![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by bark23 on September 6, 2002, at 17:20:31
Well, I just registered though Ive read posts here for quite a while. Usually this has been for my own benefit, but I have a question that is pretty important to me that has to do with my mom. She is currently on 3mg of klonopin and has been on it for about a month. Before that she took ativan pretty much as needed but her new doc wanted her stable on a medication, preferably a long acting one like klonopin. She has been experiencing confusion and memory problems that have not improved yet and has asked me to find out if there are benzos out there that would be less likely to cause these problems. She doesnt remember if ativan really did this stuff to her or not, so thats not ruled out, though a longer acting med might be best. These meds seem to help her a lot, so I would like to have suggestions for alternative ones. She has tried the other main classes of meds for anxiety without much success. So if anyone has experience they could share or point me to comparisons (the more well controlled, etc. the better, but anything would be appreciated) between the benzodiazepines regarding cognitive impairment that would help a lot as I can find nothing myself. I dont think it is necessarily a function of age (she is 53), which she is worried might be it though she is not that old, as klonopin does have a high rate of cognitive impairment from what Ive read in comparison to other benzos, but I just havent seen anything more specific than that. I know this is probably very variable from person to person, but Im hoping there is some info that could help her and give her something to suggest to her doc, who is open to suggestions, but does not really have a strong opinion on this matter herself. Its ok if any links are simply pharmacological studies or anything like that, I have a decent enough backround to most likely understand them. Anyway, thanks for any help.
Posted by judy1 on September 6, 2002, at 19:36:20
In reply to Benzos and cognition, posted by bark23 on September 6, 2002, at 17:20:31
Klonopin is rather notorious for affecting memory and has also been implicated in depression. Having said that, I think it's the best benzo for panic disorder, but if she has a different anxiety disorder she may be happier with ativan or xanax. take care, judy
Posted by J200 on September 6, 2002, at 21:08:11
In reply to Benzos and cognition, posted by bark23 on September 6, 2002, at 17:20:31
Benzos can cause not only confusion and cognition problems but plain flat total amnesia too. Been there, so I know. Does your mom consume any alcohol with the benzos ?
Posted by joy on September 6, 2002, at 22:52:46
In reply to Re: Benzos and cognition, posted by J200 on September 6, 2002, at 21:08:11
Hi. I've been taking Xanax abut 2.5 years. I was always forgetful, even in my 20's and unmedicated. I don't overtake, but I don't find any problems with memory [other than the post menopausal moronic moments we all have]. My psych feels Klonopin can be depressing, while he feels Xanax is not. I've never had a problem, and it's helped me tremendously with anxiety attacks [not too many anymore] and insomnia. I was always careful not to 'overtake'. Hope this helps a little.
Joy
Posted by bark23 on September 7, 2002, at 14:33:49
In reply to Re: Benzos and cognition, posted by J200 on September 6, 2002, at 21:08:11
No, my mom doesnt drink with the klonopin. She also seems to have the most confusion in the morning.
And thanks everyone for helping out so far.
matt
Posted by Rick on September 8, 2002, at 1:13:37
In reply to Re: Benzos and cognition, posted by bark23 on September 7, 2002, at 14:33:49
A couple thoughts re your question as well as some of the responses thus far:
-- Most importantly: I wonder if she can taper down and get by on a lower dose. It took me awhile to realize that I actually did better, with fewer side effects, on a lower dose of Klonopin than the 3 mg/day I started on three years ago. I'm now down to 1 mg a day, and it controls my anxiety very well.
-- I believe Klonopin does casue me some short-term memory impairment. But...I'm in a job that requires a lot of heavy-duty thinking, and my performance has greatly *improved* since I've been on Klonopin. On balance, when it comes to cognitive ability, the benefits that come from freeing my mind from anxiety greatly outweigh the detriment of intermittent memory lapses.
-- Gradual cognitive decline actually begins when one is in their 20's, but commonly becomes noticeable in middle age (e.g., forgetfulness and mental slowness -- both actual and perceived). Why do you think Ginkgo sales are so huge? I know this is a factor for me, too.
-- I often hear the comment one poster said about Klonopin increasing risk of depression while Xanax doesn't, and I ofetn wonder if this is overstated or even completely untrue. I know I was much more prone to low feelings on Xanax. I've never been clinically depressed, though. I've seen at least two Medline studies pointing to ANTI-depressive properties for Klonopin (let me know if you'd like to see the abstracts).
I found it interesting that a recent study debunks the longtime "conventional wisdom" that use of the beta blocker Propranolol can lead to depression.
It may not happen right away, but I'm sure you'll hit on the optimal treatment for your mother. She's fortunate to have a loving daughter/son who is helping her out like this.
Rick
Posted by bark23 on September 8, 2002, at 13:52:38
In reply to Re: Benzos and cognition, posted by Rick on September 8, 2002, at 1:13:37
Thanks for all your input. I have seen 2 abstracts searching neuroscion; one on diabetic rats (although it may have been humans) and one about klonopin in refractory depressives, both of which made me feel a bit confused about the depressogenic (sp?) claim. I think I might have also seen one about augmentation. I would like to see what abstracts you have found though. I know it has helped my depression in addition to adding some additional stabilization along with my mood stabilizers, not to mention contolling anxiety very well. I also strongly agree with your statement about freedom from anxiety clearing the mind. As for the age thing, part of it is that my mom is very scared thats what it is, although it began pretty soon after she started the klonopin. I am also on propranolol for a hand tremor, which has not affected my depression. I always thought maybe that was more just theory about beta blockers because of the theory that beta-receptor downregulation is what many think possibly makes antidepressants work. Anyways, I will talk to my mom about lowering her dose, and she is willing to wait a bit longer to see whats side effects go away. Thanks for some good suggestions.
matt
Posted by Rick on September 9, 2002, at 1:33:26
In reply to Re: Benzos and cognition » Rick, posted by bark23 on September 8, 2002, at 13:52:38
> I think I might have also seen one about augmentation. I would like to see what abstracts you have found though.
Here are the abstracts I was referring to, re Klonopin monotherapy in depression. (I know I've seen at least three or four re augmentation, too. That's actually a more "mainstream" concept.)
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3279721&dopt=Abstract
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8653596&dopt=Abstract
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.