Shown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Guy on August 12, 2003, at 22:11:25
The 1 mg clonazepam I had been taking for about a year recently stopped working for sleep, so I added Remeron and that worked for a while, but then that stopped working too. Dropped those meds and am now on low dose Seroquel, but it makes me feel very nauseous and generally ill. Don't know where to go from here. My main problems are chronic anxiety and insomnia. Just wondering if I should have tried going higher with the clonazepam before calling it quits.
Posted by jlo820 on August 12, 2003, at 22:41:34
In reply to Clonazepam poop-out, posted by Guy on August 12, 2003, at 22:11:25
I am surprised it lasted a year for you. Were you taking it every night?
Taken every night, benzodiazepines used for sleep will usually loose their effectivness after about a month, shorter in many cases. People usually have to increase their dosage. That is why benzodiazepines are usually not presribed for more than a few weeks for sleep problems. After that point, patients are usually re-evaluated and given something that is better for long-term use.
I take Trazodone for sleep, with an occassional Halcion if I am having a really hard time getting to sleep. But I don't take the Halcion ever more than once a week, so I haven't built up a tolerance.
I would think about asking your doctor for something besides clonazepam for the sleep. You can still take it for anxiety - it should not loose its effectivness for that and you should not have to increase your dosage.
Posted by Ame Sans Vie on August 12, 2003, at 22:43:24
In reply to Clonazepam poop-out, posted by Guy on August 12, 2003, at 22:11:25
Trying a higher dose of clonazepam for sleep would just lead to you needing higher and higher doses as time goes on. Tolerance develops quite rapidly to the hypnotic effects of benzos. (though, from your post, I'm not quite sure whether you take the clonazepam just for sleep or during the day for anxiety as well?)
L-tryptophan, from what I hear, is a wonderful sleep aid that's available over-the-counter, as is melatonin.
There are dozens of herbal remedies that can help as well, to which a development of tolerance is *extremely* rare. The best in the sleep-inducement category would be any high quality product including kava kava, passionflower, chamomile, valerian, California poppy, thyme, catnip, lettuce opium, lavender, lemon balm (melissa), hyssop, and/or hops. All of these are powerful hypnotics; some people give up on herbal remedies too soon though because it seems that only certain ones work well for certain people. You just have to try as many as you can.
Posted by Viridis on August 12, 2003, at 23:46:07
In reply to Clonazepam poop-out, posted by Guy on August 12, 2003, at 22:11:25
I'm curious too -- were you actually taking Klonopin as a sleeping pill, or for anxiety? My pdoc won't prescribe benzos for extended periods for insomnia, for exactly the reasons others have described -- disruption of sleep cycles and rapid tolerance to the sleep-inducing effects, requiring increased dosing.
However, he's quite comfortable with prescribing Klonopin and other benzos for anxiety (with which tolerance is much less likely), and I take K daily, in the morning. I rarely have problems with insomnia now, because my levels of anxiety are much lower. I just don't use it as a sleeping pill. I do take Xanax occasionally if I can't sleep, which is fine with him as long as I don't make it a habit (which I haven't).
He swears by Trazodone, which is supposed to induce drowsiness without affecting sleep architecture or inducing tolerance. I tried it (pre-Klonopin) and didn't like the mild "hangover" feeling in the morning, but apparently it works well for many others and might be worth a try.
Posted by Guy on August 13, 2003, at 8:12:08
In reply to Clonazepam poop-out, posted by Guy on August 12, 2003, at 22:11:25
I guess the reason clonazepam worked so long is the fact that my insomnia is caused mainly by anxiety. I have actually developed a phobia of not sleeping, and tend to get anxious rather than relaxed at bedtime. If only I were phobic about snakes, spiders or the like, I could simply avoid them. Just my rotten luck to be afraid of my bed...I face the same fears every night and often obsess all day about what a horrible night I am going to have. I've tried all kinds of relaxation techniques, but can't seem to overcome this involuntary response to insomnia. Sleep resriction is a joke for someone who gets 1 - 2 hours of sleep per night.
Posted by jlo820 on August 13, 2003, at 10:23:22
In reply to Insomnia caused by anxiety, posted by Guy on August 13, 2003, at 8:12:08
This is esentially my problem. I get anxious in the evenings as bedtime approaches.
The strategy my doctor and I employ has been pretty successful. I usually try to go to bed about 11:00 PM, so I follow this protocol:
9:00 PM - Take 2 mg Klonopin
10:30 PM - Take 150-225 mg TrazodoneThis works most nights. One the one night per week (on average) that I still can't get to sleep after staying in bed for 45-minutes or so, I will get back up, take .25 mg of Halcion, and do something for about half an hour (make to-do list, walk on treadmill, etc.), then go back to bed.
This strategy has proven very effective.
Other things to try:
1. Take hot bath before bed - this increases your body temperature and your body will relax as it cools back down. You could also take a cold shower and your body expends energy trying to warm you back up (similar to wrapping psychotic patients in ice-cold sheets).
2. Try Melatonin
3. Exercise before bed
4. Use bed only for sleep (and other bed-related activities), but not TV-watching, reading, work, etc.
5. Make sure your room is completly dark - even the little green lights on electronics. I use a sleeping mask (actually a black sock I put over my eyes).
6. Try to regulate sound based on your pesonal preferences. I have two computers and a fan running, so this "white noise" is helpful for me.Good luck.
Posted by Guy on August 13, 2003, at 15:17:58
In reply to Re: Insomnia caused by anxiety » Guy, posted by jlo820 on August 13, 2003, at 10:23:22
Thanks jlo, but I have already had a horrid experience with Trazedone--anxiety so bad I almost jumped off a moving ferry. I guess I'm wondering where I'm going to be ten years from now if the 1 mg clon pooped out on me after 1 year. I'm off the clon now, so I think I will try to go drug free for a while and see if I can get my anxiety attacks under control. I am taking only an anti-histamine right now...sleep very shallow and broken but I think it is improving. It takes a long time for the natural sleep architecture to reestablish itself. When I think back on how this phobia developed, I have to say that it did not start until after I tried pharmaceuticals and experienced several nights without any sleep at all. Oh well, water under the bridge now. I just wish I were better at relaxtion.
Posted by Viridis on August 14, 2003, at 2:23:27
In reply to Thanks jlo, posted by Guy on August 13, 2003, at 15:17:58
I've tried all sorts of relaxation techniques, from biofeedback, to classes, to tapes, to baths etc. Nothing really seems to work for me except meds; the closest thing is vigorous exercise a few hours earlier in the day. But for the last couple of years, using benzos (during the day), plus some other meds for ADD (Adderall, Strattera), I don't have much trouble with sleep. I really think Klonopin is the key for me.
It sounds like, one way or another, you need to get the anxiety under control. Maybe you just need more daytime Klonopin. Exercise certainly couldn't hurt, and another non-med approach might be cognitive therapy. If possible, some combined work wth a psychiatrist and a therapist might be the best approach. Based on my experience (only), anxiety that severe is hard to overcome without expert help.
Good luck!
Posted by Franz on August 14, 2003, at 5:02:12
In reply to Re: Clonazepam poop-out » Guy, posted by Viridis on August 12, 2003, at 23:46:07
Hi Viridis
How serious is disruption of sleep cycles by clonazepam?.
Does this mean less rest or memory problems?.
I see I tend to wake up early using klonopin.
I take 0.1mg day and bedtime since several months. I did not develope tolerance.
During the day I feel tired or a sedation at the time of the max effect which I think it is after 4 hours of intake (that is what I read and I think is correct from my experience).
Coffee sometimes work but not always. Maye it is lack of motivation or else.
Alprazolam is "nicer" than clonazepam in regards to mood I think.
Thanks
Posted by Miyu on August 15, 2003, at 0:21:33
In reply to Re: Clonazepam poop-out » Viridis, posted by Franz on August 14, 2003, at 5:02:12
Hmm......
I also have similar anxiety/sleep problems.
My Dr. had originally prescribed 1mg K-pin at night and .5mg's in the morning. This managed my anxiety really well, but didn't impact my ability to sleep very well.
He added Ambien. Which is a newer (possibly more exspensive) medication slightly related to the benzo family. (It's a modified Benzo with a GaBA site enhancer). The stuff is BRILLIANT and does not show that people build tolerance! It is however only indicated in short term treatment of insomnia. :-\ But.. my Dr. feels that it's benificial for me, so why not stay on it.
Trazadone gave me migranes and panic attacks.
Amitryptoline (an OLD tri-cyclic antidepressant) seemed to work WONDERS for me at doses as low as 10-25mgs (therapudic is 75mgs for depression)... Similiar to Antihistimines it just makes you feel groggy and faded. I did have difficulty waking, and I think all modern psyciatrists are afraid of the Tricyclics for some reason (I have no clue why?) ..
So...
Ambien 5mgs -10mgs a night and .5mgs at night of Kolonopin seem to work fine for me.
.5mgs in the morning to lower daily anxiety.
And I haven't seen a large change in tolerance.
It has only been 6 months that I've been on this combo but it seems to be working quite well.*shrugs*
Maybe this is helpful?
Fans, computers, and sleep machines all help me sleep along with some "Chill Out" music (I suggest Musical Starstream's episode of "chill out"..) VERY relaxing to go to bed too.. ;-)
Drift away music is good for the soul
Well off to bed.
*MUAH*
~Danielle
Posted by Viridis on August 15, 2003, at 1:32:22
In reply to Re: Clonazepam poop-out » Viridis, posted by Franz on August 14, 2003, at 5:02:12
Hi Franz,
I really have no idea how Klonopin affects sleep cycles -- I do take it every day, so you'd think that if it was so bad, I'd have some major sleep problem, and I don't. The key seems to be whether you actually use it as a sleeping pill, in which case (I'm told) the needed dose rapidly increases.
I haven't noticed any tiredness, but then I do take stimulants as well. Even without them, the sedation from Klonopin wore off after about a week or two for me.
I definitely agree about alprazolam (Xanax) -- I have tons of it, and always feel better the day after taking it. It's clearly a mood-lifter for me; I just try to limit its use since tolerance is more likely. Even with my infrequent use (at most once a week), I now need about 4X as much to achieve the same effect that I did initially. It's strange, since I use it so rarely, and I haven't noticed any tolerance to ther benzos, just alprazolam. My pdoc says that's fine and to take as much as I need, but if my frequency of use increases it's a cause for concern. So I limit my intake, because there seems to be something specific to alprazolam for me that could conceivably cause problems. But, mood-wise, it seems to be the best benzo, and I also use it for insomia now and then.
Have you tried Strattera (atomoxetine)? It's an odd drug, but I like it -- it seems to provide calmness and energy at the same time. Some people here respond well, others hate it, and my experience is that a gradual increase in dose is necessary if you're medication-sensitive. It just sounds to me like you might respond well, if you use it cautiously.
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