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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Jasmine Neroli on August 25, 2003, at 0:07:49
Just thought I'd let you know how it's going 7 days after starting the Klonipin .5mg. Like you said, I stopped feeling spacey upon taking it, after day 2. I take it in the a.m. and don't feel anxious at all - it's amazing. I have been exposed to anxiety laden situations several times this week..and NOTHING, no adverse reactions. Just relaxed & calm. Like "bring it on"! A couple of days ago,though, I had what would normally be for me, a high anxiety provoking situation around 4pm
and I DID start with some of the typical mild anxiety symptoms, which built up fast. I was able to remove myself from the situation pretty quick, and then was OK again. But that made me feel like I might need to take that dose twice a day, or carry some around with me for "as needed" extra boosts. What do you think? Other than that, it's been the lifesaver you described :).
O yeah, today, I've been very tired and "low", for the first time since I've been off my AD. Maybe just a "normal" mood blip, but I really noticed it, since I've been so happy and even on the Klonipin all week. I was wondering if Klonipin can have that affect (or whether it's a response to the high anxiety of 2 days ago).
Thanks again.
Jas
Posted by Ame Sans Vie on August 25, 2003, at 0:45:37
In reply to Klonipin update 4 u Ames, Peter others, posted by Jasmine Neroli on August 25, 2003, at 0:07:49
So glad to hear it's working out for you! :-)
As for your mid-afternoon anxiety attack, yes -- you should probably be taking Klonopin (at least) twice a day since its effects last anywhere from 6-12 hours. Just tell your doctor that the single dose wears off mid-day, and I'm sure he'll have no reservations about placing you on a twice (or thrice) daily dosing regime.
You're probably right about the "mood blip". It most likely has nothing to do with the Klonopin, though if it continues, you should definitely talk with your doctor.
Posted by Peter on August 26, 2003, at 5:52:18
In reply to Klonipin update 4 u Ames, Peter others, posted by Jasmine Neroli on August 25, 2003, at 0:07:49
> Just thought I'd let you know how it's going 7 days after starting the Klonipin .5mg. Like you said, I stopped feeling spacey upon taking it, after day 2. I take it in the a.m. and don't feel anxious at all - it's amazing. I have been exposed to anxiety laden situations several times this week..and NOTHING, no adverse reactions. Just relaxed & calm. Like "bring it on"! A couple of days ago,though, I had what would normally be for me, a high anxiety provoking situation around 4pm
> and I DID start with some of the typical mild anxiety symptoms, which built up fast. I was able to remove myself from the situation pretty quick, and then was OK again. But that made me feel like I might need to take that dose twice a day, or carry some around with me for "as needed" extra boosts. What do you think? Other than that, it's been the lifesaver you described :).
> O yeah, today, I've been very tired and "low", for the first time since I've been off my AD. Maybe just a "normal" mood blip, but I really noticed it, since I've been so happy and even on the Klonipin all week. I was wondering if Klonipin can have that affect (or whether it's a response to the high anxiety of 2 days ago).
> Thanks again.
> Jas
> I definitely agree with Ames. How do you feel today, Jas?
Peter
Posted by Jasmine Neroli on August 26, 2003, at 21:59:19
In reply to Re: Klonipin update 4 u Ames, Peter others » Jasmine Neroli, posted by Peter on August 26, 2003, at 5:52:18
Well Peter, Sunday was my very low and withdrawn day.Monday I felt alright, just no energy. Forced myself to the gym and did a half-assed work-out! Today, felt tired still, no zest, and got a blinding headache that stayed all day. Again dragged myself to the gym for a minimal work-out. No anxiety at all. Just low energy. Yesterday, I added .25mg of Klonipin in the afternoon to my .5mg am dose, as suggested by Ames, since I did seem to be getting nervous late in the day.
Maybe it's making me slothful? I have been asking people at this board for ideas on "activating" supplements. Maybe that'll help? Worried that my social withdrawal will happen again ( like you, huh?). I'm just fine out in public with relative strangers, just don't relish the idea of seeing friends. Wierd.
How are you doing?
Jas
Posted by Peter on August 27, 2003, at 5:59:47
In reply to Re: Klonipin update 4 u Ames, Peter others » Peter , posted by Jasmine Neroli on August 26, 2003, at 21:59:19
> Well Peter, Sunday was my very low and withdrawn day.Monday I felt alright, just no energy. Forced myself to the gym and did a half-assed work-out! Today, felt tired still, no zest, and got a blinding headache that stayed all day. Again dragged myself to the gym for a minimal work-out.
>>I hate to sound like a gym nazi, but I definitely recommend you continue trying to exercise each day (or every other day). I know it's hard at first, and you often don't feel any tangible benefits at the beginning. But when my pdoc had me taper off everything and then settled on high-dose klonopin, I found that I was MUCH MORE spaced-out and tired on the days that I didn't exercise, at least 30 min. cardio after waking up.
>> Or if the klonopin is making you particularly lethargic, try even 15-20min,.of low-impact cardio. The mental benefits build up over time; it's a real natural, gradual dopamine raiser, and I think it will help you get over this klonopin-fatigue hump.
No anxiety at all. Just low energy.
>>Yes I know the exact feeling.
Yesterday, I added .25mg of Klonipin in the afternoon to my .5mg am dose, as suggested by Ames, since I did seem to be getting nervous late in the day.
>>Good!
> Maybe it's making me slothful? I have been asking people at this board for ideas on "activating" supplements. Maybe that'll help? Worried that my social withdrawal will happen again ( like you, huh?). I'm just fine out in public with relative strangers, just don't relish the idea of seeing friends. Wierd.
>>Totally. It feels easier to walk in crowds. But there's no drive, interest, or energy to talk to anyone or get socially involved.
>>That's still a pretty low dose. I would give it a few more days + exercise and you very well might snap out of the lethargy.
>>If the lethargy remains and is bothersome, and you want to remain on the klonopin, maybe ask your pdoc about stims. If you don't want to have a go of one of the 'major' stims, I've heard good stuff about provigil - it's supposedly not as harsh and 'roller-coasterish' as an amphetamine or ritalin. A lot of people use it in combo with sedatives to minimize fatigue and increase alertness. My pdoc, for some reason, would rather put someone on adderall or ritalin, believing provigil to really be of benefit for only narcoleptics. But you might want to look into it. Unless you're ok with chugging esspresos all day(-:
No, but seriously; you might need neither stims or espressos after a few more days on the .75mg and excercise.
Good luck!
Peter
Posted by Jasmine Neroli on August 28, 2003, at 1:50:09
In reply to Re: Klonipin update 4 u Ames, Peter others » Jasmine Neroli, posted by Peter on August 27, 2003, at 5:59:47
Hey: Yeah, no need to encourage me to exercise, I've been a gym convert for about 2 years!!! Just the fact that it was so hard to go this week, made me realize something was up! I also "usually" love to dance around to music/do aerobics at home...was a way to get me upbeat on the few depressed days whilst I was on Celexa. Haven't felt like doing that either.
Anyway, I decided to split my measly .75mg Klonipin into three doses and see if that helps. I'll let you know. I still have the massive headache???
Thanks for the tip about Provigil, I did some research and it sounds a very promising idea. Gonna mention it to my doc next time.
Jasmine
Posted by Ame Sans Vie on August 28, 2003, at 8:05:20
In reply to Re: Klonipin update 4 u Ames, Peter others NEWS » Peter , posted by Jasmine Neroli on August 28, 2003, at 1:50:09
I totally agree with Peter, exercise is definitely the key. But I work out everyday on my cable-based home gym and it only improves my symptoms about 50%, which is quite substantial, but still not nearly good enough for me.
If you would like to try something "activating", I would highly recommend American or Oriental ginseng (Siberian ginseng isn't as stimulating, and isn't even ginseng at all -- it's actually called eleuthero root). They're technically "adaptogens", which is, in a nutshell, basically another way of saying "cure-all", IMO. Adaptogens seem to help your body adjust to many, many conditions, even if they're complete opposites! If you're fatigued, an adaptogen may help you to feel more energized; if you're hyperactive, an adaptogen may calm you down. Weird, huh?
Provigil is also an excellent idea though. I can pretty much give you a 95% guarantee that it won't cause any anxiety (and I think even that estimate is being conservative), unlike amphetamines, methylphenidate, or pemoline. Also unlike most other stimulants, it won't interfere with sleep (i.e. cause insomnia). It's also a pretty powerful mood-booster, usually at the higher-end dosages (i.e. around 400-600mg/day). It may work somewhat for you the very first time you take it, but it takes about three days for it to achieve its full potential.
The only concern I have is that headache... is that still a problem? If so, definitely speak with your doctor about that. And just to forewarn you, Provigil has about a 45% chance of causing headaches (though usually mild).
Posted by Jasmine Neroli on August 29, 2003, at 23:20:37
In reply to Re: Klonipin update 4 u Ames, Peter others NEWS » Jasmine Neroli, posted by Ame Sans Vie on August 28, 2003, at 8:05:20
Yeah, thanks Ames. I have been a gym-aholic for a coupla years now, so I knew something was up this week when I could barely get my ass down there!!
The headache has subsided mostly now, but was in full force for 4 days straight..including facial neuralgia. I've had what I call "3 day headaches" before, that I think are cyclical with stress/anxiety/depression whatever, but not as long lasting as this one. I had started B complex 100 and fish oils at the same time as the klonipin, so I stopped both of those yesterday. The headache reduced a lot, so it may have been caused by one or the other. I'll try adding them one at a time later and see if the headache returns. Unfortunately, a lot of supplements that I've tried for insomnia/depression give me headaches.Melatonin, Valerian, Kava-Kava and SJW all have done, so I hope Provigil won't.
I've split the Klonipin into 3 doses and I think it has lessened the lethargy. As per your suggestion, I tried Panax Ginseng yesterday and today. I noticed SOME uplifting, activating effect, but it was short lived- a coupla hours. Actually, maybe the ginseng had a reducing effect on my headache???? Haha..Who knows ?
Anyway, anxiety still absent (hooray), but I do feel a bit hollow and low (not sad or dispairing, as I've been in depressions before). Am sleeping pretty well, which has surprised me, because insomnia has been one of my major problems also.
I go to see my doc on Sept. 2 and will be suggesting Provigil to him. He is just my GP though and rather cautious, so I'm finally going to ask for a referral to a Psych doc (that's how it's done here- Canada).Maybe I can get a diagnosis or more aggressive treatment, if needed.
Thanks for your advice so far Ames, it seems to be panning out pretty nicely!!! You've been so helpful.
Jas.
Posted by Ame Sans Vie on August 30, 2003, at 13:57:44
In reply to Re: Klonipin update Ames follow-up, posted by Jasmine Neroli on August 29, 2003, at 23:20:37
Well I'm really glad to hear that everything seems to be coming together so well for you, and so quickly -- you really should count your blessings. :-)
Thinking back, I've had one of those "3-day headaches" before... and I still have no idea what brought it on, as it was before I was ever on any medication of any kind. My sister used to have migraines that sometimes lasted up to four days (she takes Zomig and Fioricet now)... I dunno, if you've had them before, this is most likely just something you're prone to experience from time to time. This time it just happened to last longer than the others. I'd certainly talk to your doctor about it, though.
By the way, I didn't know you were in Canada -- Provigil is called Alertec up there. Let me know what happens!
~~Michael
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