Prescribed Klonopin with my Ativan

[leadinglady]

I went into the doctor today (reg doc) cuz I was feeling crappy and to get me through until I can get in with the pdoc, they commiserated to give me Klonopin, 0.5 mg three times a day, Ativan 1 mg as needed, and up my Zyprexa from 2.5 to 5 mg at night.

I took one Klonopin and feel like I could sleep for days. Has anyone else been on more than one benzo at a time? I've never heard of it being done before and never tried it in all my years of psycho-dom.

[Velvet Elvis]

Well, does it work?

Klon. is longer lasting and a bit milder than other benzos IMHO, so taking it at a regular dose every day and keeping the ativan as a PRN makes a little bit of sense I guess.

.5 mgs Klon is a small dose. I take four times that and it barely gets me chilled out enough to sleep. I have no idea what kind of cumulative effect the drugs may have.

Were you already on ativan when you took to Klon. dose that knocked you out?

[Velvet Elvis]

I just saw your post in the depression forum.

Just so you know, benzos are depressants. They all have the potential side effect of making you more depressed. Clonazepam has that effect on me sometimes. Every now and then I'll just want to break down bawling about an hour after I take it.

You might want to take the minimum amount of benzos you need to get by until you can hook up with your pdoc.

Did you GP change your ADs or anything?

[mejeba]

I've been on Clonazepam for 3 yrs- .5 mg am and .5 mg pm. It doesn't make me sleepy. I've tried going off the am dose and found my anxiety level worsened, so went back to it. Pdoc thinks it's a low enough dose to be ok and anxiety is what we're targeting with this. Next visit I'm going to ask pdoc about the depressive aspect you guys mentioned.

I also take Ativan prn- only to sleep when that's a problem.

[Silver]

Um.... there's not much rationale for giving lorazepam (Ativan) and clonazepam (Klonopin) together, other than reassurance during transition from one to the other. And neither of them is particularly antidepressant in effect. So - following up with your psychiatrist sooner, rather than later, seems like a good idea.

I'm sure, since you're post-Roux-en-y, someone is monitoring your folate, B12, D, copper, etc., and CBC/anemia... Right? And those have all been checked fairly recently? Since you're in contact with your GP and she or he is listening to you, that seems like a safe bet, but I thought I should ask...

[leadinglady]

I took all the meds last night. Slept so late today my daughter missed school. Whoa. I'm not sure what the offender was -- the Klonopin/Ativan combo I took before bed, or the extra 2.5 mg of Zyprexa I took. Definitely not mixing the benzos again. My bad.

Funny, I am post roux-en-Y gastric bypass and nobody is monitoring my levels. I think I've had one set of blood work done just to check my vitamin D and I had to ask for that. Maybe it's time to insist on some labs.

[gizmo]

Funny, I am post roux-en-Y gastric bypass and nobody is monitoring my levels.

I'm not gonna say anything about your specific doctor, but here's a page I thought you might find interesting:

Obes Surg. 1999 Apr;9(2):150-4.

Survey of vitamin and mineral supplementation after gastric bypass and biliopancreatic diversion for morbid obesity.

Brolin RE, Leung M.

Department of Surgery, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey 08903, USA.

BACKGROUND: The authors investigated whether practice patterns of bariatric surgeons correlate with published data regarding metabolic deficiencies after Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion (BPD). METHODS: 109 surgeons completed a questionnaire to determine use of supplements and frequency of lab tests. RESULTS: Regarding supplements routinely prescribed after RYGB, 96% of surgeons gave multivitamins, 63% gave iron, and 49% gave vitamin B12. After BPD, 96% of surgeons gave multivitamins, 67% gave iron, 42% gave vitamin B12, 97% gave calcium, 63% gave fat-soluble vitamins, and 21% gave protein supplements. Regarding laboratory tests obtained routinely after RYGB, 95% of surgeons do complete blood counts, 56% do iron determinations, 66% do vitamin B12 determinations, 58% do folate determinations, 76% do electrolyte determinations, and 8% test for proteins. After BPD, 96% of surgeons do complete blood counts, 80% do iron determinations, 67% do vitamin B12 determinations, 71% do folate determinations, 88% do electrolyte determinations, 84% do protein determinations, and 46% test for fat-soluble vitamins. Regarding frequency of blood tests, after RYGB, 22% of surgeons obtain them after 3 months, 33% after 6 months, and 41% after 12 months; 4% do not routinely obtain postoperative laboratory tests. After BPD, 46% of surgeons obtain them after 3 months, 33% after 6 months, and 16% after 12 months; one does not obtain laboratory tests. Surgeons estimated these deficiencies after RYGB: 16% iron, 12% vitamin B12, 14% anemia, 5% protein, and 3% calcium. They estimated these deficiencies after BPD: 26% iron, 11% vitamin B12, 21% anemia, 18% protein, 16% calcium, and 6% fat-soluble vitamins. The estimated incidence of deficiencies after RYGB was considerably lower than the published incidence. Unnecessary tests were commonly performed (electrolytes after RYGB). CONCLUSION: Despite wide variations in the performance of laboratory tests and the use of supplements, the practice patterns of most surgeons protect patients from developing severe metabolic deficiencies after RYGB and BPD.

FWIW, my best friend, who is 1 year post RYGB, gets a full lab panel done every three months. And I've personally never been prescribed two benzos, and don't think it's a good idea to take two. I highly doubt that 2.5 mg of zyprexa would cause you to pass out and the benzos *wouldn't*.