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Adding a benzo


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So, I have the complete (pure-o) OCD package, which includes ADHD, depression, anxiety and tics.

The meds package: Effexor, Abilify, Lamictal...

And now that some anxiety related symptoms are coming back, my pdoc added Klonopin (Clonazepam)..

Never tried a benzo before...

What should I expect?

and some wishful thinking: could this be the med that will allow me to finally stop taking abilify?

Any input is welcome!

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Benzos can help but ideally you want to find a med that eliminates your symptoms without having to rely on a benzo. People are different. Some can find a medication combination that works and not need a benzo whereas some people even with taking multiple medications need a benzo as well. I can't take a benzo for a prolonged period at a high dose because it gives me depression. and DON'T drink while taking it. 

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The nice thing about benzos is they work quickly. What you see is what you get when trying them.  Once you find your dose that pretty well is how they are going to feel for you. They have been around decades, time enough for any surprises, in terms of side effects, to show themselves.

You can dose them as needed but if your symptoms are all the time you will need to take them all the time. Dependence happens if you take them all the time for months. I've been taking Klonopin all the time for several years. I would imagine I have some level of dependence. Tolerance has built to some benzo effects, mainly sedation but has not built to the antianxiety effects. They work as well on anxiety as they did when I first started them.

My pdoc wanted me on them all the time and I fought him on this, just taking them as needed. Finally I came round and tried them all the time. I have to say, in the long term I am much more stable. I had a horrible experience with gangrene and necrotizing fasciitis (flesh eating bacteria) that required stem cell therapy to regrow what was lost. That is when I went on Klonopin all the time and I have it to thank for keeping me pinned together. The body will not heal if stressed too much. Stress in general makes chronic conditions worse. 

I touched on dependence, I have dealt with it several times when I needed to go on a benzo for more than a few months. Dependence means you can't suddenly stop taking a benzo or you risk seizures and a number of other nasties. Tapering down over a period is the ticket. I never have had trouble getting off them. The horror stories you hear seem grandiose compared to my experience but everyone is different.

Benzos are not for everybody but in the right person they are quite useful.

Edited by notloki
spelling and last paragraph
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Thanks!

As I'd like to be as stable as possible for as long as possible, this will probably be a long-term thing.

I am supposed to take .25mg a day which is low, so hopefully that tolerance and dependance won't be an issue.

I'm wondering, since I take Abilify, which I don't like, for the very same symptoms - maybe Klonopin can replace it at some point...

Generally, GABA meds proved to be better for me than pretty much anything else.

Guess I'll give it a try :)

 

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8 hours ago, HydroCat said:

Thanks!

As I'd like to be as stable as possible for as long as possible, this will probably be a long-term thing.

I am supposed to take .25mg a day which is low, so hopefully that tolerance and dependance won't be an issue.

I'm wondering, since I take Abilify, which I don't like, for the very same symptoms - maybe Klonopin can replace it at some point...

Generally, GABA meds proved to be better for me than pretty much anything else.

Guess I'll give it a try :)

 

I don't think many doc's would replace an aap with a benzo long term...as said above its *usually* not meant to be a central med, with some exceptions of course. The thing is benzos aren't great for depression but abilify can be so I'm not sure that would be a good switch 

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9 hours ago, HydroCat said:

 

I am supposed to take .25mg a day which is low, so hopefully that tolerance and dependance won't be an issue.

I'm wondering, since I take Abilify, which I don't like, for the very same symptoms - maybe Klonopin can replace it at some point...

 

Tolerance has ended up being good thing as I became tolerant to the sedation but not the antianxiety effects. I understand you develop some tolerance to the antiseizure effects over time, thus benzos haven't been first line meds for seizure but are used in emergencies as most benzos are powerful anticonvulsants. 

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4 hours ago, Iceberg said:

I don't think many doc's would replace an aap with a benzo long term...as said above its *usually* not meant to be a central med, with some exceptions of course. The thing is benzos aren't great for depression but abilify can be so I'm not sure that would be a good switch 

My central med is Effexor which is an AD.

Abilify is a low-dose addition to it, for the anxiety/intrusive thoughts/tics

It is good for what it does, but it gives a feeling of an all-in-one pill, as if touching every brain part/receptor known to man would solve any problem.

Tried to stop taking it a few times. Not the best idea.

Maybe an anti-anxiety med could replace iy eventually.

I guess I will just have to check :)

Thx

 

Edited by HydroCat
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Second day on it. Feeling calmer than before, pretty much normal :) no euphoria or anything like that...

It also reduced my tics which is always a good sign.

Besides that, it makes waking up in the morning more difficult...

... Not anywhere close to Risperidone though.

I've done some research and couldn't figure out how long it is supposed to have an effect. Some say it lasts for less than 12 hours, if it is true then taking it at night doesn't make much sense. Is this correct?

 

 

Edited by HydroCat
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5 hours ago, HydroCat said:

  I've done some research and couldn't figure out how long it is supposed to have an effect. Some say it lasts for less than 12 hours, if it is true then taking it at night doesn't make much sense. Is this correct?

According to this link, and a few other sources I found, Klonopin (clonazepam) has a duration of action of 6-12 hours in adults, so duration of action can vary between individuals:

https://en.wikipedia.org/wiki/Clonazepam#Pharmacokinetics

I'm on clonazepam, and I take 1mg in the morning, and 2mg at night......For me personally, I can't sleep well without the night dose, so it does make sense to take it at night, if you're taking it for sleep purposes..........The morning dose I take is for daytime anxiety.

.25mg is an extremely small dose, but if you take it once a day, and it doesn't give you enough coverage that way, ask pdoc  if you could try splitting the pill, and take half in the morning, and half at night.

Edited by CrazyRedhead
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6 hours ago, CrazyRedhead said:

According to this link, and a few other sources I found, Klonopin (clonazepam) has a duration of action of 6-12 hours in adults, so duration of action can vary between individuals:

https://en.wikipedia.org/wiki/Clonazepam#Pharmacokinetics

I'm on clonazepam, and I take 1mg in the morning, and 2mg at night......For me personally, I can't sleep well without the night dose, so it does make sense to take it at night, if you're taking it for sleep purposes..........The morning dose I take is for daytime anxiety.

.25mg is an extremely small dose, but if you take it once a day, and it doesn't give you enough coverage that way, ask pdoc  if you could try splitting the pill, and take half in the morning, and half at night.

This is what I don't understand, I was perscribed this for anxiety during the day, so if I take it before bedtime the effect is expected to end at the morning-afternoon.

Based on two days only, it feels as if it works throughout the day but “scientifically” it seems that it shouldn't.

btw, it sais that the effect lasts 6-12 hours but the half-life is 19-60 hours.

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4 hours ago, HydroCat said:

This is what I don't understand, I was perscribed this for anxiety during the day, so if I take it before bedtime the effect is expected to end at the morning-afternoon.

When did your doc tell you to take it?

 

Edited by CrazyRedhead
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5 hours ago, CrazyRedhead said:

When did your doc tell you to take it?

 

He told me to take it at night, then I got to read about it. He won't be available for a couple of weeks.

It seems to work, at least for now.

It affects sleep too with longer and more vivid dreams, even though that was not the intention nor the issue.

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5 hours ago, HydroCat said:

He told me to take it at night, then I got to read about it. He won't be available for a couple of weeks.

It seems to work, at least for now.

It affects sleep too with longer and more vivid dreams, even though that was not the intention nor the issue.

From what I know about clonazepam, it can cause vivid dreaming for some people, although I have never experienced this side effect......I've been taking it for over 5 years now.

If taking it at night is working for you, that's good.

I would say if the dreaming is really bothering you, mention it to pdoc at next appointment.

Edited by CrazyRedhead
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2 hours ago, CrazyRedhead said:

From what I know about clonazepam, it can cause vivid dreaming for some people, although I have never experienced this side effect......I've been taking it for over 5 years now.

If taking it at night is working for you, that's good.

I would say if the dreaming is really bothering you, mention it to pdoc at next appointment.

It is great that you can take it for years without building up tolerance! Maybe it actually can be a long term treatment option.

I like it so far, except for the “how crazy am I?” question that pops up when adding (yet) another drug to the list.

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19 minutes ago, HydroCat said:

I like it so far, except for the “how crazy am I?” question that pops up when adding (yet) another drug to the list.

How many meds are you on, if you don't mind sharing?...... Right now I'm on 4 psych meds, although my new pdoc might want to add something else at some point.

I used to worry about that, when I was younger, but now I don't think about it much anymore....I have been taking psychiatric medications for many years.

If my pdoc thinks a medication will help me, I will at least try it...(And I've tried many).

There are many people here on multiple medications, so if I were you, I wouldn't worry about it........:)

 

Edited by CrazyRedhead
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Sure, currently taking “only” 4 psych meds: Effexor, Abilify, Lamictal, Clonazepam.

5 if you consider Ritalin.

They make me feel normal most of the time so actually it is funny if anything. :)

Took me 6 years to arrive at this particular mix.

Giving up was never an option.

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25 minutes ago, HydroCat said:

Sure, currently taking “only” 4 psych meds: Effexor, Abilify, Lamictal, Clonazepam.

5 if you consider Ritalin.

They make me feel normal most of the time so actually it is funny if anything. :)

5 psych meds is not a lot compared to quite a few people here.......If they make you feel better most of the time, that's great, IMO, and you are fortunate.

I'm still searching for a combo that makes me feel better....Even after trying many meds, plus therapy, I still haven't found the right mix.

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15 hours ago, CrazyRedhead said:

5 psych meds is not a lot compared to quite a few people here.......If they make you feel better most of the time, that's great, IMO, and you are fortunate.

I'm still searching for a combo that makes me feel better....Even after trying many meds, plus therapy, I still haven't found the right mix.

I have been sort of balanced most of the time, but I still had to change meds from time to time, so either I'm changing or the meds poop-out... or both.
The fact that I have just added another med means that I fell out of balance again.

This trial and error is frustrating. There is some progress with genetic tests but as my pdoc said they are not nearly as accurate/reliable as we'd like them to be right now.
It is very well worth the effort.

Never give up.

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