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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by avoidant on October 14, 2006, at 16:10:51
Hello folks, yesterday at bedtime i took 4 mg klonopin, 750 mg lyrica and already taking buspar 15 mg daily in three divided doses.TOday i wake up with severe ataxia,absolutely no coordination. Which ingredients of the mix could be the cause? i have never been in ataxia before with clonazepam, but it's the second day i took lyrica. Should i suspend Lyrica? or should i suspend Buspar? I don't believe buspar is the cause. What do you guys think?
Posted by yxibow on October 15, 2006, at 3:03:22
In reply to ATAXIA.. with klonopin/buspar/lyrica, posted by avoidant on October 14, 2006, at 16:10:51
> Hello folks, yesterday at bedtime i took 4 mg klonopin, 750 mg lyrica and already taking buspar 15 mg daily in three divided doses.TOday i wake up with severe ataxia,absolutely no coordination. Which ingredients of the mix could be the cause? i have never been in ataxia before with clonazepam, but it's the second day i took lyrica. Should i suspend Lyrica? or should i suspend Buspar? I don't believe buspar is the cause. What do you guys think?
The BuSpar, most likely. At least from my experience with it. Among the chief side effects is dizzyness spells, which you are experiencing as ataxia, as they are related in the inner ear and balance control of your body.Its hard to say, though.. since you have been taking the Buspar for a while. It is possible that the Lyrica synergistically activated side effects in BuSpar.
-- Jay
Posted by Lindenblüte on October 15, 2006, at 14:02:04
In reply to Re: ATAXIA.. with klonopin/buspar/lyrica » avoidant, posted by yxibow on October 15, 2006, at 3:03:22
klonopin gives me some kooky balance for about 2 hours after I take it. .5mg in the am
I've noticed that my handwriting is difficult to control lately. I've been quickly increasing my seroquel dosage, so I'm not really sure what's to blame.
hope it goes away- talk to your pdoc ASAP, because you don't want to have to motor symptoms interfering with your life.
-Li
Posted by willyee on October 17, 2006, at 0:41:14
In reply to Re: ATAXIA.. with klonopin/buspar/lyrica, posted by Lindenblüte on October 15, 2006, at 14:02:04
> klonopin gives me some kooky balance for about 2 hours after I take it. .5mg in the am
>
> I've noticed that my handwriting is difficult to control lately. I've been quickly increasing my seroquel dosage, so I'm not really sure what's to blame.
>
> hope it goes away- talk to your pdoc ASAP, because you don't want to have to motor symptoms interfering with your life.
>
> -LiSince ur taking sedatives,try using a small dose of a stimulant,a partial pieace of a caffiene tab,which you get at ur local store,pure caffiene.
Sometimes it actualy balances out.At times with too much sedation the addition of caffiene put me to sleep nicly,a stimulant doesent always cause jitters,your using it now to counterbalance so its a different story.
Posted by Lindenblüte on October 17, 2006, at 15:06:01
In reply to Re: ATAXIA.. with klonopin/buspar/lyrica, posted by willyee on October 17, 2006, at 0:41:14
I drink coffee in am, and have soda or tea at lunchtime.
that's plenty of caffeine for me!
good idea, though. I'm usually most off balance in late afternoon/evening
and I also take provigil 200mg in am.
-Li
ps good thing I'm not a professional musician/athlete
Posted by zeugma on October 18, 2006, at 18:05:35
In reply to Re: ATAXIA.. with klonopin/buspar/lyrica » willyee, posted by Lindenblüte on October 17, 2006, at 15:06:01
Buspar ataxia/wooziness is noteworthy for its extremely short duration (I'll feel seasick for about half a minute, then it passes). Ironically, it's also used to treat something called 'cerebellar ataxia' (parenthesis for Lindenblute and other biologists- there was a most interesting study in an obscure Italian journal a number of years ago which confirmed my hunch that Provigil is anti-ataxic and that this effect probably involves the cerebellum- the study merely showed cerebellar activation with Provigil, but the cerebellum is intimately involved in coordinated movement. The author of the study said the results support the role of the cerebellum in "alert experience").
As for caffeine, one Vivarin on waking for an extreme need to stay awake long enough to get out of the house.
-z
Posted by Lindenblüte on October 20, 2006, at 11:41:04
In reply to Re: ATAXIA.. with klonopin/buspar/lyrica » Lindenblüte, posted by zeugma on October 18, 2006, at 18:05:35
Hmm- thanks for telling me about the provigil effect on cerebellum control of coordinated mvmts.
That's really interesting-- I wonder if it acts on the same cerebellar system that is compromised under alcohol intoxication.
Is "ataxia" a symptom of alcohol intoxication? I'm trying to learn more about the exact meaning of what a neurologist / neuropsychologist / psychiatrist would consider "ataxia".
I did have a lovely experience a few years ago (before I ever took psych drugs) of middle ear problems that caused extreme vertigo (and of course a lot of stumbling/falling/discoordination. But it was mainly affecting my ability to walk and remain oriented relative to gravity. Even when my vestibular system was 90% compromised, I don't recall my fine motor skills seeming poor. (I was still playing in the orchestra at this point, so it couldn't have been THAT bad!)
apologies that I have nothing substantial to add regarding klonopin. I may feel ever so slightly off balance, but it's nothing compared to sleep deficit or even the mildest of alcohol intoxication. AND I've never had an attack like zeugma describes of acute wooziness. I've been feeling like that a lot, but I think it's more related to hypoglycemia and my body getting adjusted to 300mg of seroquel (which messes with bloodpressure when standing and also blood sugar).
-Li
Posted by zeugma on October 23, 2006, at 4:40:16
In reply to Re: ATAXIA.. with klonopin/buspar/lyrica, posted by Lindenblüte on October 20, 2006, at 11:41:04
interestingly, Provigil seems to be particularly effective in cerebral palsy, including cases in which walking was all but impossible prior to provigil use.
The cerebellum receives extensive inputs from the vestibular system which regulates balance. Provigil also reduces GABA levels (though not sure if it does so specifically in the cerebellum), while both alcohol and benzodiazepines potentiate GABA (and benzos do so with varying potencies in the cerebellum). That could be the mechanism by which these drugs have opposing effects on ataxia.
-z
Posted by Lindenblüte on October 23, 2006, at 9:10:31
In reply to Re: ATAXIA.. with klonopin/buspar/lyrica » Lindenblüte, posted by zeugma on October 23, 2006, at 4:40:16
> interestingly, Provigil seems to be particularly effective in cerebral palsy, including cases in which walking was all but impossible prior to provigil use.
>
> The cerebellum receives extensive inputs from the vestibular system which regulates balance. Provigil also reduces GABA levels (though not sure if it does so specifically in the cerebellum), while both alcohol and benzodiazepines potentiate GABA (and benzos do so with varying potencies in the cerebellum). That could be the mechanism by which these drugs have opposing effects on ataxia.
>
> -zVery cool- thanks for the info. I love the cerebellum. It's my favorite part of the brain. the gorgeous purkinje cells. the mossy fibers, the fact that the majority of the body's neurons are a single class of neurons in the cerebellum (granule cells)-- well, it all points to how challenging locomotion and motor coordination is, and how elegantly nature has met this challenge.
never been on provigil and alcohol simultaneously, however, I *have* experienced klonopin and provigil simultaneously [but I failed to pay attention]. I will pay more attention to gross and fine motor skills next time life demands this particular combination of drugs.
-Li
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