Posted by Peter on August 17, 2003, at 13:15:52
In reply to Re: I'm scared-am I going insane?, posted by gabbix2 on August 16, 2003, at 23:36:40
That's annoying; I just wrote up a huge post and it got erased!
Anyway, I'm sorry to go on and on again like this, but my constant worry has gotten pretty bad tonight.
Firstly, remember I said that right before my doc went away for vacation he said I should double my daily 2mg klonopin to 4mg?
Well, he was just leaving that same day and I had for weeks been sending him like 4 emails a day, so I understand his reasoning for getting my anxiety down.
But, until a few weeks ago, I had been taking lamictal, prozac, strattera, adderall, klonopin, temazepam, ambien, and trazadone daily for months, and a few weeks ago I completed my taper of everything and ended up on only klonopin!
Isn't it possible that my acute anxiety might still be due to my body/mind undergoing a process of reaching a state of equilibrium after having gone through so many biochemical shifts from so many multiple med tapers?
If so, is it worth my ramping my klonopin dose all the way up to 4mg, if my anxiety might naturally lessen anyway over time?
I've been taking klonopin at differing doses for 6 years, but never over 2mg daily. And now, all of a sudden, in a voice that didn't sound much like he was very sure of what he was saying anyway, my doc tells me to ramp it all the way up to 4mg.
I've heard that klonopin is 1 of the hardest meds to come off of. How on earth will I be able to taper from 4mg if we get to a point (and I'm sure we will) when I will have to reduce back down?
Is it really worth my raising it up until my body gets adjusted to the new 4mg dose. That will only make it all the more difficult to reduce (I was already concerned about this with my former max 2mg dose).
Don't get me wrong - I know from experience that everytime you startup, resume, or increase a med, the factor is introduced of you possibly having to undergo withdrawal if you need at some point in the future to reeduce or come off it again.
But I'm just wondering if such a severe move up to 4mg is worth the trouble it might cause reducing it in the future. Also, I already thought my memory was fried from years of up to 2mg klonopin, how much all the more will I have difficulty finishing sentences, and remembering words and events with 4mg klonopin? (even though my pdoc said he doesn't think benzo-induced memory problems are cumulative - so, if my memory probs are cause by the klonopin, I would have felt it years ago, earlier in my klonopin therapy).
Anyway, this obsessive worrying does really show that I have a definite obsessive element to my anxiety, right? In fact, my disorder touches upon multiple areas of anxiety - social anxiety, OCD and GAD (though my doctor never specifically diagnosed me with these last two), anxiety stemming from probable adult ADHD (mind spinning, worry, etc.) and/or recurring mixed-mood bipolar episodes.
Another thing wbout the klonopin; I'm in France now, so I had to get Rivotril 2mg pills (the only dose the pharmacy had). It's very hard to break up the rivotrils, so is it ok that I'm taking 2mg worth of normal 0.5mg orange klonopin pills spread throughout the day but a 2mg rivotril at bedtime? Is it the exact same med composition or am I introducing a whole new mess by mixing the two?
So:
1) is it worth ramping up the klonopin to a whopping 4mg? 2) Is it ok to mix klonopin and 'rivotril?' same exact med?
Here's my THIRD MAJOR WORRY:
I also said in a former post that my pdoc said if the higher 4mg dose of klonopin doesn't make me feel at least 80% 'better' by 4 days, I should resume 10mg adderall bid.
But I just finally got off of all that medication, and adderall was the hardest one to taper! Now he said, again with a sense of unsureness evident in his voice (unless that was my paranoia), that I should resume the adderall if I'm less than 80% 'better' - how the hell am I supposed to gage whether I'm greater or less than 80% better than 4 days ago? And in what respect 'better'?
So here's more stress - deciding whether to start up the adderall again - now it is true, however, that if I do start it up, it would be at a lower dose and not in combination with 5 other meds (I used to take 35mg adderall +lamictal, prozac, etc..).
Then I though that, while the 35mg adderall I was taking for months helped me focus, gave me drive, and seemed to put a bit of a damper on my wild, wandering worries and thoughts, it still in the end caused me to become quite callous toward others, made me a bit apathetic, and caused me to isolate, hyperfocus, and be socially avoidant.
Than again, that was a higher dose, and it was also combined with many other meds and could have been the result of some sort of synergy.
This way, it would just be a lower dose adderall with one other drug - klonopin, and a high 4mg dose of it, at that.
But still, I can't stop obsessing about how to decide if I'm 80% better tomorrow, and whether I should resume the adderall or not. It seems like a shame after all that trouble tapering off of it; but, it might really help me in ways that the klonopin is not - like it might, (especially at this lower dose), take the edge of my ADHD-related worrying, and target that area of my anxiety that the klonopin cannot.
However, if this is all stemming from an OCD disorder that, after all these years, my 'top-of-the-line' pdoc has overlooked, maybe the adderall will just get me into that zone of social avoidance and obsessive hyperfocus, which, BTW, took me along time to admit was a problem, because I liked the feeling of it! But objectively, and how it affected others, it was sort of a 'trap.' What if I get caught in that trap again? Then again, the adderall, as I said, might really help.
I'm so confused, and I'm really working myself up again. I've done everything my doc said. And now, since that night of pot terror, I'm completely avoiding pot. I also do exercise daily, which I know helps the mind a lot, and TRYING to keep a healthy sleep schedule.
But it's already almost the 4th day on 4mg klonopin, when I must decide, and I'm stressed out!
I can't reach my pdoc, obviously; he's left #'s on his machine for docs that are substituting for him while he's away, but I am so not ready to call up a new doc and tell him my whole history; in fact, I don't even know what I'd be calling to ask him.
And also, my doc said we definitely should NOT start me up again on an SSRI now, since I'm so worked up and the temporary acute side-effects could exacerbate my anxiety even further, obviously something he thinks the adderall would not do.
So should I just not listen to my 'inner chatter,' stay on the new 4mg klonopin dose and, if still feeling not so good tomorrow (which I guess is 'less than 80% better'), should I just take the damn lower-dose adderall and not think about it?
Or should I not take the adderall tomorrow since this might be an overlooked OCD element that the adderall could exacerbate?
Or should I not take it just because, maybe at the current time, after having succesfully tapered off so many meds, 'less is more.'
I'm so sorry; I just can't stop my brain, and I'm getting stressed about what to decide and do tomorrow. Maybe the first adderall dose will miraculously get right at the target of all this - maybe all the worrying is ADHD-induced. Or maybe it would help by just giving me a little mood lift and confidence and energy that the higher klonopin has taken away. Is that enough of a 'justification' to resume it after all the hard work of coming off of it?
There are so many variables, it's so hard to figure out, I'm sick and tried of second-guessing everything - did my pdoc know what he was saying this last time or was his mind on other things, like getting his family ready to leave for the airport (it was the same day, anyway).
Agh! This is pure foolishness. Maddening!
sorry,
Peter
poster:Peter
thread:251194
URL: http://www.dr-bob.org/babble/20030812/msgs/251579.html