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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by PaulB on March 11, 2001, at 9:43:51
I am just about to start on Klonopin for social anxiety. This may or may not be a good idea. Ive been on Paxil which really helped for about six months but then was just like taking a sugar-pil. My psychopharmacologist suggested Gabapentin or Klonopin. I had a better feeling about the latter drug despite the fact that it is a benzodiazepine. It would be encouraging to here from people who do well on this drug and do not find that they build up a tolerance to it. I know that this is possible but I assume that the Klonopin may well continue to work but surely not as effectively in the long-term as it did initially. Correct me if Im wrong?
Posted by judy1 on March 11, 2001, at 10:43:02
In reply to Klonopin, posted by PaulB on March 11, 2001, at 9:43:51
I've been on the same dose of klonopin (6mg/day) for 3 years for panic attacks. I have not developed any tolerance to the anti-panic properties, I have to the sedating properties (but I don't take it for sedation). Hope this helps- judy p.s. Neurontin was worthless for me in this context.
Posted by JackD on March 11, 2001, at 13:57:45
In reply to Klonopin, posted by PaulB on March 11, 2001, at 9:43:51
Klonopin is the best social phobia drug next to nardil (statistically speaking of course). If you do not abuse the drug you should not build up a significant tolerance. I've only been on it for a few months so I can't really say from experience.
Think of it this way... I drink beer a lot, or used to. Now when I would drink regularly, say 10-12 beers a night I began building a major tolerance to beer. That meant it took me 8 beers instead of 6 lets say, and it meant that I could handle myself a little better and the drunkenness was less overwhelming.
I know that's a stupid example, but my point is you shouldn't worry about tolerance because even if it builds it will never likely exceed a ridiculous point. It'll probably be just a "getting used to" kinda tolerance, where you're more used to the feeling of the meds effects.
Posted by jb on March 11, 2001, at 14:02:57
In reply to Klonopin, posted by PaulB on March 11, 2001, at 9:49:28
Hi. I have severe social phobia. I find that Klonopin is extremely effective. I was initially scared to death of benzo's, but felt better when I was recommended Nardil and Klonopin by the University of Michigan's Anxiety Disorders Program. I have taken high dose Gabapentin, up to 3800 mg/day and noticed little effect. I believe that is why Pfizer is now focusing on pregablin, a much strong version of Gabapentin, in stage III social phobia trials.
One thing to keep in mind, though, is that Klonopin works even better in conjunction with an SSRI or MAOI. Nardil and Klonopin are the most effective combination, by far. I take Nardil 60 mg/day and Klonopin 2-3 mg/day. I also take more Klonopin before a major presentation; maby 1 or 2 mg.
You might want to perform a search of PubMed and see for yourself the efficacy of Klonopin (Clonazepam) and Nardil (Phenelzine), and other drugs. Generally, I've found the efficacy of most other drugs to be substantially less than Phenelzine or Clonazepam.
The web address for PubMed is www.ncbi.nlm.nih.gov/entrez/query.fcgi
and, again, it's a free search.Good luck. I think you'll find the Klonopin enormously helpful. Also, I have had any addictive reaction. Klonopin is very long lasting, and the addictive benzo's are usually the ones with the shorter half-life.
John
Posted by judy1 on March 11, 2001, at 16:19:09
In reply to Re: Klonopin, posted by jb on March 11, 2001, at 14:02:57
Just wanted to add I agree with the MAOI+benzo combo, particularly nardil. Most of the SSRI's have an agitating effect, paticularly in the beginning, that may negate the benzo effect. And yes xanax is considerably more prone to abuse by abusive types (me) but in the midst of a panic attack if I take a tab sublingually, I have complete abatement of symptoms in 6 minutes- and yes I timed it :-) judy
Posted by jb on March 12, 2001, at 19:22:06
In reply to Re: Klonopin » jb, posted by judy1 on March 11, 2001, at 16:19:09
Hi, Judy. Nice post on the fast acting benzo, particularly taking it sublingually if the need presents itself. By the way, I'm tired of the sexual dysfunction of Nardil and the short-term amnestic effect of Klonopin. I'll see my psychdoc (who is a good psychopharmacologist) in a week, and try to review a couple of "cocktail" combinations with him:
(1) Nardil 60 mg/day (my current dosage)
Selegiline 15 mg/day (even though this is an
MAOI-B inhibitor, I'll see if he feels
comfortable with this as a way to take care
of the sexual dysfunction of Nardil)
Modafinil - 200 mg/day (I'll ask for this to
help offset the lethary and cognitive side
effects of Klonopin)
Klonopin - 2 to 3 mg/day (I'd like to stay on
this if Selegiline and Modafinil can take care
of the cognitive and short-term amnestic
effects)(2) Serzone
Modafinil 200 mg/day
Klonopin 2 -3 mg/day
Selegiline 15 mg/day (again, this is contraindicated with an SSRI, so I'll see what he says. I'd like it to, again, help with he cognitive side effects of Klonopin)Oh, well, on with the experimentation.
Thanks.
John
Posted by judy1 on March 13, 2001, at 11:34:28
In reply to Re: Klonopin - to Judy, posted by jb on March 12, 2001, at 19:22:06
Dear John,
I like your option A (it's like a Chinese menu) and will ask the obvious- have you tried a lower dose of nardil? Correct me if I'm wrong, but doesn't Serzone have a side effect of sexual dysfunction? My pdoc says it's very common to have cognitive problems with klonopin, but on 6mg/day I must be so cognitively impaired I don't know it :-). Actually, I think I've mentioned before that I'm convinced this is part of my depressive state. Best of luck- judy
Posted by jb on March 13, 2001, at 13:06:52
In reply to Re: Klonopin » jb, posted by judy1 on March 13, 2001, at 11:34:28
> Dear John,
> I like your option A (it's like a Chinese menu) and will ask the obvious- have you tried a lower dose of nardil? Correct me if I'm wrong, but doesn't Serzone have a side effect of sexual dysfunction? My pdoc says it's very common to have cognitive problems with klonopin, but on 6mg/day I must be so cognitively impaired I don't know it :-). Actually, I think I've mentioned before that I'm convinced this is part of my depressive state. Best of luck- judyHi, Judy. To answer your question, yes, I've tried reducing the dose of Nardil. I actually went from 90 mg/day down to 60. I've tried 45 mg/day, but the efficacy went right down with it. 60 mg/day seems to be the minimum therapeutic dose. Regarding the Klonopin and its impairment of cognition, memory, etc, I've heard the same thing - it's the nature of the beast. Perhaps Buspirone will work, if I'm taking Nardil. I've tried Buspirone solo, and it did nothing. But, sometimes you need to take meds together to achieve the effect. As far as Selegiline, I've taken that before, solo, at 60 mg/day. It loses its MAO-B selectivity somewhere above 15 mg/day. Unfortunately, it didn't provide the efficacy of even Parnate, a non-selective non-hydrazine MAOI. But, it did very, very substantially increase my sexual desire, arousal, sensations, and orgasm. As you see, this is why I'd like to return to at least partial Selegiline, such as 15 mg/day.
Will let you know how what I select off of the Chinese menu. Maybe I should add egg rolls?
See you. (:)
Johnb
Posted by Mr. Scott on March 13, 2001, at 18:48:23
In reply to Klonopin, posted by PaulB on March 11, 2001, at 9:43:51
If given the choice I would try the Gabapentin first.. Klonopin worked for me and I took it for 1 year, but it made me feel like my IQ was lowered by 30 points.. Thats just me though.. Itend to be sensitive.. Also withdrawal wasn't fun but I dealt with it.
Posted by judy1 on March 14, 2001, at 10:51:22
In reply to Re: Klonopin, posted by Mr. Scott on March 13, 2001, at 18:48:23
I think trying neurontin isn't a bad idea, especially since it doesn't have side effects. It is, however, like buspar, totally worthless for my panic attacks. I think I have read some people have found success with it as an adjunctive therapy. I'm sure that your feeling like your intellect suffered on klonopin is shared by many. I also tapered off it when pregnant and found it difficult too. Take care, judy
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