Shown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by bluebird on March 20, 2004, at 14:57:04
My husband is taking Paxil and Cloneazepam. Is there a stimulant that can be taken with these meds to help with the tiredness? Black coffee puts him to sleep, Cokes help but who wants all of that sugar. Is there a med that won't bring on anxiety that will help with motivation?
Thanks, Bluebird
Posted by Hattree on March 20, 2004, at 15:02:02
In reply to can stimulant be taken with SSRI Klonipin?, posted by bluebird on March 20, 2004, at 14:57:04
He could try a prescription stimulant like Adderall or Dexedrine. Might make him too anxious, but you never know (personally I find coffee jitters worse than pill jitters). There are definitely people out there on that combo.
Posted by PsychoSage on March 20, 2004, at 15:37:50
In reply to can stimulant be taken with SSRI Klonipin?, posted by bluebird on March 20, 2004, at 14:57:04
> My husband is taking Paxil and Cloneazepam. Is there a stimulant that can be taken with these meds to help with the tiredness? Black coffee puts him to sleep, Cokes help but who wants all of that sugar. Is there a med that won't bring on anxiety that will help with motivation?
> Thanks, Bluebird
A stimulant is a big leap for a person without ADHD, narcolepsy or treatment refractory depression I think.Klonipin is a sedative {benzo}, so it's supposed to bring your husband's energy level down essentially. The next new generation of antianxiety drugs in the pipeline will be more selective and not affect the entire brain as much.
I think if your husband does not have panic or trouble going to sleep then maybe he should talk to his doctor about using the klonipin for just important situations or lower the frequency or dose. From my experience with just using ativan before bed and then getting off it I learned that just 1mg influenced my energy level and thinking capacity negatively all day.
Paxil alone is used for anxiety for lots of people, so can he just stick to that. If he did an experiment where he did without the klonipin for a week I bet he would notice that his energy levels will improve. It will be like a cloud has lifted because I experienced that. Of course the anxious thought patterns and triggers of anxiety won't be removed and the relief won't last long because it won't be so novel to be clearer again, but he will be able to isolate the negative effects of being on benzos for him if he keeps a close tab on what happens. I hope that makes sense.
Effexor is used for anxiety for sure. i think it has official FDA approval for it, but don't quote me on it. For some it is definitely activating since on higher doses it works on norepinephrine.
Cymbalta which will be new from Lilly works like effexor {SNRI}, but works more evenly on serotonin and norepinephrine on lower doses compared to effexor, so there is more hope there.
It will be an antidepressant primarily, and it's close to hitting the market as long as that suicide from a healthy trial participant on it doesn't cause a disaster.And of course there is good old wellbutrin which can be an add on for the paxil. Since it works more like an antidepressant {not a quick onset like a stimulant though it is stimulating and affects norepinephrine and dopamine which are the primary spots stiulants hit} it may save your husband from the peaks and valleys of stimulants. Naturally though, the side effects are ones associated with excess CNS stimulation. Otherwise, it is really favorable.
So all in all, I would think: reconsider klonipin strategy with doctor and talk about wellbutrin before you even think about a stimulant.
Posted by gabbix2 on March 20, 2004, at 15:47:35
In reply to Re: can stimulant be taken with SSRI Klonipin?, posted by PsychoSage on March 20, 2004, at 15:37:50
No it's not a big leap at all actually, it's almost common among psychiatrists (G.P's aren't likely to prescribe a controlled substance) especially with refractory depression as it has mood boosting properties of it's own.
It was given to me 10 years ago along with Prozac and Ativan to Augment the prozac without having to increase the dosage and was one of the safest and best medications I've been on.
I was later diagnosed with A.D.D but not until long after I'd been on the dexedrine.
Posted by Hattree on March 20, 2004, at 19:01:37
In reply to Re: can stimulant be taken with SSRI Klonipin? » PsychoSage, posted by gabbix2 on March 20, 2004, at 15:47:35
I don't think its a huge leap either. Iffy, but it only takes one pill to find out, unlike most other meds. He'll know how it makes him feel in about 30 minutes. Okay, I'm exaggerating, but it isn't a commitment of many weeks like an AD.
Posted by gabbix2 on March 20, 2004, at 20:14:56
In reply to Stims etc, posted by Hattree on March 20, 2004, at 19:01:37
Dexedrine was a godsend for me, and I most definitely prefer it to Wellbutrin, they don't compare as far as I'm concerned. With Wellbutrin I got all of the anxiety and none of the benefit.
Ugh.
Wellbutrin doesn't actually have that much of a dopiminergic effect, I think it's more of an norepinephrine agonist, dexedrine is definitely dopiminergic though.
And strangely enough your husband is the only person I know who falls asleep from coffee. : )
Posted by gabbix2 on March 20, 2004, at 20:19:20
In reply to Re: Stims etc » Hattree, posted by gabbix2 on March 20, 2004, at 20:14:56
I meant to say.. the only *other* person I know
who falls asleep from drinking black coffee.
Posted by utopizen on March 20, 2004, at 21:29:46
In reply to Re: Stims etc Hattree, posted by gabbix2 on March 20, 2004, at 20:19:20
No, it wasn 't a big leap to give a leaper back in the day. At one point in the 60's, 8 billion amphetamine pills were produced in this country.
But now with Provigil, it's unlikely any psychiatrist would give a stimulant until the patient failed. I've got several sleep docs, trust me, even with my narcolepsy they want me to go off Desoxyn (methamphetamine) if the combo of Straterra+Provigil works on making me awake.
And keep in mind they know I've failed any response to Provigil at 400mg! (My doc claims he's seen patients fail either one and then later succeed on the combo).
For med-induced somnolence, your doc will dispense Provigil. Guaranteed. He or she will even be unlikely to consider a stimulant if your husband fails Provigil. They'd rather switch the meds causing the somnolence than prescribe a C-II.
No, they don't have any issues with the C-IIs for ADD, that's for sure. But one of the reasons why the DEA and ADDers and p-docs all sort of get along is that there's a sort of understanding things like weight loss (which Desoxyn continues to be FDA-approved for).
And, um, if your husband is asking for a stimulant for sleepiness from the meds rather than just complaining of sleepiness from the meds, and if I was a doctor, I'd make a point not to prescribe any stim for your husband even if I had a policy to prescribe stims for med-induced somnolence to every other patient. That's because it sounds like drug-seeking behavior.
Anyway, why you'd want your husband on another drug instead of trying out a different (activating) SSRI, a lower dose of Klonopin if it's tolerable, or simply try Provigil, I'm not sure??
I'm literally counting the days until I can go off my stim for narcolepsy/ADHD, Desoxyn. I've been on all the stims before. They all cause me to be anxious, overly-talkative, often makes it hard to sleep, gives you hyper-focused concentration on often unproductive things, causes dry mouth, makes you sweat more so you need Drysol prescriptions, eventually influencing your decision to go onto the Botox underarm injections bandwagon for $1500, makes you socially awkward, and so on.
The Provigil+Straterra combo might not work, but at least this summer, I can try it. Otherwise, it means I need to stay on amphetamines for the rest of my life. The way you guys talk of them seems to pretend you've never written an excessively long rambling message like this one, or an E-Mail you later regret sending the next morning, or sounded dorky in front of others while on it. I've had my share of experiences with the stimulants, and there's a reason why I don't feel the same way I did about using them the first week I got them.
Posted by gabbix2 on March 20, 2004, at 21:36:24
In reply to Re: Stims etc, posted by utopizen on March 20, 2004, at 21:29:46
It must be very different in Canada then. I asked for Provigil from 2 different doctors to replace the dexedrine, which at the time I was sure would eventually be bad for me, I was refused and stayed on the dexedrine with no problem.
I've even had G.P's prescribe it without knowledge of my A.D.D. They sure are tough about benzo's though.
Posted by bluebird on March 21, 2004, at 8:49:45
In reply to Re: Stims etc » utopizen, posted by gabbix2 on March 20, 2004, at 21:36:24
Thank you for all of the responses. My husband has Social Anxiety Disorder/Depression. His mind runs and never quits worrying about everything. Social situations are very difficult if not on meds. Paxil and Klonipin have changed that. I do notice a difference when he takes the Klonipin. It seems to help the depression. So, what are you to do? He takes the Klonipin at bedtime because it does make him tired. Yet it and the paxil affect the motivation so much. If we go anywhere it works great, he is able to function without all of the anxiety and panic. When we go out he does up his dose of klonipin. You would never know it though, because the anxiety and panic are so high. So, what exactly is dexedrine? I am not sure I spelled that correctly. He has concidered trying Nardil, everything we have read says it is the best for what he has. On higher doses of Paxil 90mg (that has been the highest)which I thought was way to high. He was not himself. It seemed to make him more OCD about things. It almost had the reverse effect. We know that Nardil is considered risky, but if it is the best for SAD/PD with phobias and avoidance also. Why not consider giving it a try. But does it make you as tired as Paxil. Don't get me wrong Paxil has been a wonderful thing. We have flown to Florida for Christmas for the last two years. I understand about the klonipin making you tired but sleeping is difficult. I mean it is like he needs something to make him sleep. Otherwise he is up in about 2 hours. It is motivation more than sleep that he is having such a hard time with.....Give him a coke or a latte'(the sugar) and he is ready to go. It is strange. But once again, Just caffiene alone and it put him to sleep. Strange I know but it is a fact. So, anyone on Nardil and is it working and what is dexedrine? Sorry this is so long. Thanks, Bluebird
Posted by utopizen on March 21, 2004, at 18:18:22
In reply to Re: Stims etc, posted by bluebird on March 21, 2004, at 8:49:45
I felt tired as heck for the past year, even with methamphetamine prescribed, and today, I walked for 2 1/2 hours straight. I threw myself on my bed and napped for an hour a couple of hours ago.
I feel like a new person, and I feel retarded for worrying andresearching meds all this time instead of spending that same time simply exercising so I could get out of the insomnia-daytime sleepiness cycle. If your husband is exercising, have him exercise an hour longer. If that doesn't work, have him exercise another hour longer. There are ways to get our bodies to function, we just don't like them when they aren't novel.
Posted by gabbix2 on March 21, 2004, at 18:40:07
In reply to Re: Stims etc, posted by bluebird on March 21, 2004, at 8:49:45
Dexedrine is an amphetemine. I was given it to
boost the effect of my anti-depressant and
combat fatigue. It worked very well for me.
and I didn't suffer any of the side effects mentioned in the previous posts.I'm currently not on any medication save a mood
stabilizer, I've decided to treat my symptoms differently, but I would still not hesitate to recommend dexedrine if it is available to you as an option.
Posted by PsychoSage on March 21, 2004, at 18:58:28
In reply to Re: Stims etc, posted by utopizen on March 20, 2004, at 21:29:46
you are so funny, utopzien. I love your posts.you seem pretty resilient, so i hope your next combo works.
Posted by Viridis on March 22, 2004, at 2:45:46
In reply to Re: Stims etc, posted by utopizen on March 21, 2004, at 18:18:22
Just an idea, but try some Lamictal with Klonopin and speed, plus maybe some Provigil. Be careful with Straterra -- promising but too weird, for me at least.
Posted by f l y on March 23, 2004, at 4:07:52
In reply to can stimulant be taken with SSRI Klonipin?, posted by bluebird on March 20, 2004, at 14:57:04
i take dexedrine along w/ symbyax and klonopin. i also drink diet coke during the day instead of coffee.
best to ya,
fly
Posted by f l y on March 23, 2004, at 4:17:44
In reply to Re: Stims etc, posted by utopizen on March 21, 2004, at 18:18:22
methamphetamine prescribed??????????? i could exercise from the time i got up until the time i went went to bed and still not feel better! not to mention i wouldn't get any work done!
fly
Posted by gabbix2 on March 24, 2004, at 12:36:21
In reply to Re: Stims etc » utopizen, posted by f l y on March 23, 2004, at 4:17:44
> i could exercise from the time i got up until the time i went went to bed and still not feel better! not to mention i wouldn't get any work done!
>
Yeah, when I had my first huge depressive crash
I was in training for kickboxing and working out at least 4 days a week. Its a great adjunct of course, but obviously didn't stave off my depression.
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.