Posted by paulk on June 16, 2001, at 15:45:00
In reply to Re: Linky-link » paulk, posted by Elizabeth on June 15, 2001, at 22:32:07
> > Seriously, your pdoc doesn’t seem to be up on the seritinergic effects of klonopin. Klonopin is THE benzo of choice for long-term treatment.
>
> Not necessarily, although it is definitely a first-line treatment for panic disorder or generalised anxiety. Most benzos have the potental to cause or exacerbate depression, though, including Klonopin; Xanax is often preferable for people with anxiety and depression, despite the need for frequent dosing.
>
I sure think it would be better in a XR version.> > Not that weird. I only need just a little - .25/day. Many others are in the same boat.
>
> That's surprising. I took Klonopin for a few weeks at one point, and I needed 4 mg/day (1 mg in the morning and afternoon, 2 mg at bedtime). What do you take it for? (I was taking it for panic disorder and a REM sleep parasomnia.) And most people I know who take Klonopin for panic or anxiety disorders need at least 1 mg/day.Our neuro-chemistry is probably much more variable than the shapes of our faces – YMMV. Also the effects at high dosages may not at all the same as what I get out of the drug. A similar example – Effexor has very little NE effect at 75mg and acts mostly like a SSRI, but at 300mg it becomes a true SNRI.
> > DITTO – BULLS EYE – EXCELLENT POINT! I hope some docs read what you just said. ( I think this phenomena is called ‘kindling’ in the litature.)
>
> Kindling refers to increased frequency of seizures in untreated epilepsy. (More generally it can refer to the same type of phenomenon in mood disorders or panic disorder.)
>
Yes, I’m talking about kindling as it refers to mood.
> > I have seen folks deteriorate over time on very large dosages Benzos.
>
> I haven't. But I have seen people take the same dose for years without problems and without needing to increase it.It isn’t pretty. I went to a funeral of a friend who had lost his hygiene habits after too many bezo over 15 years. He died choking to death on a hotdog. (this is not a joke)
>
> > I Really don’t think it is good practice to use benzos per attack (unless its for someone who is bi-polar.)
>
> Huh? Benzos are sometimes used to reduce psychomotor agitation in mania, but they're also used for various types of episodic anxiety. It's completely reasonable.
>
I guess I’ve seen too many people who got in trouble with benzos when I was in hospital. That dosen’t mean everyone will, but some do.> > If it is a short acting benzo “as per needed” is a good way to get someone with PA in even bigger trouble.
>
> That doesn't make sense to me. If you only take it as-needed, you don't need to be concerned about pharmacologic dependence if you ever want to go off it (or if you miss a dose). Anxiety patients, as a rule, don't abuse their medication (those who do are almost invariably abusing other drugs too).
>
I would humbly disagree; the short half-life of Xanex causes withdrawal symptoms of ‘panic and anxiety’ in some patients with a single dose. When I took Xanex – I would get quite irritable as the drug wore off. This makes a drug spiral – take Xanex for anxiety – it works, but as it wears off anxiety is there, but worse – take more – and more. Now, this doesn’t happen to everyone – but it sure happens to some folks.> > Klonopin, for me, even at a VERY low dose makes all the difference in what I do when I lose my temper. It also prevents the panic attacks (although I didn’t have that many).
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> Benzos for anger? That's interesting. Some people with anger problems become disinhibited on benzos (like alcohol).Not me – I still get mad – I just don’t kindle into a rage.
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> > Getting off higher dosages of Benzos can be nightmarish.
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> That's true if you take them around the clock. But then again, a lot of people really do need much higher doses. You're lucky -- maybe it's because you're taking it primarily for anger and never had frequent panic attacks.
>
Yes – more I’m more of GAD with Atypical depression – my entire life.> > I watched a fellow patient go through the “cold wet sheet pack treatment” getting off Valium. I think switching to klonopin and tapering would have been a much better way.
>
> That's the right way, yes: switch to a long-acting benzo, such as Klonopin or Tranxene, and then taper off *very* slowly. Any doctor who takes someone off benzos cold-turkey should have his license revoked, IMO.They tapered – the anxiety returned – only treatment was CWSP. This was a hospital that was down on drug therapy and thought they could talk away everyone’s problems (sadly some who had thyroid disease)
poster:paulk
thread:65795
URL: http://www.dr-bob.org/babble/20010612/msgs/66753.html