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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 temoigneur on December 12, 2006, at 22:48:12
Hi Ed, how are you doing... are you almost ready for Christmas... Ed... ever since Ame's death I've been thinking about my own use of medications and alcohol....
I went to a nurse practitioner last week to get abilify... I think I'm feeling a little better.. my mind is a little clearer and there's been no weight gain, so that's great...
The thing is, on clomipramine I'm still lethargic groggy etc.. and have no motivation to get my day started.
For the past few weeks, maybe four, I've been courting this romantic prospect I like in Calgary... but I've been using alcohol to calm my nerves, in conjunction with the clonazepam, (~ 6 mg/day t.i.d. that I'm taking)
I was warned by an american nurse and then by my pharmacist about respiratory failure, - that woke me up... I had two questions if I can.. ).... is it possible that by drinking lots of warm water, I might cleanse my liver and help the medications work better so that I didn't have to take so much clonazepam... and
I'm seriously thinking of leasing a hot water machine if that's the case....
and #2 could the clonazepam and alcohol (~ 2-3-shots a night) with pop... cause respiratory failure, or cardiac arrest.... and lastly could this potentially be offset my taking a respiratory stimulant such as caffeine.. I drink coffee every night with the alcohol and clonazepam... could drinking coffee reverse the effects of respiratory supression caused by alcohol and benzo's
- Stalemate -
Posted by yxibow on December 13, 2006, at 0:37:45
In reply to Klonopin + caffeine +Alcohol - input sought, posted by temoigneur on December 12, 2006, at 22:48:12
> Hi Ed, how are you doing... are you almost ready for Christmas... Ed... ever since Ame's death I've been thinking about my own use of medications and alcohol....
>
> I went to a nurse practitioner last week to get abilify... I think I'm feeling a little better.. my mind is a little clearer and there's been no weight gain, so that's great...
>
> The thing is, on clomipramine I'm still lethargic groggy etc.. and have no motivation to get my day started.Anafranil is unfortunately a tricyclic and has those side effects :/
> For the past few weeks, maybe four, I've been courting this romantic prospect I like in Calgary... but I've been using alcohol to calm my nerves, in conjunction with the clonazepam, (~ 6 mg/day t.i.d. that I'm taking)Might as well take 12 mg a day because the alcohol is just increasing the effects and is harsher on the liver...
> I was warned by an american nurse and then by my pharmacist about respiratory failure, - that woke me up... I had two questions if I can.. ).... is it possible that by drinking lots of warm water, I might cleanse my liver and help the medications work better so that I didn't have to take so much clonazepam... and
Yes -- respiratory depression is a definite possibility with high benzodiazepine use and alcohol. Without the alcohol, the small danger is there with high dosing but not like barbiturates.
Nothing out there that advertises "liver cleansing" short of a transplant is anything more than near quackery (e.g. Liverite, which was fined). The liver will manage itself on its own if it has the power to do so (and one should get liver tests at a physical on polypharmacy [multiple meds]) and you can live on surprisingly small portions of it as it is regenerative.
> I'm seriously thinking of leasing a hot water machine if that's the case....
>
> and #2 could the clonazepam and alcohol (~ 2-3-shots a night) with pop... cause respiratory failure, or cardiac arrest.... and lastly could this potentially be offset my taking a respiratory stimulant such as caffeine
Respiratory depression is a hospital emergency and with benzodiazepines can only be reversed with a GABA antagonist called Flumazenil.Caffeine has nowhere near the potency for such reversal as its cousin theophylline which is also used in the ER along with beta agonists to save what is a life threatening situation.
.. I drink coffee every night with the alcohol and clonazepam... could drinking coffee reverse the effects of respiratory supression caused by alcohol and benzo's
No.
And the combination of all of this seems counterproductive, because it seems to me that you are taking Anafranil for an anxiety or depressive condition, clonazepam for anxiety, and then adding alcohol, which just makes one more depressed in the end and one might as well have more benzodiazepines, and then throwing in a fourth drug, caffeine to block all of the above.Now I don't know your history so I am only going by what you are saying, I'm not trying to offend...
I am not standing as a teetotaler, I have taken alcohol with benzodiazepines on occasion, but I'm just trying to say that one should be very cautious if it is on a daily amount of any fair size and one is at that level of medication. It can also increase the CNS depression of the tricyclic, but that's a side issue (just additive tiredness). As far as caffeine, well, a tad of instant coffee in the morning to wake up in the morning from Anafranil I can't see that it hurts but it may exacerbate a little any anxiety disorder you have, of course.-- tidings
Jay
Posted by LlurpsieBlossom on December 13, 2006, at 7:47:06
In reply to Re: Klonopin + caffeine +Alcohol - input sought » temoigneur, posted by yxibow on December 13, 2006, at 0:37:45
Hi temoigneur
first of all, I wanted to give you my best wishes for your romantic prospects.If your (woman?) is really fond of you, she'd probably be concerned that you were taking a lot of drugs in order to be comfortable around her.
I don't want to be too preachy, but I would be really concerned about chronic alcohol and chronic caffeine consumption on your psychiatric/psychological conditions.
1) caffeine is a stimulant, and can increase feelings of nervousness and tension. I was AMAZED that I felt so much better when I cut out caffeine. (I have depression and anxiety with a Dx of PTSD). My muscles felt looser, my heartrate didn't distract me from my work, I didn't have jittery hands, and my speech felt clearer and less hasty/jibberish. The detox took 4 days (I went from >500mg to about 50 mg a day (green tea and dark chocolate)
2) alcohol is a potent anxiolytic. my pdoc says its a better anxiolytic than klonopin probably. My T said that alcohol is a wonderful anti-depressant, with some bad side-effects, namely, depression... If you're drinking 2-3 drinks most days, this is definitely enough to contribute to a depressed mood and cognitive "fuzziness". For whatever reason, when I started taking psych meds, even a single drink will make me feel quite fatigued the next day (hence- coffee!). I'm sure you can see how this builds into a vicious cycle
alcohol to have a good time socially- the next morning feeling sleepy, groggy, so you drink caffeine-- so you feel jittery & take klonopin- so you drink coffee to help you feel "sharp" again, but you feel jittery and you drink more coffee, even at night... and alcohol. Repeat...
yxibow is correct about respiratory depression being a real concern with high levels of klonopin mixed with alcohol. The mild bronchodilation you would get from a hot cup of coffee is enough to treat a very very mild asthma attack, but as an asthmatic, I need albuterol to really stop an attack.
temoigneur, since I have cut out caffeine and limited my alcohol intake to a half glass of wine or so a week, I have felt SO much better. I've been able to cut down on the klonopin and provigil, and I've been sleeping better, thinking more clearly and feeling more stable.
best,
-Ll
Posted by Phillipa on December 13, 2006, at 10:11:15
In reply to Re: Klonopin + caffeine +Alcohol - input sought, posted by LlurpsieBlossom on December 13, 2006, at 7:47:06
Didn't know theophylline was related to coffee but know that it's in chocolate. And chocolate is a stimulant. Love phillipa
Posted by yxibow on December 13, 2006, at 19:53:56
In reply to Re: Klonopin + caffeine +Alcohol - input sought, posted by Phillipa on December 13, 2006, at 10:11:15
> Didn't know theophylline was related to coffee but know that it's in chocolate. And chocolate is a stimulant. Love phillipa
Yes -- they're known as xanthines.
Chocolate is the only one that contains theobromine (mostly) and also contains caffeine (at about 1/10th the level). It contains no bromine, Theo-broma means "food of the gods" in greek (Wikipedia). It is a stimulant but bears somewhat different properties from chocolate and is the primary ingredient I believe why some people feel "good" with chocolate.
It has a potential in research studies for possible medical use.
Theophylline is in black and green tea at a minimal level, it is probably synthesized these days, I'm not sure -- as an extract it is an extremely potent xanthine agent with life saving potential but a narrow range of toxicity.
-- Jay
Posted by LlurpsieBlossom on December 13, 2006, at 22:28:13
In reply to Re: Klonopin + caffeine +Alcohol - input sought » Phillipa, posted by yxibow on December 13, 2006, at 19:53:56
Theophylline is the reason why dogs and cats cannot eat large amounts of chocolate and live to tell about it.
Posted by yxibow on December 14, 2006, at 3:39:36
In reply to Re: Klonopin + caffeine +Alcohol - input sought » yxibow, posted by LlurpsieBlossom on December 13, 2006, at 22:28:13
> Theophylline is the reason why dogs and cats cannot eat large amounts of chocolate and live to tell about it.
Actually its theobromine. There is no theophylline in chocolate, it is found in (real) tea (Camellia sinensis var.). Theobromine is strongest in unadulterated raw cocoa powder and dark chocolate.
But you're right -- the LD50 is much lower for a variety of animals because they can't metabolize it:
http://en.wikipedia.org/wiki/Theobromine_poisoning
Similarly caffeine is lethal to humans but in an extraordinary, rare, and insane amount. No comment on this for obvious reasons.
-- tidings
Posted by LlurpsieBlossom on December 14, 2006, at 8:56:50
In reply to Re: Klonopin + caffeine +Alcohol - input sought » LlurpsieBlossom, posted by yxibow on December 14, 2006, at 3:39:36
> > Theophylline is the reason why dogs and cats cannot eat large amounts of chocolate and live to tell about it.
>
> Actually its theobromine. There is no theophylline in chocolate, it is found in (real) tea (Camellia sinensis var.). Theobromine is strongest in unadulterated raw cocoa powder and dark chocolate.Oops. This is what happens when I'm too lazy to do research and rely on my memory instead. Thank you for correcting me.
> But you're right -- the LD50 is much lower for a variety of animals because they can't metabolize it:
>
> http://en.wikipedia.org/wiki/Theobromine_poisoning
>
> Similarly caffeine is lethal to humans but in an extraordinary, rare, and insane amount. No comment on this for obvious reasons.
>
> -- tidingsgood tidings to you yxibow :)
I have a question regarding these psychoactive xanthines, but I should probably go to the alternatives board. Since I've got your attention though, I'm going to ask it here, and hope that no one redirects me before I get some feedback.
I'm a big fan of yerba mate. I have read a lot about it, and it seems to have stimulant qualities, but (to me anyways) is less stimulating than coffee. Is there truly a unique xanthine called "mateine" or is it just caffeine? I find it fascinating that humans have found these diverse plants (cocoa, holly(mate), coffee, camilias...) and cultivated them for their psychoactive properties. really amazing.
all hail the Xanthines! :)
-Ll
p.s. fortunately the dosages that make us *feel* horribly sick are nowhere near the dosages that actually cause physical damage.
This is the end of the thread.
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