the same time. A few days after starting to titrate up on the Serzone, I started with Provigil and knew it was clicking. This gentle stimulant (and AD booster) was not only keeping the fatigue at bay, it was adding confidence and mood brightening properties, all without added jitters or amphetamine-type side effects. Again, getting the dosage just right (200 mg initially then down to 100 mg/day worked great for me) is important. I do know that some people with anxiety get more cognitive benefit/wakefulness than I did when adding Wellbutrin to calming meds...and minus the added anxiety. But Provigil+Klonopin+Serzone has really done the trick for me. BTW, it took a good 10 weeks until I could be confident the Serzone was adding anything to the party. Hopefully Celexa will work out for you, but if you ever end up taking Serzone you may be able to (or may NEED to) cut back on the Klonopin, since it seems to potentiate its effect, likely via hepatic metabolism dynamics.
Rick
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