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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 Annell on April 13, 2002, at 2:23:13
I've been on Klonopin 1 mg at bedtime and Effexor 225 mg. for one year now. For the past year I have experienced a "hangover" every single morning which is not pleasant and makes getting to work on time a real chore!
For the last 4 weeks, I have been experiencing hourly waking every single night and am thoroughly exhausted. I feel like I have gotten all I can get out of Klonopin and it no longer works as a sleep agent. I am exhausted and miserable due to lack of sleep which makes me feel tired and depressed.
See pdoc next week and he wants to try me on Trazadone and taper off of the Klonopin. Any ideas or suggestions? One other question. . . What exactly does Effexor do to the sleep cycle, if anything? Thanks Annell
Posted by Janelle on April 13, 2002, at 4:26:31
In reply to Need some ZZZZ's. . . Klonopin not working, posted by Annell on April 13, 2002, at 2:23:13
Hi Annell - I'm Janelle - our names rhyme and we have similar experiences with both Klonopin and Effexor.
I've been on Klonopin 1 mg in the morning (for anxiety) although there was a time when I tried it at bedtime for sleep but it did NOTHING.
I've been on Effexor 150mg for several months.
I am also experiencing REAL bad sleep problems, though different from yours - I have insomnia - I CANNOT for the life of me fall to sleep at night. It is sooooo frustrating. I toss and turn, watch the clock move and move, and feel wide awake.
As a result, I drag and feel exhausted during the day. Each day I think oh gosh, I'm so tired, I'm sure I'll be able to fall asleep tonight, but nope.
Klonopin has never worked as a sleep agent for me.
Though our patterns are different, I share your feelings of being exhausted and miserable due to lack of sleep which also makes me feel tired and depressed.
For what it's worth, I think your pdoc's plan is a good one - I have heard that Trazadone is a good sleep agent (wonder why MY pdoc hasn't recommended it - mine wants me to try Ambien, which has helped me in the past)
Good question about what Effexor does to the sleep cycle, if anything. I don't have an *official* answer but my humble opinion is that it screws the sleep cycle up! In fact, my pdoc is considering having me taper off the Effexor and try a different AD.
Hopefully someone else will respond here and can answer your question regarding Effexor and any possible effect on sleep cycle. I would love to know this myself.
Sorry I wasn't of any help ... just wanted to share experiences.
Posted by crepuscular on April 13, 2002, at 12:06:38
In reply to Re: Need some ZZZZ's. . . Klonopin not working » Annell, posted by Janelle on April 13, 2002, at 4:26:31
i've had the same problem. ultimately ambien and klonopin are not going to be the solution because you'll have to keep increasing the dose. ambien only keeps me asleep for 4 hours anyway.
how about this: seroquel + vigorous exercise. eat some carbs before bedtime w/seroquel & you will experience some impressive sleep.
Posted by Willow on April 13, 2002, at 12:27:38
In reply to Re: Need some ZZZZ's. . . Klonopin not working, posted by crepuscular on April 13, 2002, at 12:06:38
Effexor does do a number on sleep, but with time the side effect goes away or lessens. I've just started klonopin. (taken two doses - slept through the first 24hrs, but insomnia isn't really a problem for me, waking up is)
BEST WISHES
Willow
Posted by geno on April 13, 2002, at 18:14:24
In reply to Re: Need some ZZZZ's. . . Klonopin not working, posted by crepuscular on April 13, 2002, at 12:06:38
Let me revise your med combo:
Im tried every darn method for sleep. Id wake up every 2 hrs,esp when using ghb.
Id then found Remeron. Its the best sleeping pill in the world. Yes, you will eat more but watch your diet. Also serquel i have yet to try, BUT, If you pdoc is very good, he will not give you seroquel unless you are hallucinating, or dillustional.Seroquel Vs Remeron:
Remeron blocks Histamine receptors highly, Blocks 5ht2 seratonin receptors, and VERY slightly Blocks dopamine receptors.
Serouqel pretty much blocks dopamine receptors, slightly blocks histamine receptors, and slightly blocks 5ht2 receptos.
So if dopamine is your problem, excess, id go with seroquel. If it just anxiety or whatever else, remeron is the way to go. Start with 15mg and then you could up it to 30 if sedation is a probelm.
Ambein in my opinion are good for short naps. Or if you cannot get to sleep or only need 4 hrs of sleep.
benzos do not give you the proper rem sleep.
trazadone is ok for moderate sleep problems, but doesnt have the histamine properties.
sleep tight!
geno
Posted by fachad on April 13, 2002, at 22:46:18
In reply to Need some ZZZZ's. . . Klonopin not working, posted by Annell on April 13, 2002, at 2:23:13
Here are some ideas:
doxepin: as low as 10mg works for some people, may increase appetite esp. at higher doses
remeron: again, low doses like 7.5mg or 15mg, another potential appetite stimulant
trimipramine (supposed to preserve sleep architecture)
Ambien (very expensive, wears off in 4 hrs)
benzos: tolerance/dependence, disrupts sleep architecture, but may be an improvement over Effexor ravaged sleep architecture.
> I've been on Klonopin 1 mg at bedtime and Effexor 225 mg. for one year now. For the past year I have experienced a "hangover" every single morning which is not pleasant and makes getting to work on time a real chore!
>
> For the last 4 weeks, I have been experiencing hourly waking every single night and am thoroughly exhausted. I feel like I have gotten all I can get out of Klonopin and it no longer works as a sleep agent. I am exhausted and miserable due to lack of sleep which makes me feel tired and depressed.
>
> See pdoc next week and he wants to try me on Trazadone and taper off of the Klonopin. Any ideas or suggestions? One other question. . . What exactly does Effexor do to the sleep cycle, if anything? Thanks Annell
Posted by fachad on April 13, 2002, at 22:48:09
In reply to Re: Need some ZZZZ's. . . Klonopin not working, posted by crepuscular on April 13, 2002, at 12:06:38
I never had to increase my Ambien dose, but it did wear off after 4 hrs.
Seroquel works the same way as doxepin, remeron, and benedryl...H1 blockade.
> i've had the same problem. ultimately ambien and klonopin are not going to be the solution because you'll have to keep increasing the dose. ambien only keeps me asleep for 4 hours anyway.
>
> how about this: seroquel + vigorous exercise. eat some carbs before bedtime w/seroquel & you will experience some impressive sleep.
Posted by Spongemomsquarepants on April 14, 2002, at 0:35:01
In reply to Re: Need some ZZZZ's. . . Klonopin not working, posted by fachad on April 13, 2002, at 22:48:09
Hi,
My husband does not have any disorders (of known origin lol), however, he sleeps horribly. He tried ambien, did nothing at all for him. He now takes tenazapan? It is a relative of klonopin, and if he is in the right "frame" It knocks him on his rear. He can sleep uninterupted for 6 hours. He can feel a bit woozy the next day if he doesn't take it before 11 pm. I take klonopin for anxiety and I have wondered what would happen if he tried that, but I am not into sharing benzos! Too scary. So, I don't know how to compare the two. Klonopin made me very tired the first 2 days, but then I was fine with it.
He is very glad that this med works for him 70% of the time. He takes it about 3 days a week so he can simply get some rest. Maybe you could ask about this one.
Good luck!
Viki
Posted by amber_spirit on April 15, 2002, at 8:49:18
In reply to Need some ZZZZ's. . . Klonopin not working, posted by Annell on April 13, 2002, at 2:23:13
> I've been on Klonopin 1 mg at bedtime and Effexor 225 mg. for one year now. For the past year I have experienced a "hangover" every single morning which is not pleasant and makes getting to work on time a real chore!
>
> For the last 4 weeks, I have been experiencing hourly waking every single night and am thoroughly exhausted. I feel like I have gotten all I can get out of Klonopin and it no longer works as a sleep agent. I am exhausted and miserable due to lack of sleep which makes me feel tired and depressed.
>
> See pdoc next week and he wants to try me on Trazadone and taper off of the Klonopin. Any ideas or suggestions? One other question. . . What exactly does Effexor do to the sleep cycle, if anything? Thanks AnnellI ran into the same problem about 2 mo ago - waking up every hour through the nite. I'm glad to hear of someone else as my
pdoc's response that "it's underlying anxiety" didn't really explain anything. I'd been on Effexor 150mg and Klonopin 1mg for
about 2 years. I didn't have the morning "hangover" just fatigue (which appears to be an Effexor thing). My
dr. tried trazodone which did nothing for me. Tried neurontin which made me worse. I'm off everything but
the effexor now and am going to try to ditch the effexor and try a stimulant as I have a family history of responsiveness
to Adderall and recent events have led me to believe it may apply to me. I'm curious to understand what caused this. The
klonopin was helpful for anxiety and thus sleep. Did I get used to it, was it the increased stress in my life? Guess I
just hate the "vague" answers I get from the pdocs.AS
Posted by nightlight on April 17, 2002, at 0:18:46
In reply to Re: Need some ZZZZ's. . Effexor, posted by Willow on April 13, 2002, at 12:27:38
> Effexor does do a number on sleep, but with time the side effect goes away or lessens. I've just started klonopin. (taken two doses - slept through the first 24hrs, but insomnia isn't really a problem for me, waking up is)
>
> BEST WISHES
> WillowWillow,
If I may intrude, just curious~what is the klonopin treating, if not sleep? I was prescribed Klon 2 1/2 yrs. ago to help relieve severe neck and shoulder pain for a lg. herniated cervical disc.
.5-1 mg. as needed. But only allowed that max dosage daily.It was amazingly effective at relieving tense muscles throughout my back, neck & shoulders (disc was complicated by long-term chronic myofascial pain in upper back, shldrs.,& esp. neck & below occipital bone).As my depression (atypical) deepened I have found myself sleeping weeks away (or very nearly). Arising was torture.
I don't think clonazepam (I switched to generic after my 1st scrip of Klon) ever really made me sleepy, just relaxed me in a totally unobtrusive way.
I've had tons of exogenous life stressors since then. I now use 2-3 mgs. daily prn. It still works well anxiolitically, but Soma now does what the clon. used to do. It truly relaxes muscles, which the other 8 or so 'muscle relaxants' did nothing for (I had never been prescribed a benzo before).Just to be extremely verbose (& I've not read this entire thread) I have tried many, many A-D's w/no relief in depressive symptoms.
I tred EFF. 2-3 yrs. ago, and it knocked me out cold for about 20 hrs. a day. I only got up to 75mgs, and it seems like most EVERYBODY else finds it to be difficult to sleep on. So weird. I wish I found it more motivating/stimulating. But I've only been at 300mgs for about 4-5 days.
I am on it again, and I am also taking pstims, so, they are helping greatly to counteract the Eff. somnolence. (I was recently dx'd ADD).
But, I cd. still take take 300 Eff + 40 mgs. of Add. or dex and take a nap an hr later! Or, and this is what is so great, choose NOT TO and find something productive to do. I take no sleep aids and sleep extremely well.Anyway, what I'm getting to is, can you lower dosage of klonopin or, try taking it a few hrs. before bed? Might help eliminate any daytime grogginess. Does Eff. make u sleepy at all? I believe I have seen u mention that it is helping you with cognitive dulling. Always a plus!
I just know that I have waited over 30 yrs to feel truly awake and alert, not constantly drowsy & wanting a nap. If the Klon. is knocking you out, it may take many months for that effect to lessen unless you make some changes now.
Good luck!
Let me kow how it goes~nightlight
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