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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by Susan the Curious on August 2, 2003, at 8:08:45
In the last couple of years, I have been trying to get to the bottom of almost debilitating fatigue. Needless to say, they tried me on a few AD's and had various different symptoms and the Wellbutrin actually had me fairly functional for a few months. The worse thing about meds and various conditions, is the side effects from one thing always seem to cause problems with others.
I then had a sleep study and they found I have Periodic Limb Movement Disorder (PLMD), short version I kick all night long. They tried me on Mirapex, a dopamine agonist, at several different dosages and the side effect/benifit trade off wasn't worth it for me. I just started Klonopin last night, .5 mg. I went to sleep pleasently, had been having alot of insomnia problems since I stopped Mirapex. I slept for 4 hours and something woke me up, it was storming and I didn't get back to sleep. I am curious to see how it works over time. It would be so nice to be able to curl up and go to sleep at night (without the fidgeting-as I now realize I have Restless Leg Syndrome, RLS, too) and sleep through the night and then wake up after 8 or 9 hours and be awake for the day.
What a dream and asperation. In the last few years I have read so much about the various neurotransmitters that it is incredible. Thus far have been on things that either agonize or antagonize H1, H2, Norepinepherine, Seritonin, Dopamine and now GABA-and those are only the things I know they've been messing with. With no energy, I haven't traveled much outside-but I seem to get vacations with different bodies regularly.
Looking forward to meeting others and any comments,
Susan
Posted by john Henry on August 2, 2003, at 10:41:37
In reply to New on Klonopin, posted by Susan the Curious on August 2, 2003, at 8:08:45
Have you ever tried Ritalin or Dexadrine for the fatigue? It works pretty good for chronic fatigue and even with narcolepsy.Also have you tried Remeron for insomnia and the restless leg syndrome?
Take care
Posted by Sleepy Susan on August 2, 2003, at 17:29:54
In reply to Re: New on Klonopin » Susan the Curious, posted by john Henry on August 2, 2003, at 10:41:37
> Have you ever tried Ritalin or Dexadrine for the fatigue? It works pretty good for chronic fatigue and even with narcolepsy.
No, they haven't tried these. They were going to do the narcolepsy test on me, but I didn't sleep a large enough percentage of the night when I did my sleep study.
>Also have you tried Remeron for insomnia and the restless leg syndrome?
> Take careNo, went and looked it up and saw it was a tricyclic. In my reading on RLS, I've seen that they often trigger RLS. I was on a two tricyclics, started on them for their H1 and H2 properties, Doxipen and then Imipramine. The fatigue progressed while I was on them, it's been about 4 years ago.
One of the roughest things about the medicine trials is that they expect you to be on them for some time to see how they work, one thing and then another easily adds up to years. With the memory issues, it is hard to remember how different things affected what.
Thanks for the questions,
Susan
Posted by jlo820 on August 2, 2003, at 22:52:36
In reply to New on Klonopin, posted by Susan the Curious on August 2, 2003, at 8:08:45
Only problem you may run into with Klonopin for sleep is that it can loose its hypnotic/sedating effects within 7-10 days for those who are taking it for sleep. This is the same with any of the benzodiazepines. They also loose their effectiveness as muscle relaxants over the same period, so I wonder how long it will work for RLS/PLMD...?
Posted by Mimi on August 3, 2003, at 18:09:51
In reply to New on Klonopin, posted by Susan the Curious on August 2, 2003, at 8:08:45
> In the last couple of years, I have been trying to get to the bottom of almost debilitating fatigue. Needless to say, they tried me on a few AD's and had various different symptoms and the Wellbutrin actually had me fairly functional for a few months. The worse thing about meds and various conditions, is the side effects from one thing always seem to cause problems with others.
>
> I then had a sleep study and they found I have Periodic Limb Movement Disorder (PLMD), short version I kick all night long. They tried me on Mirapex, a dopamine agonist, at several different dosages and the side effect/benifit trade off wasn't worth it for me. I just started Klonopin last night, .5 mg. I went to sleep pleasently, had been having alot of insomnia problems since I stopped Mirapex. I slept for 4 hours and something woke me up, it was storming and I didn't get back to sleep. I am curious to see how it works over time. It would be so nice to be able to curl up and go to sleep at night (without the fidgeting-as I now realize I have Restless Leg Syndrome, RLS, too) and sleep through the night and then wake up after 8 or 9 hours and be awake for the day.
>
> What a dream and asperation. In the last few years I have read so much about the various neurotransmitters that it is incredible. Thus far have been on things that either agonize or antagonize H1, H2, Norepinepherine, Seritonin, Dopamine and now GABA-and those are only the things I know they've been messing with. With no energy, I haven't traveled much outside-but I seem to get vacations with different bodies regularly.
>
> Looking forward to meeting others and any comments,
> Susan
Susan,I had and have extreme fatigue + recurrent depression. Sleep disorder from PTSD. Ambien is in my opinion a much better sleep med than Klonopin. I used to take Klonopin; it's addictive and it whomps you during the day as well.
For what it's worth. Mimi
>
>
Posted by Viridis on August 3, 2003, at 18:40:41
In reply to New on Klonopin, posted by Susan the Curious on August 2, 2003, at 8:08:45
I take Klonopin every morning for anxiety, at a pretty low dose (1 mg), and Xanax occasionally. I do use Xanax once in a while for insomnia, which my pdoc says is fine, but although he's comfortable with prescribing benzos for anxiety, he discourages regular use for sleep disorders. His argument is that benzos can interfere with sleep architecture (i.e., you don't go through the normal and necessary sleep stages), and that they lose their anti-insomnia effect rapidly. So (he says) this is where people are most likely to get into the pattern of escalating doses to get the same effect (for sleep), although the antianxiety effects seem to remain using the same dose for extended periods of time.
He prefers trazodone (Desyrel) for insomnia, and says it's extremely effective for many people without the problems described above. I didn't like it (it left me groggy in the morning), and since being on regular Klonopin I rarely get the anxiety attacks that prevent me from sleeping anyway. On the rare occasions that I do, Xanax does the trick for me.
Some people here have reported success with Neurontin for RLS and other sleep-related disorders. It's generally a very benign drug, and might be worth a try. It sounds like you're working with a good doctor, but given the concerns about long-term use of benzos for sleep problems it may be worth experimenting with alternatives.
Posted by Sleepy Susan on August 3, 2003, at 21:47:16
In reply to Re: New on Klonopin, posted by Viridis on August 3, 2003, at 18:40:41
Viridis wrote
> Some people here have reported success with Neurontin for RLS and other sleep-related disorders. It's generally a very benign drug, and might be worth a try. It sounds like you're working with a good doctor, but given the concerns about long-term use of benzos for sleep problems it may be worth experimenting with alternatives.
In all of the reading I've done on the PLMD and RLS, after the dopamine agonists, Klonopin is the main thing they mention. The three main classes of meds they recomend are DA, Benzodiazapines and then Opiates, some are no adding on the Nuratonin at the end of the list.My situation is complicated by the fact that my insurance ends in September and then I will be being treated through the Indian Health Service and their formulary is rather bare, the joys of government funding. I know there are patient assistance programs through different phamasucical companies, but have to know that something works first.
One of the other concerns, when they did my sleep study they were also looking for REM Disorder, from my flailing fairly often in my sleep-never got to the stage of sleep for them to know. As far as I know, the Klonopin is the one med listed for it, does anyone else have REM disorder and take something else?
Thanks for the ideas guys,
Susan
Posted by Capri on August 3, 2003, at 21:57:13
In reply to Re: New on Klonopin, posted by Viridis on August 3, 2003, at 18:40:41
Viridis,
We posted back and forth some time ago regarding Klonopin. I follow all of your posts. You give some valuable info.
I pretty much have my mind made up to try K on a regular basis for my anxiety (irritability mostly).
I've tried so many AD's that I'm sick of them all. They don't help much and the SE's don't outway the benefits for me.
My doc wanted to try me on Depakote but I think I'm going to pass. I know K works for me so why not take it and have a quality life!! I believe in what you say about the controversary regarding benzos. I've never had any substance abuse, etc. so for me K would be totally safe.
What type of anxiety do you have?
Capri
Posted by Viridis on August 3, 2003, at 23:10:09
In reply to Re: New on Klonopin, posted by Capri on August 3, 2003, at 21:57:13
Hi Capri,
Well, my official diagnosis is panic disorder and major depressive disorder, and I do have periodic clusters of genuine panic attacks when not on benzos. But really, it seems to be more a pattern of escalating anxiety (GAD?), eventually leading to panic and then severe depression. This is complicated by a diagnosis of ADD, for which I also take meds (Adderall and Strattera).
My psychiatrist and I pretty much agree that the "flow diagram" is: ADD -- leads to anxiety -- gets worse and worse, with obsessive tendencies -- causes major, agitated depression. The pattern repeats without meds, and has done so fairly predictably since I was about five years old (i.e., as long as I can remember). I had a very nice childhood and have a highly supportive family, so it's not some trauma issue etc.
Klonopin is the key to stopping the cycle, and the other meds I take just make things better all around. I'm a big advocate of K, since it's so effective (for me, at least) for anxiety, and has no side effects beyond what I experienced in the first week or two. I've had my share of substance abuse problems in the past and discussed this extensively with my pdoc, but benzos have absolutely no appeal for me re: recreational use. At the right dose they work, and any more makes me sleepy. I don't buy the "addiction" nonsense at all -- some people no doubt abuse them, but this is rare, and inconceivable to me. They just do their job, and that's it.
As I've mentioned before, every AD I've tried has had severe side effects, and my pdoc agrees that these meds (SSRIs and Wellbutrin at least) are simply not appropriate for some people.
I'd give K a try (for at least two weeks, because you may feel a bit spaced out at first), and my guess is that you'll feel a whole lot better.
BTW, I declined Depakote too, based on the reports of emotional blunting and weight gain. My pdoc was cool with this, and is very pleased with my reaction to Klonopin.
Good luck!
Viridis
Posted by btnd on August 4, 2003, at 5:09:05
In reply to Re: New on Klonopin, posted by Viridis on August 3, 2003, at 18:40:41
The best remedy for insomnia is Xyrem (gamma-hydroxybutyrate). Right now it's prescribed for narcolepsy, but you can try to convince your doc to prescribe it for insomnia.
Posted by Mimi on August 4, 2003, at 8:48:09
In reply to Re: New on Klonopin » Capri, posted by Viridis on August 3, 2003, at 23:10:09
Hi all,
I suffer from severe social phobia, depression, and PTSD. Klonopin was too heavy a drug, even at extremely low doses. Buspar is perfect at alleviating my panic attacks and anxiety.
Mimi
Posted by Capri on August 4, 2003, at 21:43:16
In reply to Re: New on Klonopin » Capri, posted by Viridis on August 3, 2003, at 23:10:09
Viridis,
How much K do you take? I took a half of .5 today and I was tired. I guess this will take some time before my body gets used to it. If that is the only side effect I need to worry about it will be a breeze.
Let me know your thoughts or advice.
Thanks,
Capri
Posted by Viridis on August 5, 2003, at 0:19:20
In reply to Re: New on Klonopin » Viridis, posted by Capri on August 4, 2003, at 21:43:16
Hi Capri,
I just take 1 mg/day, but many people need more. At first I tried splitting it throughout the day to minimize drowsiness etc., but after a couple of weeks that side effect disappeared, so now I just take the whole 1 mg in the morning. It seems to last about 12 hrs. and I don't notice it at all, except for the relief from anxiety. It does take a little while to get used to, but typically, tolerance to the side effects develops rapidly whereas tolerance to the antianxiety effect rarely occurs.
All the best,
Viridis
Posted by Sleepy Susan on August 5, 2003, at 2:39:10
In reply to Re: New on Klonopin » Capri, posted by Viridis on August 5, 2003, at 0:19:20
>so now I just take the whole 1 mg in the morning. It seems to last about 12 hrs. and I don't notice it at all, except for the relief from anxiety.
Viridis,
Were you on other doses before? I have just been on the .5mg for 4 nights now and find they last right at 5 hours. I am wondering if going up to the 1mg will extend that time. I wake up and have the body itchies (RLS) and am unable to go back to sleep and then have a rough time the next day from not getting enough sleep.Thanks for any info,
Susan
Posted by Capri on August 5, 2003, at 13:29:16
In reply to Re: New on Klonopin » Capri, posted by Viridis on August 5, 2003, at 0:19:20
Hi,
Thanks for your info! I'm going to take .5 mg in the morning to start. How long will that last in the body?
Thanks!
Posted by Viridis on August 6, 2003, at 2:29:04
In reply to Re: New on Klonopin » Viridis, posted by Capri on August 5, 2003, at 13:29:16
Well, how long it actually stays in your system, and how long it has an effect are two different things. I think the half-life of Klonopin is (on average) something like 34 hours. So if you take 0.5 mg then theoretically, after 34 hours (or whatever), you should have 0.25 mg left, then 0.125 mg after 68 hrs etc. But in practice, it doesn't seem to work that way. My experience was that 0.5 mg helped for a few hours, then another .5 mg was necessary. But 1 mg seems to last all day for me. Clearly, there's more going on than just the half lives that pharmacologists are so fond of talking about.
The best approach is just to try it and see, and increase the dose gradually until you get used to the side effects. You should be able to find your comfort zone fairly quickly, and if you're like most people who take K, you'll probably be satisfied with that dose for a long time.
Good luck!
Posted by Sleepy Susan on August 6, 2003, at 9:43:35
In reply to Re: New on Klonopin » Capri, posted by Viridis on August 6, 2003, at 2:29:04
That sounds about right. I have found when I take the .5mg, It is good for 5 hours-and I usually fall asleep an hour after I take it so only get 4 hours of sleep. I was so tired one night, I tried taking another one and I didn't fall asleep till the next day, one of those long afternoon naps that fall under 'excessive daytime sleepiness'. Last night I was so despirate for a full night sleep, I took 1mg at 1am and slept till 9 this morning-then called my Dr to see about increasing my dosage. It was so nice to get 7 hours of sleep and at night.
You're right it seems like so much more than just a half life situation and it also seems to be a big difference between those it works for and those it doesn't. I so hope I'm one it works for, it would be such a simple solution.
Thanks so much for the information,
Susan
This is the end of the thread.
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