![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Dinah on December 12, 2002, at 8:43:10
I have had OCD related panic attacks for the last week (I think) that wake me from sleep every single night unless I double my Klonopin dose. If I double my Klonopin dose I'm groggy the next day. So after all this time I've come full circle, since this was what I first entered therapy for. I can't figure out if the panic attacks are trying to tell me something important, or if this is just one of those cyclical things.
Posted by Mr Cushing on December 12, 2002, at 9:51:05
In reply to Panic attacks, posted by Dinah on December 12, 2002, at 8:43:10
Hey, that's part of my Disorder (Panic Attacks) other end is Bi-Polarism (new word?). Anyways, I've just gone through that, doubling my Clonazepam (Klonopin) dosage since adding an AD to my MS seems to make me a "tad" hypomanic. All I can say is that if doubling the Clonazepam dosage works right now to get rid of those panic attacks, then do it. After a week or so, the mornings won't be as tough as they first were. Also, I'm not sure if you're a coffee drinker, but I find that a cup of coffee shakes the cobwebs right off for me.Either way though, the mornings are not that bad for me anymore and I don't have any panic attacks anymore. Hell, haven't had a panic attack in about 5 months, since I restarted the Clonazepam.
Posted by MarathonMom on December 12, 2002, at 19:32:27
In reply to Panic attacks, posted by Dinah on December 12, 2002, at 8:43:10
Dinah,
First of all, I am relatively new here, but I have enjoyed your thought-provoking and insightful posts. The family struggles you've shared with us could very well be contributing your panic attacks. Did you notice that they reoccured again when things escalated with your parents?
I personally think you are wise to step back and put your own needs on the forefront, at least for now. Being a wife and mother while holding down a demanding job can be a challenge. I'm right there with you on that, but instead of panic attacks, my problems manifest themselves by worsening my depression and putting me in a melancholy mood.
It is ironic that the panic attacks were the reason you initially sought treatment. Hopefully, ou and your therapist can work through it this time as well. Take care and be well.
Lisa
Posted by Mr Cushing on December 12, 2002, at 19:42:07
In reply to Panic attacks, posted by Dinah on December 12, 2002, at 8:43:10
I forgot to ask you this morning, what is your current dosage of Klonopin? What are you doubling the dose to?
Posted by Dinah on December 12, 2002, at 20:01:05
In reply to Re: Panic attacks, posted by MarathonMom on December 12, 2002, at 19:32:27
I think the panic attacks preceded the family problems. I think it's probably work stress, although my work situation hasn't changed lately.
I just think it's kind of ironic. I had been pretty proud of my ability to handle the panic attacks with CBT techniques, but those don't do much good in the middle of the night. I guess they just went away on their own and came back when they were ready. I'm fooling myself to think I have much control. I'm not upset by that. I just think it's sort of ironically funny to come full circle.
Thanks for the kind words,
Dinah
Posted by Dinah on December 12, 2002, at 20:06:52
In reply to Re: Panic attacks » Dinah, posted by Mr Cushing on December 12, 2002, at 19:42:07
I just hate to be groggy the next day because my work is one deadline after another and I can't afford unproductivity. I drink caffienated drinks to try to shake it off but found myself taking a couple of naps today anyway. Of course that could be a combination of the poor sleep for several nights and the extra klonopin.
The panic attacks have been every few nights for a couple of weeks, but every night this week. I doubled my Klonopin from 1 to 2 mg. I tried 1 1/2 but that wasn't much different from 1 in terms of prevention. I know that this too shall pass. I just hope it passes quickly. (Although I hate to say that because it will probably be replaced by something equally bad. The joys of cyclothymia, as you probably know.)
Thanks,
Dinah
P.S. Apparently an additional side effect of the extra klonopin is memory loss. I had completely forgotten I had posted this this morning!
Posted by Mr Cushing on December 12, 2002, at 20:14:53
In reply to Re: Panic attacks » Mr Cushing, posted by Dinah on December 12, 2002, at 20:06:52
I've only had to increase my dose to 1.5mg per day over like a 3-4 year period. .5 split in half during the days, and 1mg at night. I quit taking meds all together a few times, and Klonopin is the one that after withdrawal still worked time and time again. The withdrawal isn't that bad either when you compare it to most SSRIs.I'm Bi-Polar 1 with mixed symptoms, so most of my panic attacks and anxiety symptoms are taken care of by both a Mood Stabilizer (Depakote) and an Anti-Depressant (Celexa). This is taken also with Klonopin during the day. And you know, I'm starting to feel really good again. That's a good sign, now if I can just keep this up for a few months I think I've got this all under control.
If you find that you have to keep doubling your Klonopin dose, maybe it's time to try a new drug? Klonopin has always worked well for me as an "add-on". I don't think it would do jack for me if I wasn't already on different medications.
Posted by Dinah on December 12, 2002, at 20:36:44
In reply to Re: Panic attacks, posted by Mr Cushing on December 12, 2002, at 20:14:53
Klonopin and depakote are my mainstays. I have maintained the dose of 1/2 to 1 mg of klonopin for years, and I'm sure this is just a short term bump up in dose. My pdoc has told me to feel free to take extra at the beginning of the night if I am having a period of insomnia. I'm sure panic attacks would be the same.
I'm happy for you that you're having an extended good period. My moods never seem to last longer than a couple of weeks, darn it or thank heavens, depending.
Posted by Mr Cushing on December 12, 2002, at 21:09:35
In reply to Re: Panic attacks » Mr Cushing, posted by Dinah on December 12, 2002, at 20:36:44
Yeah, I know how Cyclothemia is, my Mom had it. I just recently bumped my Depakote up to 500mg per day, along with 20mg of Celexa every morning and 1mg of Klonopin every night. I'm actually starting to feel really good. This is like the first time in as long as I can remember that I'm not bouncing from one extreme to the next. Like a rollercoaster....I'm just worried about having to bump up too high on the Klonopin. For some reason, it just doesn't feel that right to take too much of that drug. However, I do need it to sleep at nights. If I don't take a strong enough dose, I don't sleep. If I don't sleep, I'm in a horrible mood the next day which could set off another episode.
The only thing I try to remember is that Klonopin has an 8 hour life if you're taking it by the mg. So I always take it at least 8 hours before I have to get up. Then with a cup of coffee and a little something to eat after I wake up, I'm fine, wide awake, no real "medication hangovers".
Posted by bluedog on December 13, 2002, at 8:22:15
In reply to Panic attacks, posted by Dinah on December 12, 2002, at 8:43:10
> I have had OCD related panic attacks for the last week (I think) that wake me from sleep every single night unless I double my Klonopin dose. If I double my Klonopin dose I'm groggy the next day. So after all this time I've come full circle, since this was what I first entered therapy for. I can't figure out if the panic attacks are trying to tell me something important, or if this is just one of those cyclical things.
Dinah
Rather than doubling your Klonopin dose, have you tried taking a high potency valerian capsule with your regular dose of Klonopin. I suffer from night time panic attacks myself and adding valerian to my usual Diazepam dose works wonders witout giving me the groggy feeling I get when I increase my Diazepam dose. I can see absolutely no reason why this would not also work with Klonopin.
Because this is a med related response from me I have linked to a post I made not so long ago on the med board giving my personal doseages. You can of course make the necessary adjustments for your own regular doseages but I think it is important to have the valerian in the "complex" I described because the various ingredients work synergistically with eachother.
see http://www.dr-bob.org/babble/20021203/msgs/130575.html
You can also try taking this combination together with 100mg of Phosphatidylserine as this substance influences your brain's messages to your adrenal glands so that they stop the innapropriate release of adrenaline, cortisol and DHEA at night which can lead to night-time waking and of course panic attacks. With the Phosphatidylserine if you don't notice an imorovement within two nights, then increase the dose to 200mg at bed-time. Phosphatidylserine has been reported to be so effective that you may not even need to add the valerian to your mix.
give it a try
bluedog
Posted by Dinah on December 14, 2002, at 4:42:37
In reply to Re: Panic attacks » Dinah, posted by bluedog on December 13, 2002, at 8:22:15
Posted by bluedog on December 14, 2002, at 6:14:57
In reply to Re: Thanks! I'll look into it. (nm) » bluedog, posted by Dinah on December 14, 2002, at 4:42:37
Dinah
I actually had an appoimtment with my Psychiatrist yesterday afternoon and I asked him the very same question about combining Benzo's with Valerian that I had posed recently on the med board in the thread that I directed you to in my above post.
My Pdoc advised me that it should be perfectly safe to combine Valerian with Benzo's. He told me that Valerian and Benzo's actually have similar effects on your central nervous system but that the effects do differ in very subtle ways so that these two substances can actually produce very beneficial synergistic effects when they are combined. However when you try the combination it is imperative to "listen to your own body" so that you can adjust the doseages you take according to your own individual reactions and circumstances.PLUS....don't forget to try the phosphatidylserine!!
I wish you all the best
bluedog
Posted by judy1 on December 14, 2002, at 23:16:57
In reply to Re: Thanks! I'll look into it. (nm) » bluedog, posted by Dinah on December 14, 2002, at 4:42:37
This happens all the time to me- the periods (almost always nocturnal PAs) when I have numerous PAs/day. My pdoc gave me xanax for those times, and I take 1-2mg (I know it's a lot, but I have high tolerance) sub-ling and within 5 minutes I'm fine with no hangover like I get with increased klonopin. Have you tried that method yet? Take care, Judy
Posted by Dinah on December 14, 2002, at 23:38:09
In reply to Hey Dinah » Dinah, posted by judy1 on December 14, 2002, at 23:16:57
I'll ask my pdoc. He's been pretty good about prescribing klonopin, but he's never suggested any other benzo. I don't know if he'd be willing, but if it doesn't leave you groggy the next day it's worth a try.
This is the end of the thread.
Psycho-Babble Social | 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.