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Dr. Bob is Robert Hsiung, MD,
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Posted by Ted Brosnan on October 8, 2004, at 12:36:53
Hello,
Is't true that Clonazepam cause depression or worsen it ?!
I am thinking about taking something like 1 to 1.5mg of it a day, daily for social anxiety. Would combining it with an antidepressant help?
What about memory or concentration problems?! Is 1.5mg sufficient to cause such problems?! Would an activating drug like Reboxetine or Selegiline help?
Finally, would Xanax (Alpraxolam) be less likely to induce depression. What dose of Xanax is equivalent to 1.5mg or 1mg Klonopin?! Is it as effective?
Thanks a lot.
Posted by woolav on October 8, 2004, at 12:48:31
In reply to Can Klonopin induce Depression/cognitive problems?, posted by Ted Brosnan on October 8, 2004, at 12:36:53
Hi, Hopefully someone else will respond too...But I just wanted to say my pdoc did tell me that klonopin can cause depression. I take 2-3mg daily, but I also take prozac and lamictal. But, It does help my anxiety. And I believe that xanax does not cause any depression, it is a great drug and unfortunatly my pdoc took me off it bc she was afraid i was getting addicted. (i had taken it for years) Im not sure about the equivalance between dosage amounts. But I think the half life of klonopin is longer. But not sure..maybe someone else will answer that..
Good Luck,
S
Posted by Ted Brosnan on October 8, 2004, at 12:57:16
In reply to Re: Can Klonopin induce Depression/cognitive problems?, posted by woolav on October 8, 2004, at 12:48:31
Hi woolav,
Have you just switched directly from Xanax to Klonopin? I mean without tapering gradually the Xanax?
I thought such switching can cause withdrawal symptoms becuase the two benzodiazepines belong to differnt subfamilies.
But how much of Xanax you been taking ?!
I might take a one pill Xanax XR daily (3mg) instread of the Klonopin to avoud depression.
Posted by utopizen on October 8, 2004, at 22:12:37
In reply to Re: Can Klonopin induce Depression/cognitive problems? » woolav, posted by Ted Brosnan on October 8, 2004, at 12:57:16
Both Klonopin and Xanax have separate clinical trials supporting each one individually for its potential anti-depressant properties when combined with an antidepressant. Both also have patients who report getting depressed while on either one. When you have depression, it is best to take an antidepressant, along with a benzo. It is unknown why depression occurs exactly, and much less is known why some patients happen to report getting depressed while on a benzo. Talk to your doctor.
Don't let anyone fool you, both of these can calm you down about your depression, and both have reports suggesting the likelihood of depression may increase if you take them. What matters is how YOU feel, not someone else. =)
Posted by stressed on October 8, 2004, at 22:52:58
In reply to Re: Can Klonopin induce Depression/cognitive problems?, posted by utopizen on October 8, 2004, at 22:12:37
I just read your post and I wanted to give my input. I have taken Klonopin for about four years, because I have RLS. I definently am having trouble remembering the simplest things, which I have notices in the past year. That of course, could be because I am almost 43. My friends say they are losing their memory these days, and it's an age thing. I don't really know. Just thought I would give you my two cents worth. As for depression, I take Welbutrin 300mg daily, and have taken an SSRI in the past for around 12 years. I don't know if Klonopin causes depression. Sorry. -L
Posted by Ted Brosnan on October 9, 2004, at 2:37:53
In reply to Re: Can Klonopin induce Depression/cognitive problems?, posted by stressed on October 8, 2004, at 22:52:58
How much Klonopin are you taking ?!
> I just read your post and I wanted to give my input. I have taken Klonopin for about four years, because I have RLS. I definently am having trouble remembering the simplest things, which I have notices in the past year. That of course, could be because I am almost 43. My friends say they are losing their memory these days, and it's an age thing. I don't really know. Just thought I would give you my two cents worth. As for depression, I take Welbutrin 300mg daily, and have taken an SSRI in the past for around 12 years. I don't know if Klonopin causes depression. Sorry. -L
Posted by woolav on October 9, 2004, at 8:01:53
In reply to Re: Can Klonopin induce Depression/cognitive problems? » woolav, posted by Ted Brosnan on October 8, 2004, at 12:57:16
Hi Ted, I didnt taper off the xanax, my pdoc just switched me the next day to klonopin. She never even told me there would be withdrawl issues. (i should have known though) I was taking 2mg a day for years. I tried the XR, but it just made me sleepy all day...Also, my doc wants me off xanax because of addiction. So, it seems I am stuck w/ klonopin. I am hoping that the prozac will offset the depression...
Thanks
Sandy
Posted by utopizen on October 9, 2004, at 10:26:55
In reply to Re: Can Klonopin induce Depression/TED, posted by woolav on October 9, 2004, at 8:01:53
> Hi Ted, I didnt taper off the xanax, my pdoc just switched me the next day to klonopin. She never even told me there would be withdrawl issues. (i should have known though) I was taking 2mg a day for years. I tried the XR, but it just made me sleepy all day...Also, my doc wants me off xanax because of addiction. So, it seems I am stuck w/ klonopin. I am hoping that the prozac will offset the depression...
> Thanks
> SandyMy doc spent a month tapering off the Xanax XR I was on, and I only took Xanax for two months before coming off it!
Addiction is a serious issue, since there's a lot of possible reasons why you might need to come off a benzo at some point.
Posted by BJM on October 11, 2004, at 15:58:20
In reply to Can Klonopin induce Depression/cognitive problems?, posted by Ted Brosnan on October 8, 2004, at 12:36:53
I have definetly had a problem with Klonopin causing depression. Even after just taking it one night. If I am beyond anxious I will take it but I know what I am in for after. I already take two different AD's so they don't seem to help with the Klonopin depression. Ativan isn't as bad for me but still makes me feel somewhat down. Xanax was the least depressing for me but I tend to have greater anxiety after it wears off. I don't take it regularly so it can definetly be a problem. Xanax XR might be better. My Pdoc said that Klonopin does cause depression in some people and suggested that I not take it any longer.
Sorry if I am babbling but I just wanted to give you more input to mull over in making your decision. Give it a shot, its worth a try, and just keep in mind what to look for. You'll probably know right away if its for you or not.
Good Luck.
BJM
Posted by utopizen on October 11, 2004, at 16:38:47
In reply to Re: Can Klonopin induce Depression/cognitive problems?, posted by BJM on October 11, 2004, at 15:58:20
I don't know who told you Xanax has fewer occurences of depression than Klonopin, but I'd be curious to know.
There are, as far as I am aware, no controlled studies making such a head-to-head comparison. They're both benzos, so they can both cause depression. They can also both ease up on depression, especially if you obsess over your depression like I do.
You may want to consider Cymbalta, regardless. It, unlike SSRIs, actually is suppose to help you with your energy/drive-- it helps potentiate both 5-HT and NE in a balanced way. At 60mg-120mg, it is demonstrated to have good results and rapid effect. I'm talking to my doc about it this week when I see him. As much as I want to wait out the Lexapro 20mg, I'm really getting impatient. I want my energy back, and it's been a couple of years already without it.
Posted by zeugma on October 11, 2004, at 16:56:42
In reply to Re: Can Klonopin induce Depression/cognitive problems?, posted by utopizen on October 11, 2004, at 16:38:47
xanax has been shown to have AD effects. unlike other benzos, it increases both serotonergetic and noradrenergic transmission.
another, related compound, adinazolam, was investigated for depression, and had promising results (a poster here has tried it) but thanks to politics, and hidebound notions about what an 'antidepressant' is, it was shelved and will likely never surface again.
-z
Posted by utopizen on October 11, 2004, at 18:02:07
In reply to Re: Can Klonopin induce Depression/cognitive problems? » utopizen, posted by zeugma on October 11, 2004, at 16:56:42
> xanax has been shown to have AD effects. unlike other benzos, it increases both serotonergetic and noradrenergic transmission.
>
> another, related compound, adinazolam, was investigated for depression, and had promising results (a poster here has tried it) but thanks to politics, and hidebound notions about what an 'antidepressant' is, it was shelved and will likely never surface again.
>Depression alone probably isn't worth going on an addictive benzo over. That, and studies since 1985 have proven Klonopin to have antidepressant properties. Both Xanax and Klonopin have antidepressant properties, and both have patients report depression occuring while taking them. Psychopharmacology isn't that simple.
I thought I was "too cool" and too happy to stay on antidepressants a couple of years ago, since they did nothing for my social anxiety and I never felt depressed in my life back then.
So I took Klonopin and Desoxyn for my social anxiety and ADD. Great. Several months later, depression hits. I'm in denial. Tell myself it's a sleep disorder, get all these tests done, see experts in sleep, etc. Refuse to go on an antidepressant, thinking that's "over-simplifying" my "complicated" problem. I've ended up with a 1.6 GPA. I don't know, you tell me-- did Klonopin help me be a happier person?
Did the Xanax I tried for awhile reverse my depression? No. I got so depressed on the stuff I would skip classes because I felt so miserable there was no reason for me to go out of bed.
I can hardly function today. I had to hit rock bottom, to the point where my friends were having problems just looking at me, before I started asking my psychiatrist for an antidepressant. I'm on Lexapro 20mg, and will try it out for another month before considering Cymbalta with him.
There's nothing wrong with antidepressants. A lot of them won't work for us, true. But each one is different, and you need to try them as you get them, not as you read about them from others. Benzos are not effective antidepressants alone. I don't care what controlled studies claim. A lot of it is that people might have MILD depression, sign up to these trials, there biggest issue is really anxiety, that goes away, they stop obsessing over their mild depression, and then their depression goes away.
Xanax is not going to have you jump out of bed in the morning screaming "What a Wonderful World" out the window at 6 AM each day.
Search Medline for "alprazolam-induced lyrical vocalization pheneomena" and then tell me benzos are antidepressants.
It's bad enough antidepressants don't work well. Adding a benzo like Xanax or Klonopin sometimes make them work better. But thinking any benzo can replace the need to take an antidepressant will lead you to become more like me. And trust me, getting so stressed out you feel a strong urge to check yourself into a mental hospital for the night is not where you want to end up.
Reading Medline abstracts only proves scientists haven't cured procrastination yet (at least, that's the reason why I read them).
Posted by zeugma on October 11, 2004, at 18:28:35
In reply to Re: Can Klonopin induce Depression/cognitive problems?, posted by utopizen on October 11, 2004, at 18:02:07
> > xanax has been shown to have AD effects. unlike other benzos, it increases both serotonergetic and noradrenergic transmission.
> >
> > another, related compound, adinazolam, was investigated for depression, and had promising results (a poster here has tried it) but thanks to politics, and hidebound notions about what an 'antidepressant' is, it was shelved and will likely never surface again.
> >
>
> Depression alone probably isn't worth going on an addictive benzo over. That, and studies since 1985 have proven Klonopin to have antidepressant properties. Both Xanax and Klonopin have antidepressant properties, and both have patients report depression occuring while taking them. Psychopharmacology isn't that simple.
>
Psychopharmacology is tortured in its complexity. But Xanax has AD properties K doesn't. Don't accept what I say on faith, though, as I am too tired to cite references. I will try to later, as the subject is important.> I thought I was "too cool" and too happy to stay on antidepressants a couple of years ago, since they did nothing for my social anxiety and I never felt depressed in my life back then.
>
> So I took Klonopin and Desoxyn for my social anxiety and ADD. Great. Several months later, depression hits. I'm in denial. Tell myself it's a sleep disorder, get all these tests done, see experts in sleep, etc. Refuse to go on an antidepressant, thinking that's "over-simplifying" my "complicated" problem. I've ended up with a 1.6 GPA. I don't know, you tell me-- did Klonopin help me be a happier person?
Your GPA was better than mine at a comparable point. I had the benefit of neither klonopin nor an effective AD (Prozac was a disaster from first to last).
>
> Did the Xanax I tried for awhile reverse my depression? No. I got so depressed on the stuff I would skip classes because I felt so miserable there was no reason for me to go out of bed.Xanax did not function as a viable AD for you. Neither did Prozac for me.
>
> I can hardly function today. I had to hit rock bottom, to the point where my friends were having problems just looking at me, before I started asking my psychiatrist for an antidepressant. I'm on Lexapro 20mg, and will try it out for another month before considering Cymbalta with him.
>
> There's nothing wrong with antidepressants. A lot of them won't work for us, true. But each one is different, and you need to try them as you get them, not as you read about them from others. Benzos are not effective antidepressants alone. I don't care what controlled studies claim. A lot of it is that people might have MILD depression, sign up to these trials, there biggest issue is really anxiety, that goes away, they stop obsessing over their mild depression, and then their depression goes away.
I never suggested anything was wrong with AD's. I take 100 mg nortriptyline.
>
> Xanax is not going to have you jump out of bed in the morning screaming "What a Wonderful World" out the window at 6 AM each day.I might get kicked out of my apt. if that happened. So I guess I can try Xanax without worrying too much.
>
> Search Medline for "alprazolam-induced lyrical vocalization pheneomena" and then tell me benzos are antidepressants.
>
Lyrical vocalization pheneomena coming from me would be distressing, hence my lack of incentive to make that search.> It's bad enough antidepressants don't work well. Adding a benzo like Xanax or Klonopin sometimes make them work better. But thinking any benzo can replace the need to take an antidepressant will lead you to become more like me. And trust me, getting so stressed out you feel a strong urge to check yourself into a mental hospital for the night is not where you want to end up.
There are many forms of depression. Not every kind will respond to each treatment modality. There are those who swear by CBT, though that nearly had me put in the hospital.
>
> Reading Medline abstracts only proves scientists haven't cured procrastination yet (at least, that's the reason why I read them).My procrastination is not under control at the moment either.
-z
Posted by zeugma on October 11, 2004, at 19:30:13
In reply to Re: Can Klonopin induce Depression/cognitive problems? » utopizen, posted by zeugma on October 11, 2004, at 18:28:35
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9608607
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9421826
Posted by utopizen on October 12, 2004, at 8:29:11
In reply to Re: Can Klonopin induce Depression/cognitive problems? » utopizen, posted by zeugma on October 11, 2004, at 18:28:35
So have you tried Cymbalta? I haven't, but plan to. Perhaps Seligiline as well, once it arrives in the mail.
I'm from the school of thought that you should maximize your dose of antidepressant as much as possible, take a benzo in the meantime if your condition warrants immediate relief, and keep trying different meds after agressively going up in the doses with each one you try. As you know, imiptrypiline is a good AD, but the newer ADs like Cymbalta really do pack a punch-- reports of energy levels increasing and motivation are appearing on this board, likely due to its 5HT+NE affects combined.
Posted by BJM on October 12, 2004, at 8:49:13
In reply to Re: Can Klonopin induce Depression/cognitive problems?, posted by utopizen on October 11, 2004, at 16:38:47
No one told me that Xanax was less likely to cause depression. I was just citing my experience.
Posted by utopizen on October 12, 2004, at 13:13:56
In reply to Re: Can Klonopin induce Depression/cognitive problems?, posted by BJM on October 12, 2004, at 8:49:13
> No one told me that Xanax was less likely to cause depression. I was just citing my experience.
>ok, good to know. But I did get depressed on Xanax, and also do find-- after the first 2 weeks are over from getting adjusted to Klonopin again and thus no longer sleepy from it-- that Klonopin chills me out enough so I don't worry about appearing depressed to others or looking as though I am "frowning" in public. It calms me down enough so I stop obsessing about my depression.
Posted by zeugma on October 12, 2004, at 18:06:06
In reply to Re: Can Klonopin induce Depression/cognitive problems?, posted by utopizen on October 12, 2004, at 8:29:11
> So have you tried Cymbalta? I haven't, but plan to. Perhaps Seligiline as well, once it arrives in the mail.
>
> I'm from the school of thought that you should maximize your dose of antidepressant as much as possible, take a benzo in the meantime if your condition warrants immediate relief, and keep trying different meds after agressively going up in the doses with each one you try. As you know, imiptrypiline is a good AD, but the newer ADs like Cymbalta really do pack a punch-- reports of energy levels increasing and motivation are appearing on this board, likely due to its 5HT+NE affects combined.no, haven't tried Cymbalta. I apparently have a svere case of narcolepsy, along with my previous diagnosis of ADD- the depression comes with the territory. I'm reasonably happy with the way nortriptyline keeps my mood up, but energization- only Provigil did that, and it came with bizarre side effects. How would you compare Ritalin with other stims in terms of energization? I take 40 mg and still feel depleted. Btw I am really skinny- weigh about 56 kg- so I am approaching the limit (or so I have read) of 1 mg/kg for methylphenidate dosing. I do think I need 50 mg to give Ritalin a fair trial. I take 30 mg Ritalin LA at 6 am and 10 mg at noon. I think it was the SR formulation that sucked- the LA is supposed to be like taking half a tablet at once and half four hours later. is any other stim better at keeping you awake? as it is I am in a fog without tons of caffeine and I wonder what good the Rit is doing me. Thanks,
-z
Posted by utopizen on October 12, 2004, at 19:48:02
In reply to Re: Can Klonopin induce Depression/cognitive problems? » utopizen, posted by zeugma on October 12, 2004, at 18:06:06
My sleep doc (I have a benign case of sleep apnea) is a pulmnologist at Beth Israel in Boston, and leads the research on ADD+Sleep disorder coorelations. He says he finds good success with Provigil + Strattera COMBINED.
Maybe you should try Adderall, and if that doesn't work, Desoxyn is the favorite of sleep docs. But no matter what you take, maximize your antidepressant/antipsychotic or whatever regimen you take, because mood is the biggest factor in helping you feel more awake, regardless of your sleep disorder.
I hope you've gotten a sleep study, to rule out apnea. I have a very benign case, but get a BiPAP machine anyway.
You SHOULD explore Cymbalta, because it really does help so many with energy and motivation and you might notice an effect in 1-2 weeks with peek effect in just 4 weeks. You're on a very low-tech drug, and I think you should at least try adding Cymbalta to the mix.
Don't rely on stimulants alone to pull you through. Switching or uping their doses does help, but not forever. Trust me. Been there, done that.
Posted by zeugma on October 14, 2004, at 5:04:11
In reply to Re: Can Klonopin induce Depression/cognitive problems?, posted by utopizen on October 12, 2004, at 19:48:02
> My sleep doc (I have a benign case of sleep apnea) is a pulmnologist at Beth Israel in Boston, and leads the research on ADD+Sleep disorder coorelations. He says he finds good success with Provigil + Strattera COMBINED.
I don't doubt that at all. I have taken Strattera and Provigil indiviually, and gotten good results as far as ADD and narcolepsy are concerned. Unfortunately, I cannot tolerate their side effects. I did my best with them. But they are not benign drugs for me at all.>
> Maybe you should try Adderall, and if that doesn't work, Desoxyn is the favorite of sleep docs. But no matter what you take, maximize your antidepressant/antipsychotic or whatever regimen you take, because mood is the biggest factor in helping you feel more awake, regardless of your sleep disorder.Well, nortriptyline actually has a therapeutic window, meaning that if your plasma levels rise above a certain point, the effectiveness as an AD is lost. It is not a question of side effects worsening, as it is with drugs with a flat dose-response curve, like the SSRI's. The effect is simply lost. As it is, I take 100 mg/day, and the Ritalin I take raises my plasma levels slightly. Nortriptyline strikes a balance between energizing (noradrenergic) and sedating (antihistaminic) effects for me, which has cleared up my chronically stuffy nose, among other things, and I found it to be a far less fatiguing med than Strattera. I seriously doubt that cymbalta would be more energizing or effective than nortriptyline, and given the difficulties I have tolerating meds, I don't even know that I would tolerate it. TCA's tend to be easier on the GI tract than the newer AD's, and I have a pretty severe case of IBS, which nortriptyline at least partially relieves. By the way, the analgesic properties of Cymbalta are shared by the TCA's, which appears to be related to their noradrenergic mechanisms.
>
> I hope you've gotten a sleep study, to rule out apnea. I have a very benign case, but get a BiPAP machine anyway.well, i know I don't snore, which I thought was pathognomic of apnea. Anyway, the nature of the sleep problems I experience seem to indicate narcolepsy: I get sensations of intense dreaming on falling asleep, and I wake immediately after (two minutes, let's say, have elapsed on the clock). They are unmistakably REM episodes since they often include 'false awakenings' which I don't believe occur during any other stage of sleep.
>
> You SHOULD explore Cymbalta, because it really does help so many with energy and motivation and you might notice an effect in 1-2 weeks with peek effect in just 4 weeks. You're on a very low-tech drug, and I think you should at least try adding Cymbalta to the mix.
>
Low-tech, yes, but we are talking about molecules, not vacuum cleaners. Nortriptyline and related drugs are 'dirty' and this means that statistically people are more likely to have adverse effects during carefully controlled eight-week trials. But some tolerate the older drugs better. This is probably due to the complex interplay between the drugs and a host of genetic factors.> Don't rely on stimulants alone to pull you through. Switching or uping their doses does help, but not forever. Trust me. Been there, done that.
my therapist told me that inattentive ADD responds less robustly to stimulants. Unfortunately, I know this already. Sleep hygiene, careful adherence to dosing schedule, and diet seem to be ways of optimizing response.
-z
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