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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by aphexonset on February 15, 2005, at 4:21:07
Over a year ago I was diagnosed with Generalized Anx. Disorder. After trying Effexor and Paxil, I gave up on trying new medication, since the only thing to actually work was the Xanax prescribed by my physician a year earlier when I complained to him of constant nervousness. The PDoc that diagnosed me didnt believe in Benzodiazepines, and since the Effexor and , later,Paxil didn't work, I tapered off of the Paxil.
Now I have found a doctor who isn't dead-set against benzos, and prescribed me, just yesterday, 50mg zoloft and .5mg Klonopin. I noticed a not as pronounced as xanax feeling of non-nervousness. This was much needed and appreciated. I felt and feel like all the little life tasks that used to scare the crap out of me aren't as daunting as I always feel.
The way he sounded the Klonopin is supposed to be taken just for now, as I need it, and I will stay on the Zoloft, at the right dosage for me, whatever that may be.
My first question is that whether or not it is unusual to prescribe Klonopin for 'takeas needed'. The directions actually say take 2 times a day, and thats about how long script works(and he can't want me on it too shortly since I have 5 refills on it).
I have a feeling I'm going to want to keep the Klonopin, but of course first I have to get used to the Zolft and see how that works. Believe it or not,with only 1 50mg dose I already have experienced a side effect that I experienced on Paxil: A weird feeling in my jaw, so that I feel a jaw tremor/spasm type feeling, similar to yawning, but I am not especially tired. Also some very dull feeling in my teeth. I realize that side effects for the most part go away, but I didnt have that luck on Paxil(again, I was on only paroxetine, no clonazepam), just less side effects after a couple of months, with no real help with anxiety.
Another question is about zoloft,and what time of day people prefer to take it. Does it tend to make you tired, so it should be taken at night, or more awake, so its best in the AM?
Thank you.
-Paul
Posted by Michael Bell on February 15, 2005, at 7:09:44
In reply to Newly on(and ?s)about Zoloft and Klonopin, posted by aphexonset on February 15, 2005, at 4:21:07
>
Paul,
Klonopin is usually the benzo prescribed for those with continuous anxiety disorders (GAD, social phobia, etc.) because it has the longest half-life. For this reason its often prescribed by non benzo-phobes as the first line of treatment for the disorders listed above. Meanwhile, meds like Xanax are often used for occasional spikes in anxiety not controlled by your main med.Sorry, don't know much about Zoloft in particular. But as far as Paxil, I didn't find it all that helpful for for social anxiety.
Over a year ago I was diagnosed with Generalized Anx. Disorder. After trying Effexor and Paxil, I gave up on trying new medication, since the only thing to actually work was the Xanax prescribed by my physician a year earlier when I complained to him of constant nervousness. The PDoc that diagnosed me didnt believe in Benzodiazepines, and since the Effexor and , later,Paxil didn't work, I tapered off of the Paxil.
>
> Now I have found a doctor who isn't dead-set against benzos, and prescribed me, just yesterday, 50mg zoloft and .5mg Klonopin. I noticed a not as pronounced as xanax feeling of non-nervousness. This was much needed and appreciated. I felt and feel like all the little life tasks that used to scare the crap out of me aren't as daunting as I always feel.
>
> The way he sounded the Klonopin is supposed to be taken just for now, as I need it, and I will stay on the Zoloft, at the right dosage for me, whatever that may be.
>
> My first question is that whether or not it is unusual to prescribe Klonopin for 'takeas needed'. The directions actually say take 2 times a day, and thats about how long script works(and he can't want me on it too shortly since I have 5 refills on it).
>
> I have a feeling I'm going to want to keep the Klonopin, but of course first I have to get used to the Zolft and see how that works. Believe it or not,with only 1 50mg dose I already have experienced a side effect that I experienced on Paxil: A weird feeling in my jaw, so that I feel a jaw tremor/spasm type feeling, similar to yawning, but I am not especially tired. Also some very dull feeling in my teeth. I realize that side effects for the most part go away, but I didnt have that luck on Paxil(again, I was on only paroxetine, no clonazepam), just less side effects after a couple of months, with no real help with anxiety.
>
> Another question is about zoloft,and what time of day people prefer to take it. Does it tend to make you tired, so it should be taken at night, or more awake, so its best in the AM?
>
> Thank you.
> -Paul
Posted by med_empowered on February 15, 2005, at 9:01:25
In reply to Re: Newly on(and ?s)about Zoloft and Klonopin » aphexonset, posted by Michael Bell on February 15, 2005, at 7:09:44
hey! Klonopin is prescribed PRN, or take as needed a good bit. It kinda sucks that this is the case...once you take Klonopin, it takes about an hour or so for it to really "kick in" and a few hours for peak blood levels to be achieved. But, the theory is that since it's so long-lasting and there's little sense of euphoria or anything, it's probably less likely to turn people in to addicts than, say, Ativan or Xanax. As for Zoloft...its good stuff for alot of people with anxiety...I always took my dose at nite, because I was at 150mgs/day. Good luck!
Posted by SLS on February 15, 2005, at 10:07:25
In reply to Newly on(and ?s)about Zoloft and Klonopin, posted by aphexonset on February 15, 2005, at 4:21:07
Hi.
I hope people who actually use Klonopin for anxiety disorders contribute here.
It is my impression that it is better to use Klonopin on a regular dosing schedule and not as a PRN.
- Scott
Posted by Kon on February 15, 2005, at 11:19:57
In reply to Newly on(and ?s)about Zoloft and Klonopin, posted by aphexonset on February 15, 2005, at 4:21:07
I've used both. Zoloft gave me headaches,no relief from anxiety (a slight increase) and GI problems. I stopped it after about 6 weeks. Klonopin is the best med I've used so far. Valium was also good...but I haven't used it for years. I've used klonopin for 2.5 years, PRN since my anxiety is primarily situational (but quite a few situations). Wrt PRN use, the disadvantage over say ativan, xanax is it takes a little time (~2 hours) to reach maximum effect but if you can anticipate them, it's perfectly fine to use it PRN. Not many use klonopin for PRN but I prefer it over ativan because to get the same relief from anxiety, I find ativan mentally impairs me more. Another problem for me with klonopin is trying to match dose with situation which is why I do use ativan occassionally as an add-on (keep it close by) in situations where I underestimate the klonopin dose since ativan is faster acting. I'm suspecting some tolerance to ativan..but not sure.
Posted by Glydin on February 15, 2005, at 13:10:13
In reply to Re: Newly on(and ?s)about Zoloft and Klonopin » aphexonset, posted by SLS on February 15, 2005, at 10:07:25
> I hope people who actually use Klonopin for anxiety disorders contribute here.
>
> It is my impression that it is better to use Klonopin on a regular dosing schedule and not as a PRN.
~~~Okay, that includes me. I did trials and trials of AD's to no avail for my Anxiety Disorder. I consider myself a garden variety suffer with GAD, ruminations, agoraphobic tendencies, and panic attacks. I have been on Klonopin as monotherapy for 3 three years, give or take a few months when I tapered to off. Klonopin has been a great med for me. The med has greatly improved the quality of my life and my functioning. I require it daily but I am able to tirate my dose within a range. I'm low dose and have been able to maintain that for the three years.While there are pitfalls to any number of meds, I think sometimes, in some cases, there can be a tendency to get rid of a fly using a sledgehammer when maybe a flyswatter would do.
Posted by Phillipa on February 15, 2005, at 17:49:06
In reply to Re: Newly on(and ?s)about Zoloft and Klonopin, posted by Glydin on February 15, 2005, at 13:10:13
I truly believe the anti-depressants do not work for anxiety. At least the newer ones. I've never taken the TCA's or MAOI's. Before the new meds came out I was first started on valium that worked really well. As the trends changed i was given ativan, xanax, back to valium, and finally klonopin. To be perfectly honest, i don't like the drug. I feel it dulls me tremendously. I'm just going to go back on valium, so we'll see how I feel after I've been on it. I just hope my chemistry hasn't changed since menopause, and I haven't built a tolerance to it. I don't know why I continue to take the new AD's because I don't feel a thing with them. Everybody has to find the drug that works for them, and unfortunately that takes some of us a long time. Fondly, Phillipa
Posted by franco neuro on February 16, 2005, at 15:46:41
In reply to Newly on(and ?s)about Zoloft and Klonopin, posted by aphexonset on February 15, 2005, at 4:21:07
Hey our doctors must think alike. I've been on the same combo for the past 6 weeks: 50mg Zoloft and .5mg Klonopin. The Klonopin is mostly to help normalize my horrendous sleep patterns. It's been OK so far. It doesn't knock me out like the Xanax used to do. A much "milder" effect. I'm planning on adding Wellbutrin into the mix soon because my real problem right now is anhedonia and lack of motivation. Which the Klonopin may or may not be exacerbating.I took Paxil for about a year and couldn't deal with the anorgasmia and loss of libido. I find this to be much less of a problem with the Zoloft. At least so far. I have gotten a couple of those strange jaw sensations but they've been very minor events. I'm also having trouble pinning down the best time of day to take it. Everybody reacts differently. The first week I was yawning all day. That's pretty much passed and right now I'm taking it at lunch time.
By the way we also have the same name. Are you sure you're not me? I hope not because that would mean I'm a lot crazier than I think I am!:-)
Posted by Phillipa on February 16, 2005, at 16:51:36
In reply to Re: Newly on(and ?s)about Zoloft and Klonopin, posted by Phillipa on February 15, 2005, at 17:49:06
My last Post was confusing. I don't like klonopin. It's great that you're having good results with it, many on the Board are. I started the valium in it's place last night, and unfortunately I don't feel the wonderful relaxing way I did in the past. Fondly, Phillipa
Posted by dkscully on February 17, 2005, at 14:43:42
In reply to Newly on(and ?s)about Zoloft and Klonopin, posted by aphexonset on February 15, 2005, at 4:21:07
I think it's probably actually BEST to take Klonopin as needed, rather than on a regular basis.
My doctor prescribed 1 mg of klonopin for me to help with sleep on a nightly basis. I switched a psychiatrist about a month after that, as I realized my doctor was clueless, and she gave me ambien for sleep, and told me to stop the klonopin, but use it "as needed" for my anxiety. Well, I've tapered off it, in terms of taking it for sleep, and tried to avoid taking it for any other reason until I'd gotten through the addiction that I'd developed, it seems, after a mere month. I felt increased anxiety when I didn't take it, as well as headaches and such.
It really is an addictive drug (yeah, they all are, but I've heard a lot of bad stories about this one) and I think it's a good thing to have when you're going into a really anxiety-causing situation, but I'd be careful with it... After weaning down to 1/8 of a tablet, and then stopping last Friday, I'm starting to feel more normal like a week later...
At any rate, good luck with everything!
Posted by Glydin on February 17, 2005, at 16:06:18
In reply to Re: Newly on(and ?s)about Zoloft and Klonopin, posted by dkscully on February 17, 2005, at 14:43:42
> It really is an addictive drug (yeah, they all are, but I've heard a lot of bad stories about this one)With all due respect, this is not true for everyone. There is a filpside to the horror stories which include successful long term use without pitfalls. Those with successful use can have a medical dependence on Klonopin that differs from addiction. Addiction has four characteristics: Psychsocial disruption, inapproiate use, tolerence not leading to maintance dosing, and drug seeking behavior. Because a drug has a discontinuation syndrome or withdrawal symptoms does not, in and of itself, define it as an addiction.
There are inapprioate consumers and inapproiate prescribers, but benzo's can be a very safe and properly used choice in treatment. Klonopin has been around long time, there is alot known about it, which is more than can be said of some of the other meds.
Posted by Phillipa on February 17, 2005, at 16:21:59
In reply to Re: Newly on(and ?s)about Zoloft and Klonopin » dkscully, posted by Glydin on February 17, 2005, at 16:06:18
When it is used for seizures, it is rx'd in doses up to 20mg I think. If it works for your anxiety, then take it, and don't worry about addiction. You won't take more than you need. What does your pdoc say? Fondly, Phillipa
Posted by jasmineneroli on February 18, 2005, at 18:15:04
In reply to Re: Newly on(and ?s)about Zoloft and Klonopin » aphexonset, posted by SLS on February 15, 2005, at 10:07:25
>hope anxiety sufferers respond.
Well, that would also be me!
I have GAD, that also comes with periodic, soft depression & some OCD (as a way to deal with my worries).
I take Klonopin .5mg per day and I've taken it for about 20 months with no problem. I started at 1mg per day and found I was easily able to taper down to a level(.5mg) that continued to work for me. For a while (when I was also on Celexa) I was able to manage on .25mg per day, with an extra ,25mg per day, as needed, in stressful times.
I gave up Celexa due to side effects. I have none to Klon.
I think doctors often prescribe an amount that is too high for general type (continual) anxiety. It seems to me, from reading posts for over 2 years on this board, that quite often, anxiety-only sufferers do well with low-doses.
IMO Klonopin should be taken every day, in as low a dose that is effective, then add an extra tiny bit, as needed, for higher anxiety situations.
It would also seem that, by nature, anxiety sufferers tend to be too "worried" to abuse benzo's. And I prefer to use the word "abuse" rather than addiction, because there always seems to be a lot of confusion over the definitions of addiction, dependence and the symptoms of discontinuation/withdrawal.
I encourage you to try a daily low-dose Klonopin regimine, if your anxiety is uncomplicated by other disorders. Do some research and present it to your doctor.
My own Pdoc is completely unconcernd about my Klonopin use, because he knows I'm almost a drug-a-phobe (having tried 9 different meds...and counting, none of which have worked as well as Klon. and most have given me S.E's, unlike Klon).
Initially, he wanted to try to replace it with something else, but now sees that it works for me.Everyone is different in their response and also in their attitudes to different drugs. As Philippa said (I think!!), you just have to keep on trying.
All the very best,
Jas
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