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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by LAURAH952 on June 25, 2013, at 9:57:37
Hi all,
I've been suffering with extremely debilitating panic attacks for about 25 years. I've worked my way up to 8mg Klonopin over that time, and am now at 6mg daily. (Xanax was not a great med for me)
I still have anxiety, and the "beginnings" of panic attacks, but the Klonopin works wonders.
Many pdocs are now saying that it's too much, (tell me something I don't know) but only the benzos have helped thus far.
Is anyone successfully taking something else for severe panic attacks? (or know of something I could try?) My attacks do not subside over time. I need to take the Klonopin. I hate having to rely on this med, and it may only be a matter of time before it won't be prescribed for me. That thought terrifies me.
My other meds/conditions:
Cymbalta/depression & pain
Tegretol/bi-polar II & pain
Trazadone(prn)/insomnia
Lyrica 100mg/day for idiopathic peripheral neuropathyThank you,
Laura
Posted by Phillipa on June 25, 2013, at 11:53:25
In reply to Klonopin for severe panic disorder, posted by LAURAH952 on June 25, 2013, at 9:57:37
Laura I had debilitating panic starting age 24 and at the time was given valium and miltown which was popular then. It worked wonders. About a year later just stopped the miltown continued with valium 5mg three times a day. Over the years the anxiety was up and sometimes gone. So it's been 40 some odd years. For a number of years Xanax was a good med at .25mg three times a day. Klonopin and I didn't get along. Now I take 7.5mg of valium at night & .25mg of Xanax, and 25mg of luvox and 2.5mg of Lexapro none of which seem to work.
I see you have pain may I ask what type as I have severe back pain that is degenerative. At one time took Cymbalta when new on the market and I do think it helps with pain as didn't know I had any till went off it. But the cost is so expensive.
8mg of klonopin I think is the equivalent of 80mg of valium. So I do think it's a high dose. Phillipa
Posted by LAURAH952 on June 25, 2013, at 12:50:01
In reply to Re: Klonopin for severe panic disorder » LAURAH952, posted by Phillipa on June 25, 2013, at 11:53:25
> Laura I had debilitating panic starting age 24 and at the time was given valium and miltown which was popular then. It worked wonders. About a year later just stopped the miltown continued with valium 5mg three times a day. Over the years the anxiety was up and sometimes gone. So it's been 40 some odd years. For a number of years Xanax was a good med at .25mg three times a day. Klonopin and I didn't get along. Now I take 7.5mg of valium at night & .25mg of Xanax, and 25mg of luvox and 2.5mg of Lexapro none of which seem to work.
>
> I see you have pain may I ask what type as I have severe back pain that is degenerative. At one time took Cymbalta when new on the market and I do think it helps with pain as didn't know I had any till went off it. But the cost is so expensive.
>
> 8mg of klonopin I think is the equivalent of 80mg of valium. So I do think it's a high dose. Phillipa
Hi Phillipa,No antidepressant has ever worked for my panic attacks, even though I believe it's sometimes prescribed for that. The pdocs believed that the attacks were caused in part from an underlying depression, so even when I wasn't depressed, I had the antidepressant/benzo combination. Xanax had too short a half life for me, so I think that's why I didn't care for it long term.
I'm sorry the combo you're on now doesn't seem to work. I don't know of anything else that would, unless you were willing to give a small dose of Klonopin another shot.
The Cymbalta was mainly prescribed for depression, but was said to help with pain, so a perk for me. (I'm not really sure if it's helping the pain or not) I was given tegretol initially in a small dose for the peripheral nueropathy, as I can't tolerate more than 100mg Lyrica/day. It really helps with that nerve pain. Funny, but now I'm up to 400mg for bi-polar II which, again is a perk - I was already on it.
Other than the neuropathy, I have spinal stenosis, lumbar spondylosis, herniated discs in c-spine, and bulging discs in lumbar spine. I don't pay that much attention to that pain, but have had injections, and muscle relaxers here and there.
Do you have insurance? I just used my plan's prescription by mail, and saved a ton - Cymbalta costs only $60 for 3 mos. I was told also to look for coupons, and write the pharmaceutical company that makes this (and other meds) to see if they would send it free or at a discount. I also have a card for Lyrica given me by my neurologist, and I pay only $25/mth for it.
BTW - I can take 6mg Klonopin at once, and barely feel it in my system - it just gets rid of that panic. (not that I'm proud of that.....)
HTH some - Laura
Posted by Hugh on June 25, 2013, at 14:37:38
In reply to Klonopin for severe panic disorder, posted by LAURAH952 on June 25, 2013, at 9:57:37
Niacinamide has benzo-like properties. Here's a case report about someone who used it to get off the Klonopin he'd been taking for anxiety.
http://jonathanprouskynd.com/uploads/Nicotinamide___Anxiety_-_Case_Report.pdf
I just started taking d-Limonene a few days ago. I've been feeling much calmer and have been sleeping unusually well since then. Here's some info I found about it online:
D-Limonene is a selective activator of the adenosine A(2A) receptor on cell membranes, which senses molecules outside the cell and in turn triggers activity within the cell. These receptors are vital for nervous system function. The lack of their activation is associated with anxiety, insomnia, and impaired dopamine transmission (addictive tendencies and lack of motivation). A lack of activation of adenosine A(2A) receptors on immune cells results in a hyperimmune response (allergic reactions).
Various doses of d-Limonene have a potent anti-anxiety effect. Even inhaling the vapors of d-Limonene can calm down nerves as well as allergic reactions.
Taking d-Limonene before bedtime will help calm nerves and promote restful sleep, yet another benefit of this multitalented nutrient.
Posted by Beckett on June 25, 2013, at 17:46:38
In reply to Re: Klonopin for severe panic disorder, posted by Hugh on June 25, 2013, at 14:37:38
Thanks Hugh. I'm going to print this out.
Posted by LAURAH952 on June 25, 2013, at 17:47:58
In reply to Re: Klonopin for severe panic disorder, posted by Hugh on June 25, 2013, at 14:37:38
> Niacinamide has benzo-like properties. Here's a case report about someone who used it to get off the Klonopin he'd been taking for anxiety.
>
> http://jonathanprouskynd.com/uploads/Nicotinamide___Anxiety_-_Case_Report.pdf
>
> I just started taking d-Limonene a few days ago. I've been feeling much calmer and have been sleeping unusually well since then. Here's some info I found about it online:
>
> D-Limonene is a selective activator of the adenosine A(2A) receptor on cell membranes, which senses molecules outside the cell and in turn triggers activity within the cell. These receptors are vital for nervous system function. The lack of their activation is associated with anxiety, insomnia, and impaired dopamine transmission (addictive tendencies and lack of motivation). A lack of activation of adenosine A(2A) receptors on immune cells results in a hyperimmune response (allergic reactions).
>
> Various doses of d-Limonene have a potent anti-anxiety effect. Even inhaling the vapors of d-Limonene can calm down nerves as well as allergic reactions.
>
> Taking d-Limonene before bedtime will help calm nerves and promote restful sleep, yet another benefit of this multitalented nutrient.
Hi Hugh,Ahh, here's the post.. I'm most intrigued by the link about the Niacinamide! I perused it, but bookmarked it to read later. Perhaps this can help me as well.
Thanks so much!
Laura
Posted by Beckett on June 25, 2013, at 17:53:34
In reply to Klonopin for severe panic disorder, posted by LAURAH952 on June 25, 2013, at 9:57:37
I use Xanax XR. I have switched back and forth between klonopin and Xanax, but Xanax seems to work better for the start of panic and how irrational my thoughts become during and episode. Instant Xanax was too rough a ride..
Lately I will take 300mg of gabapentin instead of extra Xanax. It helps me, but I have to be careful because too much gabapentin will give me edema. I know because I tried it for neuropathy myself. Right now tramadol ER works for my neuropathy and for spinal pain, too.
Posted by Phillipa on June 25, 2013, at 20:43:49
In reply to Re: Klonopin for severe panic disorder, posted by LAURAH952 on June 25, 2013, at 12:50:01
Seems we have a lot of the same back issues. Add in some osteoporosis. PT every other week and daily excercises on floor also help ease pain after bike riding. Walking is the worst for me.
Medicaire & United Healthcare as supplemental is my insurance. $60 is that much as the Lexapro is I think about $90 a month. Phillipa
Posted by Hugh on June 25, 2013, at 22:43:01
In reply to Re: Klonopin for severe panic disorder » Hugh, posted by Beckett on June 25, 2013, at 17:46:38
> Thanks Hugh. I'm going to print this out.
You're welcome. The interesting thing about d-Limonene is that it has a completely different mechanism of action than SSRIs, SNRIs, benzos, etc. D-Limonene appears to work by increasing adenosine levels. And it's a potent anti-inflammatory. There's increasing evidence that inflammation plays a role in depression and anxiety. So far it's working for me, but it's only been a few days.
Posted by jono_in_adelaide on June 26, 2013, at 0:35:13
In reply to Klonopin for severe panic disorder, posted by LAURAH952 on June 25, 2013, at 9:57:37
Adding 1mg of risperidone at night helps a good proportion of people with severe panic disorder, it might be worth a months trial to see how it works for you.
I take it and it made a real measurable difference
Posted by LAURAH952 on June 26, 2013, at 11:07:12
In reply to Re: Klonopin for severe panic disorder, posted by Hugh on June 25, 2013, at 14:37:38
Posted by Hugh on June 25, 2013, at 14:37:38
In reply to Klonopin for severe panic disorder, posted by LAURAH952 on June 25, 2013, at 9:57:37
Niacinamide has benzo-like properties. Here's a case report about someone who used it to get off the Klonopin he'd been taking for anxiety.
http://jonathanprouskynd.com/uploads/Nicotinamide___Anxiety_-_Case_Report.pdf
I just read the case report, and I see how Niacinamide may have worked in several different ways to reduce anxiety in this man. (and in general) It's certainly worth trying as there appears to be no toxicity unless, perhaps, mega-dosing.
The man in the study was only on 1mg Klonopin, and I wish that was my case. The lowest dose I've been on in 25 years was when I was pregnant, and that was 2mg/day. (I tapered completely off, but my attacks were so disabling that my doc put me on 2mg - my baby was absolutely fine, and is not the daughter with the psychiatric conditions I've been talking about) I suffered with endless panic attacks, and high anxiety throughout the pregnancy.
This leads me to wonder why I need so much.(6mg/day) Am I just addicted to it? Did I hurt my brain function using so much? Would I ever be able to live "a normal life" on low doses (or none) again? I'm sure much more than this needs to be considered, such as my bi-polar II disorder, depression (if I'm not being redundant) These conditions run rampant in my family.
With all that being said, I am certainly going to experiment with this, and perhaps other "non-benzos" and see how it works for me.
Thanks so much,
Laura
Posted by LAURAH952 on June 26, 2013, at 12:50:15
In reply to Re: Klonopin for severe panic disorder » LAURAH952, posted by Phillipa on June 25, 2013, at 20:43:49
> Seems we have a lot of the same back issues. Add in some osteoporosis. PT every other week and daily excercises on floor also help ease pain after bike riding. Walking is the worst for me.
>
> Medicaire & United Healthcare as supplemental is my insurance. $60 is that much as the Lexapro is I think about $90 a month. PhillipaHi Phillipa,
I've been injured hiking on a couple of occasions, falling on my tailbone a few times skating, (you would think once would have been enough) and I was also in a serious car accident. I've definitely done some damage over the years! My skating and skiing days are over unfortunately, but I was just hiking in the Rockies, (nothing extreme) and now I need a little PT again. It's mostly my lower back, and walking or standing still exacerbates the situation. Some day surgery may be indicated. Bones still dense as far as I know... (so am I... I need to stop doing these things!)
I pay $60 for 3 mos. of the Cymbalta, which used to be the most costly med I've been on. Your Lexapro (I've been on it as well) is $90/mth?? Ouch! Have you looked for coupons or discount cards online? Asked the doc?
Good Luck,
Laura
Posted by bleauberry on June 26, 2013, at 15:08:23
In reply to Klonopin for severe panic disorder, posted by LAURAH952 on June 25, 2013, at 9:57:37
Just wanted to say I do not agree with the word idiopathic in your diagnosis. That simply means they are too lazy to work at finding what's up. Instead, just throw drugs at it to calm it down whatever it is. In my journeys I have discovered the so-called idiopathic stuff really isn't all that hard to figure out. They just don't have the time or the environment to do that. You pay the price.
Those symptoms of yours are likely to respond favorably to the same treatments used in Malaria or Lyme or Cat Scratch Fever, and psych meds likely never needed again.
But that's just my own eyes, my own intuition guided by experience. sharing opinion, that's all.
Posted by LAURAH952 on June 27, 2013, at 13:36:23
In reply to Re: Klonopin for severe panic disorder, posted by bleauberry on June 26, 2013, at 15:08:23
Just wanted to say I do not agree with the word idiopathic in your diagnosis. That simply means they are too lazy to work at finding what's up. Instead, just throw drugs at it to calm it down whatever it is. In my journeys I have discovered the so-called idiopathic stuff really isn't all that hard to figure out. They just don't have the time or the environment to do that. You pay the price.
You have a good point there - after brain MRI's, tests for lyme disease, tests for diabetes (A1c's) and more, they just stopped testing. I had one high A1c in these years of testing, (pre-diabetic) and although other A1c's have been normal thereafter, I can't help but wonder if measures to combat a possible future diabetic condition may help, and thus here's the culprit??
I also dropped the ball, as when I had a brain/C-spine MRI to rule out MS, a tumor was found in my left frontal lobe. My neurosurgeon 1st called it a stage 1 Glioma, then changed her mind after the 2nd MRI a year later (no growth), and called it an unknown "benign mass". As to why I dropped the ball, hearing your doc tell you that you have a brain tumor, you really don't care much about the pain in your feet. You're thinking you could die..... Since then, my neurologist said it was nothing.... just needs to be followed w/ MRI's
I can't afford any more testing, even the MRI follow-ups, as my insurance has drastically changed for the worse and would bankrupt us. Just don't know what else to do.....
thanks for your input!
Laura
Posted by herpills on June 30, 2013, at 12:17:12
In reply to Klonopin for severe panic disorder, posted by LAURAH952 on June 25, 2013, at 9:57:37
> My other meds/conditions:
> Cymbalta/depression & pain
> Tegretol/bi-polar II & pain
> Trazadone(prn)/insomnia
> Lyrica 100mg/day for idiopathic peripheral neuropathy
>
> Thank you,
> Laura
>Have you ever tried a higher dose of Lyrica to see if it helps anxiety, some people here have used it for that purpose. Klonopin is certainly one of the best meds for anxiety/panic in my view, but as you know could become a tolerance issue. Have you ever tried switching to a different benzo like Ativan? herpills
Posted by Zyprexa on July 5, 2013, at 20:24:21
In reply to Klonopin for severe panic disorder, posted by LAURAH952 on June 25, 2013, at 9:57:37
zyprexa for panic/anxiety. Works very well for that for me, 15 years now.
Posted by laurah952 on July 6, 2013, at 10:03:16
In reply to Re: Klonopin for severe panic disorder, posted by Zyprexa on July 5, 2013, at 20:24:21
> zyprexa for panic/anxiety. Works very well for that for me, 15 years now.
I wonder if I could add that to my current meds to help with bipolar symptoms as well as anxiety. (My pdoc would probably blow a gasket, as I'm on 6mg Klonopin already)
Do you know if it would typically give Cymbalta a boost?
Thanks for the info!
Laura
Posted by Zyprexa on July 8, 2013, at 20:00:51
In reply to Re: Klonopin for severe panic disorder » Zyprexa, posted by laurah952 on July 6, 2013, at 10:03:16
They use it for bipolar. I don't know if it will give cymbalta a boost or not. It goes well with zoloft.
Posted by kevinb529 on July 13, 2013, at 1:54:39
In reply to Re: Klonopin for severe panic disorder » laurah952, posted by Zyprexa on July 8, 2013, at 20:00:51
This is the end of the thread.
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