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Dr. Bob is Robert Hsiung, MD,
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Posted by KrissyP on March 2, 2003, at 13:49:43
In reply to Re: KLONPIN users,help?? » male34, posted by Mikey_C on March 2, 2003, at 3:09:08
OK-I need to make a point. When I saw my psychiatrist Friday, she re-iterated AGAIN that benzos are very addicting. She says to me " you might as well be addicted to street drugs-heroin"- I was like okaaaaaaaaaaayyyyyyy Geez-Klonopin is great-it works for me and I only take 2mg- so I compromised and will follow her advice of cutting to 1 1/2mg for a week, and then 1mg for a week an stay on only 1mg a week. My opinion--------I agree, and I don't want to be hooked on this med to a point where I start building tolerance-I have seen that happen in a sibling. If the Seroquel prevents you from having to take Klonopin and possibly getting hooked, building up tolerance, etc. -GO FOR IT. Just my opinion Good luck:)
Kristen
I would also definitely recommend Clonazepam (Klonopin) for help with anxiety... I've been taking 1mg per night for the last 8 months and don't seem to be having any real problems with it...
Though, come to mention it... that whole thing about not missing a few doses is starting to scare me.... Since I started on that Seroquel I haven't taken the Clonazepam because the Seroquel has been far too sedating for me already... hmmmm...
Posted by jonh kimble on March 2, 2003, at 14:12:58
In reply to Re: KLONPIN users,help?? » Mikey_C, posted by KrissyP on March 2, 2003, at 13:49:43
how about this? what if klono is the only thing that helps, and as soon as you go off all the dehabilitating anxiety returns and you simply cant function? can I stay on a dose like 3mgs a day for life? thanks
Posted by Guy on March 2, 2003, at 14:47:42
In reply to KLONPIN users,help??, posted by male34 on March 1, 2003, at 22:34:37
Not sure if clonazepam will remain effective for life. I've heard conflicting reports. I do know Seroquel has potential for very serious side-effects, unlike clonazepam which is extremely safe from a physical point of view. My shrink says I can stay on con for the rest of my life, but who knows...the choices we have to make. It just adds to all the stress in my opinion.
Posted by KrissyP on March 2, 2003, at 17:42:05
In reply to Re: KLONPIN daily for life?, posted by jonh kimble on March 2, 2003, at 14:12:58
If Klonopin is the ONLY thing that help you, then by all means, stick with it. The issue of TOLERANCE comes up again here: I don't know how old you are, BUT if you stayed on 3mg for minimum of 10 years- I am almost positive your body would definately build up tolerance to it-causing you to have to up the dose-I would ask your doc on this and let ME know:)I'm curious.
Kristen
how about this? what if klono is the only thing that helps, and as soon as you go off all the dehabilitating anxiety returns and you simply cant function? can I stay on a dose like 3mgs a day for life? thanks
Posted by KrissyP on March 2, 2003, at 17:47:01
In reply to Re: KLONPIN users,help??, posted by Guy on March 2, 2003, at 14:47:42
Male 34-hiya,
May I ask what side effects of Seroquel you are talking about here? I'm on it! yikes I agree, regarding Klonopin, the only serious side-effect, if that's what we could call it---is ADDICTION. Oh yeah-the choices we have to make huh?........It adds to my stress too. Please try to get back to me
Take it easy:)
Kristen-------------------------------------------------
Not sure if clonazepam will remain effective for life. I've heard conflicting reports. I do know Seroquel has potential for very serious side-effects, unlike clonazepam which is extremely safe from a physical point of view. My shrink says I can stay on con for the rest of my life, but who knows...the choices we have to make. It just adds to all the stress in my opinion.
Posted by jonh kimble on March 2, 2003, at 18:24:55
In reply to Re: KLONPIN daily for life? » jonh kimble, posted by KrissyP on March 2, 2003, at 17:42:05
well im 19. so i guess that presents a problem. but in ten years, who knows, maybe theyll find a non tolerance building anti anxiety med. (that works for me)
Posted by utopizen on March 2, 2003, at 18:42:48
In reply to Re: KLONPIN daily for life?, posted by jonh kimble on March 2, 2003, at 18:24:55
> well im 19. so i guess that presents a problem. but in ten years, who knows, maybe theyll find a non tolerance building anti anxiety med. (that works for me)
>
I'm 19, too. Do you really want to be anxious now? You won't even have to worry about thinking about worrying about going off Klonopin until you're at least 40, and by then nothing matters because you're fat and old anyway.
So go on the K-Pax like I am about to in 2 days and get your life back. It's more important right now than worrying about something you shouldn't be thinking of at this stage.
Besides, you could be on it for 20 years with no tolerance at all, that depends on the person.
Posted by mattdds on March 2, 2003, at 18:45:23
In reply to Re: KLONPIN daily for life? » jonh kimble, posted by KrissyP on March 2, 2003, at 17:42:05
Guys,
People routinely take benzos for decades, without loss of its ANTIANXIETY effect. This is an important distinction to make, as there are different effects of benzos (e.g. anxiolytic, anticonvulsant, and sedative). The tolerance you are all so freaked about is more to the sedative and anticonvulsant effects, and NOT so much to the antianxiety effects. Furthermore, the anxiolytic properties are what most of us are interested in, right? This is pretty well documented in the literature. I will look for some references, but did learn this in my pharmacology class in dental school.
Yes, if you take benzos for extended periods of time, you will likely become dependent on them. I don't understand why this is so disturbing. This doesn't mean they stop working, it just means you need to taper when you come off them. What is it that people don't get about this? If you come off of most psychoactive drugs (even the pristine and free of sin SSRI's and atypical neuroleptics that seem to be so en vogue these days) without a good slow taper, you are going to get withdrawals! This is true of Paxil, Celexa, Seroquel, and even with drugs that aren't psychoactive, like B-blockers and Coumadin. Why is this aspect, dependence requiring a SLOW taper, so magnified with only the benzos? Honestly, in my opinion, if you go off a benzo without a taper and experience withdrawals, you only have yourself to blame. These effects can be minimized or even eliminated with a good slow taper. Read about this in Goodman & Gilman's pharmacology, where they say that withdrawals from diazepam and clonazepam are virtually nonexistent in slow tapers (1-2 months, gradually).
In sum, I am not convinced that in the majority of people there is much tolerance to the antianxiety effects of benzos. This is obviously possible in some, but I think it's the exception, rather than the rule. There is, however substantial tolerance to their sedative and anticonvulsant effects, but in my opinion, benzos should not be taken for these purposes long-term, because there are drugs which are much better suited for these concerns (e.g. zolpidem for sleep, valproate et. al for seizures)
Finally, PLEASE explain why people have such a difficult time distinguishing between two simple words: ADDICTION and DEPENDENCE. These are two very different things. Addiction involves intense cravings and a compulsive need to take a substance, and antisocial behavior. Benzos do not do this, especially in people with diagnosed anxiety disorders. Please, why is this so difficult to use the appropriate language?Matt
Posted by viridis on March 2, 2003, at 19:12:31
In reply to Tolerance more to sedative and anticonvulsive , posted by mattdds on March 2, 2003, at 18:45:23
I'll just second Matt on pretty much all of his points. It's frustrating to hear the word "addiction" used so casually (and inappropriately) -- one person in this thread even had a doctor comparing Klonopin to heroin!
Here are some definitions, from the American Society of Addiction Medicine website:
The American Society of Addiction Medicine (ASAM), the American Academy of Pain Medicine (AAPM), and the American Pain Society (APS) recognize the following definitions and recommend their use:
Addiction: Addiction is a primary, chronic, neurobiological disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.
Physical Dependence: Physical dependence is a state of adaptation that often includes tolerance and is manifested by a drug class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist.
Tolerance: Tolerance is a state of adaptation in which exposure to a drug induces changes that result in a diminution of one or more of the drug's effects over time.
What people are describing with Klonopin is almost always physical dependence. This is common with many drugs that are used for all kinds of conditions. In the list of "hardest-to-quit" meds recently released by the World Health Organization, SSRIs and Effexor figured prominently in the top 10 (benzos didn't), with Paxil at #1, as I recall. It's just that with meds that are still under patent, the preferred term for withdrawal is "discontinuation syndrome", and no one would suggest you were ever addicted.
When I started Klonopin about a year and a half ago, my psychiatrist told me that if I took it for an extended period of time I would have to slowly taper off it. Early on, I talked about quitting it, and he said fine, but chances are I'd go back to my previous, frequent high anxiety state. He considers this much worse for my mental and physical health than use of Klonopin, and I agree. I quickly developed complete tolerance to the sedative and dulling effects, but the same dose (1 mg/day) continues to have the same anxiolytic effect as in the beginning. Apparently, this pattern is pretty standard for people with anxiety disorders, and many take the same dose for years.
If I'm an addict, I sure don't feel like one.
Posted by SBOATRN on March 2, 2003, at 19:56:39
In reply to Re: KLONPIN daily for life?, posted by utopizen on March 2, 2003, at 18:42:48
> I'm 19, too. Do you really want to be anxious now? You won't even have to worry about thinking about worrying about going off Klonopin until you're at least 40, and by then nothing matters because you're fat and old anyway.
Well, I'm OVER 40 and I'm not fat. I don't think I'm old and I have things that still matter alot in my "old age". I realize your point, just wish you could have picked another way to make it !!
Posted by viridis on March 2, 2003, at 20:45:10
In reply to Nothing matters after forty ??? » utopizen, posted by SBOATRN on March 2, 2003, at 19:56:39
My feelings too (not yet 40 but getting close...and not fat yet either).
But hey, when you're 19, 40 does seem old. In the 60s, wasn't it the conventional wisdom that you can't trust anyone over 30?
Anyway, I'm really not too offended; it just reminds me how differently I thought about things when I was that age.
Posted by KrissyP on March 2, 2003, at 22:29:42
In reply to Tolerance more to sedative and anticonvulsive , posted by mattdds on March 2, 2003, at 18:45:23
BECAUSE THAT IS WHAT SOME IDIOTIC, UNPROFESSIONAL, DEAF PSYCHIATRISTS HAVE INSTILLED IN MY HEAD-
just my experience:-)
Kristen
> Guys,
>
> People routinely take benzos for decades, without loss of its ANTIANXIETY effect. This is an important distinction to make, as there are different effects of benzos (e.g. anxiolytic, anticonvulsant, and sedative). The tolerance you are all so freaked about is more to the sedative and anticonvulsant effects, and NOT so much to the antianxiety effects. Furthermore, the anxiolytic properties are what most of us are interested in, right? This is pretty well documented in the literature. I will look for some references, but did learn this in my pharmacology class in dental school.
>
> Yes, if you take benzos for extended periods of time, you will likely become dependent on them. I don't understand why this is so disturbing. This doesn't mean they stop working, it just means you need to taper when you come off them. What is it that people don't get about this? If you come off of most psychoactive drugs (even the pristine and free of sin SSRI's and atypical neuroleptics that seem to be so en vogue these days) without a good slow taper, you are going to get withdrawals! This is true of Paxil, Celexa, Seroquel, and even with drugs that aren't psychoactive, like B-blockers and Coumadin. Why is this aspect, dependence requiring a SLOW taper, so magnified with only the benzos? Honestly, in my opinion, if you go off a benzo without a taper and experience withdrawals, you only have yourself to blame. These effects can be minimized or even eliminated with a good slow taper. Read about this in Goodman & Gilman's pharmacology, where they say that withdrawals from diazepam and clonazepam are virtually nonexistent in slow tapers (1-2 months, gradually).
>
> In sum, I am not convinced that in the majority of people there is much tolerance to the antianxiety effects of benzos. This is obviously possible in some, but I think it's the exception, rather than the rule. There is, however substantial tolerance to their sedative and anticonvulsant effects, but in my opinion, benzos should not be taken for these purposes long-term, because there are drugs which are much better suited for these concerns (e.g. zolpidem for sleep, valproate et. al for seizures)
>
> Finally, PLEASE explain why people have such a difficult time distinguishing between two simple words: ADDICTION and DEPENDENCE. These are two very different things. Addiction involves intense cravings and a compulsive need to take a substance, and antisocial behavior. Benzos do not do this, especially in people with diagnosed anxiety disorders. Please, why is this so difficult to use the appropriate language?
>
> Matt
>
Posted by Mikey_C on March 2, 2003, at 22:38:35
In reply to Re: Tolerance more to sedative and anticonvulsive » mattdds, posted by KrissyP on March 2, 2003, at 22:29:42
Ooooh... I just LOVE an aggressive woman LOL....
Posted by bluedog on March 2, 2003, at 22:41:10
In reply to Re: Tolerance more to sedative and anticonvulsive » mattdds, posted by viridis on March 2, 2003, at 19:12:31
Hi Viridis
I tend to agree with you and Matt. My social anxiety and major depression really started taking a turn for the better since my Pdoc placed me on a daily dose of Valium. The drowsiness was initially a problem but I can now take up to 30mg per day at 10mg 3x per day (I think 30mg of valium is roughly equivalent to about 6 mg of Klonopin) with NIL sedation, co-ordination or memory problems whatsoever YET it really king hits my social anxiety and the anxiolytic effects are as good as when I first started taking valium nearly a year ago now. Most days I really only take 10mg to 15mg and I reserve the doseages of 20mg to 30mg ONLY for those days where I know I am going to be placed into socially stressful circumstances. So I usually only take the equivalent of 2mg to 3mg of Klonopin each day. I did build up the doseages over an exteneded period of time and I feel absolutely no need nor desire to increase my doseages of the valium beyond what I already take. In fact I'm now considering a trial reducing my doseages to see if the anxiolytic effects remain effective at a lower daily dose and I will discuss this with my Pdoc when I next see him.
By the way my anxiety symptoms just so happen to be the usual trigger for my depressive symptoms so the Valium has also very noticeably reduced my depressive symptoms and I feel like I'm able to live my life again. (In fact it has worked against my depressive symptoms MUCH MUCH more effectively in COMBINATION with an SSRI rather than SSRI monotherapy. The combination has worked so well in fact that I've been able to reduce my AD dose of Lovan (generic Prozac) to the very low amount of 10mg daily without any return of my major depressive symptoms.
What's more the Valium has also helped enormously with my Chronic Fatigue Syndrome(CFS) and Valium is actually indicated in low daily doses as therapy for CFS and Fibromyalgia symptoms.
I should add that these drugs have of course not cured or completely eliminated my symptoms as no medication is capable of doing this but it has made my life much more manageable.
I just wish that the Psychobabble search option was up and running because there used to be a poster before my time called Elizabeth who wrote some absolutely EXCELLENT posts on the differences between addiction and medical dependance in relation to Benzodiazepine useage. She was aslo exrtremely knowledgeable about Benzo useage in general.
I think she stopped posting shortly after some of her very best posts on this subject because the anti-benzo posters at that time made life very difficult for her and started attacking her personally rather than sticking to the facts at hand. She never posted again on PB after the personal attacks were made against her and that I find a REAL shame. I really wish that Elizabeth would come back and contribute to this really great discussion.
I've tried the Google search option that Dr Bob suggested but it's no where near as efficient in trying to locate past posts as the PB search option. If I could find some of her really good posts back I would post a link to them right now!!! Can anyone help in this regard?
regards
bluedog
Posted by jrbecker on March 2, 2003, at 23:22:09
In reply to Re: I agree with Matt and Viridis. » viridis, posted by bluedog on March 2, 2003, at 22:41:10
Posted by KrissyP on March 2, 2003, at 23:53:55
In reply to Nothing matters after forty ??? » utopizen, posted by SBOATRN on March 2, 2003, at 19:56:39
SBOTRN, you say this:"Well, I'm OVER 40 and I'm not fat. I don't think I'm old and I have things that still matter alot in my "old age"."---
W a y t o g o! :-) For both of you, I'm 32, and at 19-40 is OLD. Wait til you get 30! I worry a lot about things that will or will not may happen when I'm 40, 50, or 60 for that matter. No one knows what the future holds so live pleasantly. Yesterday is history, Tomorrow is a mystery and today is a gift-that's why they call it the present.
All the best,
Kristen
-------------------------------------------------I realize your point, just wish you could have picked another way to make it !!
I'm 19, too. Do you really want to be anxious now? You won't even have to worry about thinking about worrying about going off Klonopin until you're at least 40, and by then nothing matters because you're fat and old anyway.----------------------------------------------------------------
Well, I'm OVER 40 and I'm not fat. I don't think I'm old and I have things that still matter alot in my "old age". I realize your point, just wish you could have picked another way to make it !!
Posted by Guy on March 3, 2003, at 0:11:07
In reply to Re: KLONPIN users,help??, posted by KrissyP on March 2, 2003, at 17:47:01
Kristen,
People who take Seroquel or other anti-psychotics should be concerned about a permanent, debilitating movement disorder (tardive dyskinesia). This neurological damage may not manifest itself for years, even after you have stopped the med. Here is a link with info how to possibly prevent this disorder caused by major tranquilizers:
http://www.alternativementalhealth.com/articles/td.htm
Posted by KrissyP on March 3, 2003, at 0:15:58
In reply to Re: Tolerance more to sedative and anticonvulsive » KrissyP, posted by Mikey_C on March 2, 2003, at 22:38:35
Uhh oh.......lol I forgot what i said:-( please refresh my memory
Luv ya!
KristenOoooh... I just LOVE an aggressive woman LOL....
Posted by KrissyP on March 3, 2003, at 1:00:09
In reply to Re: Tolerance more to sedative and anticonvulsive » KrissyP, posted by Mikey_C on March 2, 2003, at 22:38:35
I went and looked-sorry, but that has been my experience LOL you said GO TO A DOCTOR like you were yelling it loud and clear-I got it now..;)
Kristen>
> Ooooh... I just LOVE an aggressive woman LOL....
Posted by SBOATRN on March 3, 2003, at 6:34:27
In reply to Re: Nothing matters after forty ??? » SBOATRN, posted by viridis on March 2, 2003, at 20:45:10
Thanks for a nice reminder... I was having a sensitive moment !!!
Posted by Jaynee on March 3, 2003, at 11:39:09
In reply to Re: Nothing matters after forty ??? » viridis, posted by SBOATRN on March 3, 2003, at 6:34:27
I will be starting a "NEW" life at 40. My daughter will graduate, and my husband and I are getting ready to travel and live some new adventures. Of course I will always be there for my daughter, financially, emotionally, etc, etc, she has been my life, but I feel that once she starts to create her own adult life, I will be more free to live mine.
I am really excited about turning 40. I am in great shape, and the most important thing of all, is not how I will look when I get old, but that I get old.
Would I rather be 19 again, no....to confusing.
Posted by viridis on March 3, 2003, at 13:13:25
In reply to Re: Nothing matters after forty ???, posted by Jaynee on March 3, 2003, at 11:39:09
I think you can change your life at almost any age. My father took early retirement at 55, stayed "retired" for about a month, then started a very successful consulting business. My mother recently retired and is now developing all sorts of hobbies and interests that she didn't have time for before. They're in their mid-sixties and now spend a fair bit of the year traveling (my father is still very active in consulting too). I think they're both happier than they've ever been before.
And my pdoc made some interesting changes: he was an English professor at a major university, then went to med school, practiced as a GP for years, and then trained as a psychiatrist when he was in his fifties. He says he's happiest now, loves what he's doing, and is great at it. He suffered from major depression along the way, so is actually experienced personally with some of the meds he prescribes.
Anyway, this is moving into the social arena, but it is encouraging to see that getting older can be a positive experience that opens up all sorts of new opportunities.
Posted by utopizen on March 3, 2003, at 13:27:32
In reply to Re: Nothing matters after forty ??? » Jaynee, posted by viridis on March 3, 2003, at 13:13:25
Sorry,
I was referring to the mating thing.
I've never dated or kissed a girl before, but um, I could easily model, so it's weird. I try really hard to avoid them with social anxiety disorder and all. They try to stare me down in class, and I act like I don't notice and look away, because I know I can't handle it.
So anyway, when you're 40, you're not as good looking, but you've been able to establish a partner that is in the same straights as you are, so you make this mutual commitment to survive sexually together in the similar way to people stranded on a desert island would do. Or at least that's my impression of why people continue to do things at 40. Anyway, all I know is that it's not fair to the female population at my college for me to continue this way.
If my doc doesn't put me on Klonopin tomorrow, I'm just telling him I'm seeing my GP and telling her I've never dated. She wouldn't let me leave the room without a script.
Posted by Beastress on March 3, 2003, at 19:56:33
In reply to Re: Nothing matters after forty ???, posted by utopizen on March 3, 2003, at 13:27:32
May you be forty too someday.
Posted by KrissyP on March 3, 2003, at 20:03:54
In reply to Re: Nothing matters after forty ??? » utopizen, posted by Beastress on March 3, 2003, at 19:56:33
Who was this intended for me? I'm confused.
Kristen> May you be forty too someday.
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