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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by floatingbridge on August 15, 2009, at 16:23:00
Hi,
I see pdoc on Monday. He suggested I might try xanax xr for long term anxiety relief. I get physically clenched sometimes, and xanax has muscle relaxant properties. Then again, Klonopin is an anti-siezure w/ mild mood stabilizing properties. Any experiences? (askapatient.com had way too many responses--I felt overwhelmed.) Any input on this minor adjustment is appreciated.
fb
Posted by Phillipa on August 15, 2009, at 17:33:31
In reply to switch from klonopin to xanax xr? any advantage?, posted by floatingbridge on August 15, 2009, at 16:23:00
Personally FB klonopin depressed me greatly, regular xanax is fine, didn't care for the long acting as I don't seem to need a benzo during the day it interferred with my sleep and some say it doesn't release accurately so they supplement with the regular. Love Phillipa
Posted by SLS on August 15, 2009, at 18:06:22
In reply to switch from klonopin to xanax xr? any advantage?, posted by floatingbridge on August 15, 2009, at 16:23:00
> I see pdoc on Monday. He suggested I might try xanax xr for long term anxiety relief. I get physically clenched sometimes, and xanax has muscle relaxant properties.
I am not very well-versed in the comparison of different benzodiazepines. Certainly, Xanax is great at reducing anxiety, but you have to be careful if it produces a robust euphoriant effect. You might get to like it too much.
> Then again, Klonopin is an anti-siezure w/ mild mood stabilizing properties.
Do you need a mood stabilizer?
At a time before the advent of Depakote, I used Klonopin as an antimanic agent in combination with lithium. Interestingly, some people experience depression with Klonopin.
How are you to go about switching drugs?
- Scott
Posted by floatingbridge on August 15, 2009, at 18:24:08
In reply to Re: switch from klonopin to xanax xr? any advantage? » floatingbridge, posted by SLS on August 15, 2009, at 18:06:22
Hi Scott,
You've brought up some good questions.
>
> I am not very well-versed in the comparison of different benzodiazepines. Certainly, Xanax is great at reducing anxiety, but you have to be careful if it produces a robust euphoriant effect. You might get to like it too much.Yeah, I am concerned about this. I wouldn't say euphoriant--but great relief. Pdoc says the 'high' effect is blunted on the xr.
And I've been resorting to my regular emergency xanax too much lately.
>
> > Then again, Klonopin is an anti-siezure w/ mild mood stabilizing properties.
>
> Do you need a mood stabilizer?I think I might--I'll discuss this with him
>
> At a time before the advent of Depakote, I used Klonopin as an antimanic agent in combination with lithium.Interesting. How did this work for you?
>Interestingly, some people experience depression with Klonopin.
Yes, I feel it has a depressive effect as well.
> How are you to go about switching drugs?That's up for discussion. I assumed one for the other all in one day? But I don't know...
>
> - ScottThanks, Scott!
Posted by floatingbridge on August 15, 2009, at 18:43:41
In reply to Re: switch from klonopin to xanax xr? any advanta » SLS, posted by floatingbridge on August 15, 2009, at 18:24:08
Can lithium be used in smaller dosages w/ any effectiveness? I've been diagnosed most recently as BP III nos. I don't do well on AP's and I'd like to avoid depakote as a woman due to side effects--though I have tolerated it well. I know there is lamictal. I read in some of your posts that lithium had neuroprotective properties.
thanks again,
fb
Posted by morganator on August 15, 2009, at 19:10:31
In reply to Scott, an extra question » floatingbridge, posted by floatingbridge on August 15, 2009, at 18:43:41
I think Scott will agree that lithium can be therapeutic at lower less toxic doses. It usually acts more as an antidepressant than a mood stabilizer though. I will leave it up to Scott to explain why.
I am assuming you are worried about depakote and weight gain. If weight gain is your only issue, I would recommend considering getting back on it again. Did you gain weight the first time? There are things you can do to minimize weight gain. And, in many cases, the weight gain issues diminishes with time. Also, depakote has it's own neuroprotecive properties. A combination of lithium and depakote may work well and protect your brain in synergy.
Posted by Glydin 00 on August 15, 2009, at 19:29:18
In reply to switch from klonopin to xanax xr? any advantage?, posted by floatingbridge on August 15, 2009, at 16:23:00
Tried that switch when the XR version was released. Was on Xanax XR for 3 months. The switch did not prove any advantage for me. Xanax XR *by far* did not have the anxiety control/panic attack control I had with clonazepam. Plus, the Xanax XR was quite expensive at that time...
Posted by floatingbridge on August 15, 2009, at 19:33:37
In reply to Re: Scott, an extra question » floatingbridge, posted by morganator on August 15, 2009, at 19:10:31
Hi Morganator,
Well, I recently heard, maybe on NPR or NYT that depakote gives women's bodies 'the' signal to store abdominal fat specifically. I've seen this in a friend of mine, and it really bums her out (and she failed lamactil). Plus it can cause hair loss--as it has done to same friend. If I don't have to go that route, I won't--my self-esteem (and social anxiety) has enough to handle ;)
Though I won't rule out a combination--and maybe in a small dose, those properties will be minimized. My friend is BPII and I'm sure her theraputic dose is higher. I do think my brain needs some protection....
Thanks for weighing in--I appreciate it!
fb
How is your cocktail going? (If I may ask) (well, I hope)
Posted by floatingbridge on August 15, 2009, at 19:43:53
In reply to Re: switch from klonopin to xanax xr? any advantage? » floatingbridge, posted by Glydin 00 on August 15, 2009, at 19:29:18
Glydin,
Did it not last as long or work as 'deeply'? Are you on klonopin again? I'm up to 1-1.5 (of klonopin) to control symptoms.
thanks!
fb
Posted by morganator on August 15, 2009, at 19:50:07
In reply to Re: Scott, an extra question » morganator, posted by floatingbridge on August 15, 2009, at 19:33:37
Yeah maybe you want to avoid Depakote if you can. Although it may be beneficial still at a lower dose that does not cause these issues, like you mentioned.
Also, many people on Depakote are not aware that it depletes the body of l-carnitine and folic acid. I think supplementing with l-carnitine while on Depakote might help with the fat storing issues. If you are on any medication that depletes your body of any nutrient, you should supplement it if you can. I think Depakote also depletes the body of biotin, which may be one reason why it can cause hair loss.
I don't know why doctors don't tell their patients these things. There are many out there that supplement extra Zinc(need copper with) and Selenium to avoid hair loss issues. There are things we can do when on these medications to hopefully avoid side effects. We just have to try to stay informed and be proactive. Our doctors sure as heck are not going to help us.
Posted by Glydin 00 on August 15, 2009, at 20:44:11
In reply to Re: switch from klonopin to xanax xr? any advanta » Glydin 00, posted by floatingbridge on August 15, 2009, at 19:43:53
> Glydin,
>
> Did it not last as long or work as 'deeply'?~~~ Hey fb,
Both.....
> Are you on klonopin again? I'm up to 1-1.5 (of klonopin) to control symptoms.
~~~ I was monotherapy on clonaz for three years, during which time - maybe a year in - was the Xanax XR trial. With clonaz, I tirated at .25 mgs at the lowest dosing and 1.5 mgs at my highest. BID dosing, generally. I have not been on it routinely for quite some time. I weaned off after beginning Lexapro over four years ago. I have used it rarely PRN - which I find works okay using it that way for me - when things get especially edgy.
For a very long time clonazepam was a Godsend for me and I found it to be one of the most effective meds I've used. I would not hesitate returning to it if I ever felt the need.
The only way to tell the difference is a trial. You may find you like Xanax XR better as we are all so very different.
>
> thanks!
>
> fb~~~ You're Welcome. Good Luck...
Posted by floatingbridge on August 16, 2009, at 17:20:55
In reply to switch from klonopin to xanax xr? any advantage?, posted by floatingbridge on August 15, 2009, at 16:23:00
I really appreciate the help--lots of good food for thought, information and personal experience. I don't know what I'd be doing w/o this board for advice and shared experience!
kindest regards,
fb
This is the end of the thread.
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