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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by woolav on October 12, 2004, at 10:10:01
Hi, If i take a benzo for anxiety, can i also take a stimulant? Or will they counter-act each other. I am so sleepy on my klonopin and wonder if i could add something to it (if my pdoc lets me) and what would be good?
Thanks
sandy
Posted by utopizen on October 12, 2004, at 11:37:29
In reply to question about stimulants!!!!!!!!!!!!!!!!!!!!!!!!, posted by woolav on October 12, 2004, at 10:10:01
> Hi, If i take a benzo for anxiety, can i also take a stimulant? Or will they counter-act each other. I am so sleepy on my klonopin and wonder if i could add something to it (if my pdoc lets me) and what would be good?
> Thanks
> sandySleepiness, unless this is your first couple of weeks on Klonopin, suggests a couple of things:
1. Your Klonopin is to high. Consider lowering the dose and experimenting with antidepressants like Cymbalta and Zoloft to try to lower your Klonopin dose.
2. Your sleepiness is an early warning sign of depression, and needs to be treated regardless of what you do with your Klonopin dose.
Most likely, it's a combo of these two things that are occuring. I went off antidepressants entirely for my social anxiety disorder, went on Klonopin and Desoxyn (for my ADD) and months later became very sleepy, developed insomnia, and before I knew it was depressed. I still am.
I don't think anyone with an anxiety disorder should be treated with a benzo solo regimen-- antidepressants can and do help to some extent, even if it's not comprable to the immediate relief you find from Klonopin. It's worth trying each one, as you can fail 20 and succeed with the 21st. I'm about to try Cymbalta, and am also on Klonopin and Adderall.
Don't turn to stims for sleepiness. Take some Provigil, lower your Klonopin dose, and add an antidepressant. If it doesn't work, up the antidepressant as high as your doctor wants, and then later add some Lithium or an antipsychotic. But treat this seriously. Stimulants just mask the issues in the short-term, believe me. Their effect at hiding depression-related sleepiness goes away over time, and I am living proof.
Posted by Hattree on October 12, 2004, at 11:46:47
In reply to Re: question about stimulants!!!!!!!!!!!!!!!!!!!!!!!!, posted by utopizen on October 12, 2004, at 11:37:29
I think if you are anxiety prone you would probably climb the walls on a stimulant. There are people do well taking both, though. It would only take a day or two to find out (in the unlikely event that your doc goes for it). Provigil, in my experience, might as well be just another stimulant.
Posted by woolav on October 12, 2004, at 12:19:17
In reply to Re: question about stimulants!!!!!!!!!!!!!!!!!!!!!, posted by Hattree on October 12, 2004, at 11:46:47
Thanks everyone. I am actually on prozac and lamitcal. I might try to lower my klonopin dose and see what happens..
thanks
Posted by utopizen on October 12, 2004, at 12:56:01
In reply to Re: question about stimulants!!!!!!!!!!!!!!!!!!!!!, posted by woolav on October 12, 2004, at 12:19:17
> Thanks everyone. I am actually on prozac and lamitcal. I might try to lower my klonopin dose and see what happens..
>
> thanksI re-define what "social anxiety disorder" means, with or without a stimulant. I've taken every stimulant, as well as Provigil (Provigil didn't work, but it might have been because it was depression-related somnolence).
If you're on Klonopin, and you take a stimulant, the anxiety you might get from the stimulant should be relieved by the Klonopin. I love taking Klonopin with Desoxyn (now I'm on Adderall, a yucky stimulant comparatively).
I have ADD + social anxiety, so I don't have the option to go "oh, I have anxiety, so no stimulants for me!" That would be like saying "Oh, I have anxiety, so I guess I'll not go to college anymore."
Posted by utopizen on October 12, 2004, at 13:06:40
In reply to Re: question about stimulants!!!!!!!!!!!!!!!!!!!!!, posted by woolav on October 12, 2004, at 12:19:17
> Thanks everyone. I am actually on prozac and lamitcal. I might try to lower my klonopin dose and see what happens..
>
> thanksI'd up the dose of Prozac, and later up the dose of Lamictal if you don't notice anything, as much as your doc feels comfortable going up to. Lowering the Klonopin is a step in the right direction, but do this with your doc's advisement, don't go solo.
I really don't think taking a stimulant is appropriate when it's only to reduce drug-induced somnolence.
Provigil is more acceptable, and your doc shouldn't have any problems giving you it if you tell him you're open to lowering the Klonopin for the time being as well as bumping up the Prozac and later the Lamictal to see if your somnolence is partially due to depression, which you should never overlook, since it only gets worse if you ignore its possible presence.
So, lower the Klonopin, but up the Prozac, agressively and I mean agressively, and if you still find little relief from your anxiety, talk with your doc about uping the Lamictal-- but be on the look-out for rashes. If this combo doesn't work, consider talking with your doc about Cymbalta, or combining the Prozac with around 300mg of Lithium (target dose)-- Lithium also helps improve depression in non-responders.
Whether you think it's a recurrence of depressive episodes or not, you need to treat it as though it is to get your energy back.
Seriously talk with your doc about Cymbalta though, as energy is often something it gives you at 60-120mg and it has rapid action (1-2 weeks signfigiant and 4 weeks for substantial improvement).
I know I sound like a Cymbalta sales guy, but I just find this so promising-- I just left a message with my doc saying I'm interested in it, to make sure he's prepared about the drug for our visit in two days.
Always call your doc when you are noticing side effects or aren't noticing progress, at least once a week. And if you're curious of exploring a new med option, leave a message with him the day before or earlier so he has time to think it over before he sees you. It makes your sessions more productive.
Keep in mind if you're taking the Klonopin for the first 2 weeks, the somnolence tends to go away after this.
Nevertheless, talk with your doc about lowering your dose so you can adjust to it without the somnolence and take your lowered energy drive SERIOUSLY and not try to isolate it to only the Klonopin. I did that, and I'm in a very depressed state that will take a lot of work to dig myself out of. I shouldn't have trusted myself so much.
Posted by woolav on October 17, 2004, at 19:22:51
In reply to Re: question about stimulants!!!!!!!!!!!!!!!!!!!!!, posted by utopizen on October 12, 2004, at 13:06:40
This is the end of the thread.
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