Shown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Veagus on September 16, 2003, at 1:21:36
So far (1 mg/day for 4 weeks) Klonopin has been fantastic for GAD and mild social phobia... in fact there have been benefits I didn't expect (Sleeping better, more energy (no kidding), *confidence*, libido, clear headed and at least 10% smarter :). No side effects yet.... save that my photographic memory has ceased tormenting me with useless images from the past. For the first time in my life I feel that I am able to think my own thoughts!
But one thing I am confused.... mentally I am perfectly clear and relaxed... but the typical unsettledness and anxiety in my chest has been replaced by a heavy, dead tension, almost a physical pain. In fact when my mind is clearest, soon after a dose, the chest tension is the worst.
So disregarding the token benzophobe within me, I doubled up to 2mg. this morning and the chest tension was mostly gone... for about half the day. So great... but I am worried to increase to 2mg. or even 4 or more that might be needed for full relief. My pdoc was not thrilled with that either. He had no constructive ideas.
This happened to anyone else? Maybe there is a benzo more effective for chest anxiety?
BTW I am not worried about dependence and am fully aware of the withdrawal. Although I am concerned about tolerance and side effects at high doses.
Posted by HenryO on September 16, 2003, at 3:31:20
In reply to Klonopin excellent so far.... but a question, posted by Veagus on September 16, 2003, at 1:21:36
No advice, but I hope you keep posting as things progress. I like the sound of Klonopin more and more, but I really understand your concerns. I'd like to benefit from your experiences.
Does Klonopin get consumed, so to speak, in the presence of anxieity. I think that is one of the meanings of the word titrate. To offset or deminish the effects of a drug as it works on its target. Not sure that is the proper use of the word.
Does greater anxiety mean that an increases in the drug adequate to control the pain balances out those side effects which contribute to abuse potential? As in, more pain- more drug, but still the dose is appropriate to the need. Hence even a big dose in the case of severe anxiety might not be excessive. Do you get what I'm trying to ask?
Posted by rianny on September 16, 2003, at 3:56:34
In reply to Re: Klonopin excellent so far.... but a question, posted by HenryO on September 16, 2003, at 3:31:20
My pdoc prescribed me Klonopin for SP + minor OCD.
He said it's 100% up to me to decide whether to take this med or not.
Anyway, I'm still hesitating to take this med because of its dependency and body's tolerance.
He recommeneded to take .5mg in the morning and another .5mg at bedtime.
On last Thursday and Friday, I took .25mg each in the morning. I felt a little calm, but wasn't that effective. That might be because of Celexa withdrawal effects that I was experiencing. I still have some, but fortunately it's getting lessened everyday.
Today, I took .5mg in the morning and .25mg at bedtime (a few minutes ago).
.5mg was much more effective. I could concentrate on what I must do. However, I was questioning if the new feeling was normal...maybe cuz I have been with this anxiety disorder for too long. What I'm saying is that I'm not used to this comfortable feeling...so I was a little confused about that.
So, have you been taking .5mg in the morning and .5mg at bedtime, too?
If you have, how long did it take to make you feel perfectly normal.
I mean, if you have had anxiety disorder for a long time, you must have been anxious for a long time. Then, you take the pill that makes you feel less anxious. I think it might have surprised or confused you because you got the comfort, that you haven't felt for a long time, so suddenly....
It was my case....more precisely, today.
So, I'd like to hear about your experience that is similar to that, if it existed.
Posted by Viridis on September 16, 2003, at 4:37:06
In reply to Re: Klonopin excellent so far.... but a question, posted by rianny on September 16, 2003, at 3:56:34
It took me about a week or two to get over mild side effects from Klonopin (drowsiness, clumsiness, etc.). Now I notice absolutely nothing, except that I don't freak out over minor things and feel calmer in general. I've been at the same dose (1 mg/day) since I started it about 2 1/2 years ago, and the anti-anxiety effects have remained. My pdoc says he's had many patients on it for years without any need for dosage increase. Tolerance to the anxiolytic effects (according to him) is uncommon, and discontinuation is pretty straightforward IF done very gradually.
I wouldn't worry too much about benzos -- they have a long record of safety, few or no long-term side effects, and, on average, are easier to withdraw from than most antidepressants.
Posted by Veagus on September 16, 2003, at 19:56:51
In reply to Re: Klonopin excellent so far.... but a question, posted by rianny on September 16, 2003, at 3:56:34
Yes the experience was definitly there.... a realization I guess, that I wasn't (was?) crazy all this time and something *was* amiss. Now I am growing comfortable with being comfortable.
Here's hoping for no tolerance, even if I need a higher dose for the chest tension.
Probably worth mentioning, I have had my best results while experimenting with GABA supplements. Now I know they "do not cross the BBB" and whatever but I have no doubt they promote calm thoughts (thinking is good) as opposed to the blank mind sensation. I tried up to 3 x 750mg (at night -- it is great for sleep and causes a temporary brain fog).
Perhaps the GABA will prevent tolerance due to GABA depletion, or at least potentiate the benzo and lower the required dose. At least it shouldn't hurt.
I have had no luck searching if GABA + benzos has been discussed previously.
> My pdoc prescribed me Klonopin for SP + minor OCD.
>
> He said it's 100% up to me to decide whether to take this med or not.
>
> Anyway, I'm still hesitating to take this med because of its dependency and body's tolerance.
>
> He recommeneded to take .5mg in the morning and another .5mg at bedtime.
>
> On last Thursday and Friday, I took .25mg each in the morning. I felt a little calm, but wasn't that effective. That might be because of Celexa withdrawal effects that I was experiencing. I still have some, but fortunately it's getting lessened everyday.
>
> Today, I took .5mg in the morning and .25mg at bedtime (a few minutes ago).
>
> .5mg was much more effective. I could concentrate on what I must do. However, I was questioning if the new feeling was normal...maybe cuz I have been with this anxiety disorder for too long. What I'm saying is that I'm not used to this comfortable feeling...so I was a little confused about that.
>
> So, have you been taking .5mg in the morning and .5mg at bedtime, too?
>
> If you have, how long did it take to make you feel perfectly normal.
>
> I mean, if you have had anxiety disorder for a long time, you must have been anxious for a long time. Then, you take the pill that makes you feel less anxious. I think it might have surprised or confused you because you got the comfort, that you haven't felt for a long time, so suddenly....
>
> It was my case....more precisely, today.
>
> So, I'd like to hear about your experience that is similar to that, if it existed.
Posted by McPac on September 16, 2003, at 21:19:44
In reply to Re: Klonopin excellent so far.... but a question, posted by Veagus on September 16, 2003, at 19:56:51
Yeah, I always hear folks saying that GABA does not cross the BBB well too....yet I also know that Doc Amen says GABA works very well for many folks.
Posted by Jasmine Neroli on September 16, 2003, at 23:58:15
In reply to Re: Klonopin excellent so far.... but a question, posted by McPac on September 16, 2003, at 21:19:44
I've been on Klonopin .5mg AM and .5mg PM for about 5 weeks. I have GAD. I started at .5mg AM and found I became anxious again SOMETIMES, by late afternoon. When I added the bedtime .5mg I found a HUGE improvement. No anxiety, calm/relaxed. No irritability, more sociability etc. At first I felt a little spacey ( maybe for one day). However after a week, I felt very low energy and sedated. So I took it "as needed", but soon found my previous regular anxiety returned. I'm now back on the 2 x .5mg Klonopin each day.
In the meantime my Pdoc has put me on BUSPAR ( 7 days ago). With the plan to taper off Klonopin when Buspar kicks in (after 3 weeks).
Paradoxically, I seem to now have completely adjusted to the 1mg daily Klonopin, energy level has improved, no sedation...just all the positive effects!!! I know it's not the Buspar (too soon!). I'm now thinking of asking my Pdoc if I can remain on Klonopin, if my Buspar trial doesn't work!
SOOOOOOOO, I recommend Klonopin at a low daily dose. Just keep in mind that it may take a while to adjust to it and everyone is different. But I really think it's a GREAT med for anxiety. Talk to your Doc and good luck!
Jas
Posted by lesliekay on September 17, 2003, at 4:31:05
In reply to Re: Klonopin excellent so far.... but a question, posted by Jasmine Neroli on September 16, 2003, at 23:58:15
What I have done with my agitation and anxiety works great for me..maybe it might work for you. I take a routine dose of Klonopin in the morning and then for any kind of breakthrough anxiety, I take Ativan. Ativan is more rapid acting and more tailored for panic etc. I can go for days without needing it, maybe you should look at a combination approach, rather then end up on some huge dose of Klonopin......just a thought leslie
Posted by Jasmine Neroli on September 17, 2003, at 20:50:43
In reply to Re: Klonopin excellent so far...a possible answer, posted by lesliekay on September 17, 2003, at 4:31:05
Hiya Leslie: That's an interesting plan. I have taken Ativan, when I was initially prescribed Celexa over a year ago, and found it did work very quickly, but was a bit sedating.
What amount of daily Klonopin do you take in the morning? And how much as needed Ativan for any "flare-ups" do you take. I'd like as many alternatives to suggest to my Pdoc as poss when I see him next.It's too bad El's doc is so against benzo's. Your solution might really help.
Posted by Ame Sans Vie on September 17, 2003, at 21:27:08
In reply to Re: Klonopin excellent so far.... but a question, posted by Veagus on September 16, 2003, at 19:56:51
I'd suggest getting your doctor comfortable with raising the dose to whatever it takes for *you* to feel comfortable. Don't worry about tolerance -- it doesn't happen. You'll become tolerant to any sedative effects you may have, but anti-anxiety effects will always remain. And that pretty much answers your concern about side effects as well -- it's the *side effects* you grow tolerant to, *not* the therapeutic effects.
Aa for GABA to increase effects of benzos, I'd bet it's a placebo effect. Picamilon (GABA bonded to niacinamide, capable of crossing the BBB) and GABOB (gamma-amino-beta-oxybate -- sort of a cross between GABA and GHB) have a definite effect on benzodiazepine potency though. So if your doctor doesn't want to increase your dose and you feel it isn't adequate, you can "naturally" increase its effectiveness with one of these. Inderal (propranolol) also potentiates clonazepam and might even help with that chest tension you mentioned, since it's a blood-pressure med. Finally, cimetidine (Tagamet) taken about 15-20 minutes before your Klonopin dose will increase its effects by about 25%. Tagamet increases Xanax's effects by about 50%, and doubles the effect of Halcion. Finally, Serzone also increases most benzodiazepines' effects and has a mild anxiolytic/antidepressant effect of its own.
Posted by Veagus on September 17, 2003, at 22:33:18
In reply to Re: Klonopin excellent so far.... but a question » Veagus, posted by Ame Sans Vie on September 17, 2003, at 21:27:08
Thank you so much for the wealth of information.
The GABA was not a placebo effect, although perhaps it wasn't technically enhancing the Klonopin. I would describe it as a transition from an anxiety free mental void to a more engaged, relaxed mental state (after about an hour of brain fog, hence the nightly dosing).
Perhaps the GABA provides raw materials to produce natural GABA, or maybe does something entirely unrelated. But I definitely find a nightly dose of GABA creates a more pleasant Klonopin effect the next day.
Anyway thanks again and I will be trying some of these suggestions.
Posted by lesliekay on September 18, 2003, at 6:45:17
In reply to Re: Klonopin excellent so far...a possible answer » lesliekay, posted by Jasmine Neroli on September 17, 2003, at 20:50:43
I have a benzo tolerance so you might have to cut down the doses I quote you. I take 1mg of Klonopin in the morning and then I take 2mg of Ativan for breakthrough. Sometimes I don't need Ativan at all, sometimes I take it 3 times a day, it just depends on the day. However, it works very well for me. I hope this helps. leslie
Posted by Jasmine Neroli on September 19, 2003, at 15:54:45
In reply to Re: Klonopin excellent so far...a possible answer, posted by lesliekay on September 18, 2003, at 6:45:17
Thanks LK! I also take 1mg Klonopin, split into 2 doses (Am/PM), so I might ask to add Ativan, if the Buspar doesn't work in a week or two.
Jas
Posted by Veagus on September 20, 2003, at 23:00:27
In reply to Re: Klonopin excellent so far.... but a question » Veagus, posted by Ame Sans Vie on September 17, 2003, at 21:27:08
I cheated (in the name of science) and took 6mg today. My first 2mg (morning) worked very well for a few hours, the chest tension was gone and I felt great. My second 2mg (midday).... mentally calm, but did nothing to relieve the chest tension... in fact it gradually worsened. My third 2mg (evening), I develped a blank mind (a symptom previously relieved by GABA supplements) and the full dead tension in my chest. The Klonopin potentiates the GABA receptors, and my theory is the high doses steadily depleted my GABA levels as the day progressed (perhaps I have a faulty GABA production system).
So a high dose may not be the solution. I need to attack this from both angles - Increasing GABA effectiveness (Klonopin), and maintaining healthy GABA levels. I've done some more research and found some encouraging things!
First thanks for the tip on Picamilon, which is proven to increase brain GABA levels. Surely much more efficently than simply swallowing GABA. Mine is in the mail.
Second, I will try Neurontin, also proven to increase brain GABA levels (mechanism unknown). Regarding combining Klonopin and Neurontin, I was encouranged by this by quote from Micael:
"Takes a bit of getting use to...but when you do you feel that "fire" in your belly is gone, and you're off to a 'normal" day. Klonopin, I feel saved my life....now Neurontin just helps me live it to the fullest ever."
(From http://www.dr-bob.org/babble/19991123/msgs/15698.html)
Third here is an interesting link on Klonopin.
http://www.cfsresearch.org/cfs/cheney/18nf.htm
Who knows who this Cheney guy is, but the article makes sense. People who need a benzo for healthy brain function will have little side effect and perhaps, initially, mild sedation. People who do not will have worse side effects (sleepiness, memory loss, depressive states etc.) Maybe this is too simplified but I'm trying to come to terms with taking benzos long term. Klonopin (in the right dose) gives me a renewed focus, wakefulness, and enthusiasm every time... so bottom line, if my brain isn't screaming neurotoxicity and drug cravings I'm sticking with it.
> I'd suggest getting your doctor comfortable with raising the dose to whatever it takes for *you* to feel comfortable. Don't worry about tolerance -- it doesn't happen. You'll become tolerant to any sedative effects you may have, but anti-anxiety effects will always remain. And that pretty much answers your concern about side effects as well -- it's the *side effects* you grow tolerant to, *not* the therapeutic effects.
>
> Aa for GABA to increase effects of benzos, I'd bet it's a placebo effect. Picamilon (GABA bonded to niacinamide, capable of crossing the BBB) and GABOB (gamma-amino-beta-oxybate -- sort of a cross between GABA and GHB) have a definite effect on benzodiazepine potency though. So if your doctor doesn't want to increase your dose and you feel it isn't adequate, you can "naturally" increase its effectiveness with one of these. Inderal (propranolol) also potentiates clonazepam and might even help with that chest tension you mentioned, since it's a blood-pressure med. Finally, cimetidine (Tagamet) taken about 15-20 minutes before your Klonopin dose will increase its effects by about 25%. Tagamet increases Xanax's effects by about 50%, and doubles the effect of Halcion. Finally, Serzone also increases most benzodiazepines' effects and has a mild anxiolytic/antidepressant effect of its own.
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.