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So I am currently having lots of anxiety and I am taking klonopin .5mgs twice a day.  My pdoc doesn't want to increase it because of addiction blah, blah.  He wants me to try thorazine 10mgs 3 times a day for the anxiety.  I am a little nervous because when I was hospitalized they gave me the lowest dose of haldol and the side effects were unbearable.  Are these medications simular or do they work differently?  Any information would be great.

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@Beth45, Haldol is considered a high-potency typical anti-psychotic......Thorazine is also a typical anti-psychotic, but it is considered low potency in comparison to Haldol.

In the past, I used to take 100mgs/day Thorazine for my anxiety, so 10mg 3x a day would be considered a very low dose.

Edited by CrazyRedhead

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Thank you Crazyredhead for the information.  I am not familiar with the anti-psychotic medications so I wasn't sure what to expect.  I start taking them tomorrow so I hope that they can give me some relief!

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I only took 1 pill the other day and it made me drowsy.  I don't know if it worked for the anxiety or not.  I can take them if needed but I guess I'm just stubborn and I want to fight the anxiety on my own.  I will hold onto them just in case.  

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@Beth45 You could talk to your doctor about loxapine. It is also a typical antipsychotic like Thorazine but in low doses (<50mg/day) it behaves like an atypical antipsychotic. They actually use it in the ER to treat agitation at 25mg every hour until the agitation subsides. I take 20mg at bedtime every night and it does a really good job at managing anxious thoughts. I've taken up to 35mg before in a manic episode. Worst side effects would be if I take it too late in the evening I'll feel sedation the next day and a bit of restlessness. Nothing I can't manage though. The only thing that controlled my racing thoughts other than loxapine was olanzapine (Zyprexa).

My only complaint with loxapine is that it doesn't have a very long half-life and because of that I sometimes feel like I don't get "all-day coverage". Like in the afternoons I'll feel antsy and "worried". I'm actually thinking about asking my doctor for an Rx for the 5mg capsules that I can take during the day for breakthrough anxiety. But 10-25mg at night usually does the trick.

Edited by browri

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So your pdoc would rather prescribe you a typical antipsychotic than increase your Klonopin? That's ridiculous. Why not something like Vistaril instead of Thorazine??

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For some people, the core of their anxiety really is a dopamine problem and can be addressed with a dopamine antagonist. I feel like Xanax calms me down but it doesn't quiet my thoughts. The core of the anxiety is still there. I've started taking 5mg of loxapine in the morning to deal with my anxiety during the day and so far it has helped tremendously and I haven't needed Xanax at all. Some minor sedation but nothing like Xanax. I don't feel like I need a nap.

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The doctor doesn't want to increase the klonopin because it is addictive and causes early onset dementia.  I tried the Thorazine and I didn't like the way it made me feel.  I have tried vistrail and it doesn't work for me.  I even tried 10 mgs of Thorazine to help me sleep and all it did was give me nightmares!  UGH!

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6 minutes ago, Beth45 said:

I even tried 10 mgs of Thorazine to help me sleep and all it did was give me nightmares!  UGH!

Thorazine gave me nightmares too in the end. I was on 100 mg for sleep and at first it left me like a zombie in the morning, then I got used to it. Then the nightmares came and that was that for Thorazine for me... lol

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21 hours ago, Beth45 said:

  I tried the Thorazine and I didn't like the way it made me feel.  I have tried vistrail and it doesn't work for me.  I even tried 10 mgs of Thorazine to help me sleep and all it did was give me nightmares!  UGH!

Have you tried gabapentin (Neurontin)?......if not, that is another possibility......Works well on anxiety for some folks here.

Buspar is another anti-anxiety med that works for a few people, but I would suggest asking your doc about gabapentin first. if he is open to changing your meds.

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Thank you.  I was thinking about gabapentin and I will talk to the dr about it when I see him next.  I tried buspar and it made me feel like I was jumping out of my skin.

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Oxcarbazepine (Trileptal) is another option for anxiety (I like it, personally), but you have to watch out for low sodium levels (I assume in the higher doses).

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1 hour ago, mikl_pls said:

Oxcarbazepine (Trileptal) is another option for anxiety (I like it, personally), but you have to watch out for low sodium levels (I assume in the higher doses).

I can definitely second oxcarbazepine's effect on anxiety. It's very soothing. It's just that I've hit a mixed episode that isn't well controlled with oxcarbazepine, so I'm switching to divalproex, which is much more calming.

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On 10/2/2017 at 1:09 PM, mikl_pls said:

So your pdoc would rather prescribe you a typical antipsychotic than increase your Klonopin? That's ridiculous. Why not something like Vistaril instead of Thorazine??

Generally, I agree that that sounds ridiculous, but there may be situations where this makes special sense. In my case, I am being prescribed 25 mg Thorazine to be taken early in the morning before ECT treatment. It not only helps with the apprehensive anxiety I experience when getting prepped for the treatments, but I was told by my pdoc that Thorazine can act to lower the seizure threshold - a side effect that can be useful when receiving ECT. Particularly good for those who do not experience a good seizure unless the power used for the treatment is maxed out. It also changes the "shape" of the seizure response on the EEG which appears to be correlated with better therapeutic response. 

Prescribing something like Klonopin in this case would not be feasible because its anti-convulsive properties would prevent a seizure and make ECT poorly effective.  

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On 10/5/2017 at 2:02 PM, Beth45 said:

The doctor doesn't want to increase the klonopin because it is addictive and causes early onset dementia.  I tried the Thorazine and I didn't like the way it made me feel.  I have tried vistrail and it doesn't work for me.  I even tried 10 mgs of Thorazine to help me sleep and all it did was give me nightmares!  UGH!

Dies Klonopin really cause dementia? 

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58 minutes ago, TakeAChillPill said:

Dies Klonopin really cause dementia? 

If this is the study I'm thinking of, I don't think it proved causation. However, maybe there are more recent studies?*

Study: http://www.bmj.com/content/349/bmj.g5205

"Conclusion Benzodiazepine use is associated with an increased risk of Alzheimer’s disease. The stronger association observed for long term exposures reinforces the suspicion of a possible direct association, even if benzodiazepine use might also be an early marker of a condition associated with an increased risk of dementia. Unwarranted long term use of these drugs should be considered as a public health concern."

"Whether causal or not, the nature of the link cannot be definitively established: benzodiazepine use might also be an early marker of a condition associated with an increased risk of dementia."

Article talking about the study: "The researchers acknowledge that the use of benzodiazepines could be just a signal that people are trying to cope with anxiety and sleep disruption—two common symptoms of early Alzheimer’s disease. If that’s true, their use of a benzodiazepine may not be a factor in causing dementia but an indication it is already in progress."

https://www.health.harvard.edu/blog/benzodiazepine-use-may-raise-risk-alzheimers-disease-201409107397

*http://www.bmj.com/content/352/bmj.i90

"Conclusion The risk of dementia is slightly higher in people with minimal exposure to benzodiazepines but not with the highest level of exposure. These results do not support a causal association between benzodiazepine use and dementia."

*Apparently there are 9 total studies showing a "deleterious effect" but some (but not all) of those studies may have had the reverse causation bias issue...according to this abstract: https://link.springer.com/article/10.1007/s40263-015-0305-4

[I only spent about 5 minutes total "researching" & writing this post so please keep that in mind.]

Edited by aquarian
Removed duplicate quote
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On 10/5/2017 at 0:02 PM, Beth45 said:

The doctor doesn't want to increase the klonopin because it is addictive and causes early onset dementia.  

It is not completely clear that benzos cause dementia, there are studies going either way.

Oh, I see aquarian did a much more thorough job than I.

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On 13/10/2017 at 6:08 AM, ByePolarCoordinates said:

Generally, I agree that that sounds ridiculous, but there may be situations where this makes special sense. In my case, I am being prescribed 25 mg Thorazine to be taken early in the morning before ECT treatment. It not only helps with the apprehensive anxiety I experience when getting prepped for the treatments, but I was told by my pdoc that Thorazine can act to lower the seizure threshold - a side effect that can be useful when receiving ECT. Particularly good for those who do not experience a good seizure unless the power used for the treatment is maxed out. It also changes the "shape" of the seizure response on the EEG which appears to be correlated with better therapeutic response. 

Prescribing something like Klonopin in this case would not be feasible because its anti-convulsive properties would prevent a seizure and make ECT poorly effective.  

I'm also being encouraged to use Thorazine for anxiety because I'm doing ECT. I declined and have moved to Serax which is shorter acting than Klonopin and they make sure not to give it to me 12 hours before I have ECT. I ME, AP's just aren't as good for anxiety.

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