![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 38. This is the beginning of the thread.
Posted by Peter on August 15, 2003, at 21:05:42
After years of one med cocktail after the next, my pdoc had me taper off of a lot of the latest meds I've been taking - lamictal, prozac, adderall, strattera.
For months afterwards-well, months after stopping the 1st 2 - only weeks now since stopping the last 2- I've been experiencing some very acute symtpoms. And supposedly I was taking a fairly 'small' dose of everything (50mg lamictal, 5mg prozac, 25mg strattera, and 35mg adderall). BTW, I forgot - I also tapered off of trazadone 50mg and will soon cut mt temazepam 15mg down to the new 7.5mg strength restoril for 2 weeks and then stop it. The adderall was the latest, quickest taper, taking a bit over a week and ending almost3 weeks ago.
Not a day goes by when there isn't constant, obsessive, chatter in my head about all these morbid, shocking things; the inevitable death of my parents, since they're growing old; questions of my own sanity, sudden flashes of haunting memories - constant worry, self-criticizing; can't talk to people, 'cause the self-deprecating voice just keeps questioning me and making me always feel like a 'loser' who can't survive in this world, and will never be able to, no matter what new meds I continue to try.
My pdoc said the best thing for me to do, (now that I am overseas and we can't meet in person (and he's going on vacation) is to double my daily intake of klonopin, the only med I still take and that I've been on at varying doses for 5 years (for anxiety, panick, social anxiety, and insomnia)-even though i find it no longer does anything but prevent panick attacks.
He said that the most important thing now is to just get my anxiety levels way down, so he has me increasing to 4mg daily.
He's also aware that adderall, in the past, had some benefits for me, including 'calming' me and at least 'narrowing down' the constant, random chatter. While it stimulates, it also calms me, albeit in a different way than how klonopin does. I suppose this is where my ADHD-related symptomology comes in, though different doctors have told me different things regarding if I have ADHD or not.
I find, especially now with the increased klonopin, that I am more emotionally numb - this is good in the sense that the constant overall anxiety has lessened.
But it also makes me very tired and inactive throughout the day, and causes me to crave some stimulation. He told me that if, within 4 days of higher klonopin, I don't feel at least 80% better, I should start in again on the adderall 10mg bid. But he also said if I do feel 80% better but I am also tired, that that is another reason for me to resume the stimulant. On the other hand, he seemed to be quite happy when I finally got off of the stimulant, and he even said to me to be careful in assessing my need ofr adderall after 4 days, because I've already come so far in getting off of it.
Bare with me, please. I'm quite confused, and he's already away. He's telling me, I think, that the only reason to NOT start up adderall in 4 days is if I feel at least 80% better and NOT tired (it seems quite unlikely that I won't be tired after the first 4 days of DOUBLING my klonopin intake-wouldn't you say)?
But, in the same sentence, he also gave me the ides to only take the stim if absolutely necessary, as if taking it would negate my former 'accomplishment' of succesfully coming off of it. Can anyone see clarity here where I don't?
As I said above, while the higher klonopin takes away some anxiety, it also makes me more withdrawn and numb. I always remember that with klonopin - it helped my social anxiety in that it helped me get out there around people, but it left me bereft of any drive, motivation, interest, confidence, or 'pep' in being able to step out and talk to anyone or be social in any way.
The stimulant, though it caused problems in synergy with the many other meds with which i took it, seemed to compensate for this withdrawn, sluggish quality and lent me some social interest (unless i took higher doses - like I think the 35mg might have been too high a dose, since it caused me to hyperfocua on singular tasks and made me isolate, callous to the outide world).
Anyway, sorry - I'm almost done. Agh! i could never just write a straightforward, succinct ,short post!
Because of the 'withdrawn numbness the higher klonopin has been giving me, I've been resorting to 1 or 2 beers each night (no more) AND a few puffs of pot, in a search for stimulation.
Tonight, as I smoked pot with a group of people, I felt like I was having a psychotic episode; everyone else seemed 'together' but I was losing it. I was convinced it was sprayed with angel dust or some hallucinogen. My mind was all convoluted, racing, random, negative, morbid thoughts. I was super-self-conscious. Funny, since a few nights before, the pot seemed to rid me of anxiety and help me relax. But I became a basketcase - at least on the inside - I somehow didn't show it on the outside.
So I guess it would seem that the current higher klonopin dose + the addition in 4 days of 20mg adderall makes most practical sense - they both in their own way narrow my thoughts and calm me down.
But this negative episode that the pot triggered (which was, in essence, an exxagerated, though similar, version of what I go thru day by day), makes me consider that I might actually be undergoing a type of psychotic episode in my life, in which case, it would seem that any dopamine/NE increasing or reuptake-blocking meds like stims (adderall included) should be avoided at all costs.
How do I know if this is psychosis? I've even experienced suicidal ideations and the mood-states are non-reactive to my environment; I'm in a beautiful place on vacation, but none of it phases me in a positive way. I just seem to be getting more insane and hopeless (anxious and depressed). I feel like I'm at the end of my rope, and I have no friends to confide in. Please help me, if not with the technical psychopharmacology opinions, than even with a word of encouragement or advice? I'd really appreciate it, and thank you if you even got to the end of this monstrously long, self-obsessed post.
Peter
Posted by McPac on August 15, 2003, at 23:30:07
In reply to I'm scared-am I going insane?, posted by Peter on August 15, 2003, at 21:05:42
"Not a day goes by when there isn't constant, obsessive, chatter in my head about all these morbid, shocking things; the inevitable death of my parents, since they're growing old; questions of my own sanity, sudden flashes of haunting memories - constant worry, self-criticizing;"
>>>>>>>>>>>>>> Sounds like obsessive thinking (OCD), taking an anti-obsessional could help GREATLY! Taking a stimulant could easily make you obsess even more; I'd stay away from the stimulants. Your own words echo this, "(unless i took higher doses - like I think the 35mg might have been too high a dose, since it caused me to hyperfocua on singular tasks and made me isolate". Get that obsessional thinking under control with an anti-obsessional and you'll likely feel MUCH better. Klonopin for the anxiety sounds very good (Klonopin is a good med to take along w/ an anti-ocd med, the combo works well for many. Take care Peter!!!!!!!!!
Posted by stjames on August 15, 2003, at 23:48:30
In reply to Re: I'm scared-am I going insane?, posted by McPac on August 15, 2003, at 23:30:07
You are not going insane. Far from it. Actually, I hate the word. It seems it is the obsessive thoughts
that are the major issue, and consern you the most, correct ? Do you have any compulsive behaviors or rituals that you get caught up in or cannot stop ?I think treating the anxiety is a good place to start, till you can consult face to face with your doc. Then consider some meds that are more specific
for obsessive thinking
Posted by kara lynne on August 16, 2003, at 1:41:17
In reply to I'm scared-am I going insane?, posted by Peter on August 15, 2003, at 21:05:42
-Not a day goes by when there isn't constant, obsessive, chatter in my head about all these morbid, shocking things; the inevitable death of my parents, since they're growing old; questions of my own sanity, sudden flashes of haunting memories - constant worry, self-criticizing; can't talk to people, 'cause the self-deprecating voice just keeps questioning me and making me always feel like a 'loser' who can't survive in this world, and will never be able to, no matter what new meds I continue to try.-
Wow. Can I relate to this one. I'm sorry if I'm stating the obvious, but Peter, I would definitely be staying away from the pot at these times. It is notorious for facilitating 'enhanced' states of paranoia-- something I don't need, thank you very much. It sounds to me like that may be responisible for some of your intense feelings this evening.
Drink some tea and do something calming for yourself to get through the night. Start again tomorrow and try not to throw something so potentially disturbing into the mix, especially while you're going through such a precarious time.
Good luck.
Posted by Jasmine Neroli on August 16, 2003, at 1:48:17
In reply to I'm scared-am I going insane?, posted by Peter on August 15, 2003, at 21:05:42
Hi Peter:
You're not insane, you're desperate for a way out of the pain of continual anxiety. Stick with your Klonopin for now, I've just been learning on this board, about how useful it is for so many people. It seems like you have an extreme case of Generalized Anxiety Disorder, since most of your anxieties are anticipatory in nature, continual worries about "what if" or "what might happen". Do you go over dangerous or tragic scenarios in your head? Trying to figure out how you would react, or what would happen if they really occurred? Then do you feel like you mightn't be able to cope,if they did happen? That's a GAD type of thinking. Your mind can't shut off those thoughts, especially at night. (I used to be like that and found Celexa really helped).There might be an obsessional aspect to it as well. I wonder if adding an SSRI for GAD/OCPD would help??.
Sounds to me like you need to stay away from the stimulants for now....if your mind has this constant agitated thinking going on all the time. Why do you think you crave them so? Did they give you social confidence? Or is it just that the new Klonipin dose makes you dozy?
I'm sorry that I've just given you a bunch more questions to add to your own, and little concrete info!! I was just hoping to help you evaluate your situation and give you encouragement to hang in there! I hope you are able to talk to you doc real soon. Let us know how you are doing and take care!
Posted by Janmar on August 16, 2003, at 2:30:13
In reply to I'm scared-am I going insane?, posted by Peter on August 15, 2003, at 21:05:42
> After years of one med cocktail after the next, my pdoc had me taper off of a lot of the latest meds I've been taking - lamictal, prozac, adderall, strattera.
> For months afterwards-well, months after stopping the 1st 2 - only weeks now since stopping the last 2- I've been experiencing some very acute symtpoms. And supposedly I was taking a fairly 'small' dose of everything (50mg lamictal, 5mg prozac, 25mg strattera, and 35mg adderall). BTW, I forgot - I also tapered off of trazadone 50mg and will soon cut mt temazepam 15mg down to the new 7.5mg strength restoril for 2 weeks and then stop it. The adderall was the latest, quickest taper, taking a bit over a week and ending almost3 weeks ago.
> Not a day goes by when there isn't constant, obsessive, chatter in my head about all these morbid, shocking things; the inevitable death of my parents, since they're growing old; questions of my own sanity, sudden flashes of haunting memories - constant worry, self-criticizing; can't talk to people, 'cause the self-deprecating voice just keeps questioning me and making me always feel like a 'loser' who can't survive in this world, and will never be able to, no matter what new meds I continue to try.
> My pdoc said the best thing for me to do, (now that I am overseas and we can't meet in person (and he's going on vacation) is to double my daily intake of klonopin, the only med I still take and that I've been on at varying doses for 5 years (for anxiety, panick, social anxiety, and insomnia)-even though i find it no longer does anything but prevent panick attacks.
> He said that the most important thing now is to just get my anxiety levels way down, so he has me increasing to 4mg daily.
> He's also aware that adderall, in the past, had some benefits for me, including 'calming' me and at least 'narrowing down' the constant, random chatter. While it stimulates, it also calms me, albeit in a different way than how klonopin does. I suppose this is where my ADHD-related symptomology comes in, though different doctors have told me different things regarding if I have ADHD or not.
> I find, especially now with the increased klonopin, that I am more emotionally numb - this is good in the sense that the constant overall anxiety has lessened.
> But it also makes me very tired and inactive throughout the day, and causes me to crave some stimulation. He told me that if, within 4 days of higher klonopin, I don't feel at least 80% better, I should start in again on the adderall 10mg bid. But he also said if I do feel 80% better but I am also tired, that that is another reason for me to resume the stimulant. On the other hand, he seemed to be quite happy when I finally got off of the stimulant, and he even said to me to be careful in assessing my need ofr adderall after 4 days, because I've already come so far in getting off of it.
> Bare with me, please. I'm quite confused, and he's already away. He's telling me, I think, that the only reason to NOT start up adderall in 4 days is if I feel at least 80% better and NOT tired (it seems quite unlikely that I won't be tired after the first 4 days of DOUBLING my klonopin intake-wouldn't you say)?
> But, in the same sentence, he also gave me the ides to only take the stim if absolutely necessary, as if taking it would negate my former 'accomplishment' of succesfully coming off of it. Can anyone see clarity here where I don't?
> As I said above, while the higher klonopin takes away some anxiety, it also makes me more withdrawn and numb. I always remember that with klonopin - it helped my social anxiety in that it helped me get out there around people, but it left me bereft of any drive, motivation, interest, confidence, or 'pep' in being able to step out and talk to anyone or be social in any way.
> The stimulant, though it caused problems in synergy with the many other meds with which i took it, seemed to compensate for this withdrawn, sluggish quality and lent me some social interest (unless i took higher doses - like I think the 35mg might have been too high a dose, since it caused me to hyperfocua on singular tasks and made me isolate, callous to the outide world).
> Anyway, sorry - I'm almost done. Agh! i could never just write a straightforward, succinct ,short post!
> Because of the 'withdrawn numbness the higher klonopin has been giving me, I've been resorting to 1 or 2 beers each night (no more) AND a few puffs of pot, in a search for stimulation.
> Tonight, as I smoked pot with a group of people, I felt like I was having a psychotic episode; everyone else seemed 'together' but I was losing it. I was convinced it was sprayed with angel dust or some hallucinogen. My mind was all convoluted, racing, random, negative, morbid thoughts. I was super-self-conscious. Funny, since a few nights before, the pot seemed to rid me of anxiety and help me relax. But I became a basketcase - at least on the inside - I somehow didn't show it on the outside.
> So I guess it would seem that the current higher klonopin dose + the addition in 4 days of 20mg adderall makes most practical sense - they both in their own way narrow my thoughts and calm me down.
> But this negative episode that the pot triggered (which was, in essence, an exxagerated, though similar, version of what I go thru day by day), makes me consider that I might actually be undergoing a type of psychotic episode in my life, in which case, it would seem that any dopamine/NE increasing or reuptake-blocking meds like stims (adderall included) should be avoided at all costs.
> How do I know if this is psychosis? I've even experienced suicidal ideations and the mood-states are non-reactive to my environment; I'm in a beautiful place on vacation, but none of it phases me in a positive way. I just seem to be getting more insane and hopeless (anxious and depressed). I feel like I'm at the end of my rope, and I have no friends to confide in. Please help me, if not with the technical psychopharmacology opinions, than even with a word of encouragement or advice? I'd really appreciate it, and thank you if you even got to the end of this monstrously long, self-obsessed post.
> Peter
Hi Peter. I just read your post while looking for some kind of hope on here myself. It does suck when there seems to be no one to confide in. Well, I'm off to a positive start here...It sounds like you just have a need to explain so someone can truly understand you and maybe help.
There are so many things I could comment on in your post, but it's way late, and my brain is getting dopier, so just take this as a "word of encouragement". Even though you think you're not being succinct, this really explained things very well. I think psychotic is a break from reality, and the crap of it is, you're totally in reality. You are tired of feeling the way you do, but you're right there in it. And you're making it through each day even though you feel this way. You're posting in here for help.
You ARE going to make it out of this pit!
Posted by wingedcat on August 16, 2003, at 4:43:01
In reply to I'm scared-am I going insane?, posted by Peter on August 15, 2003, at 21:05:42
I'm so sorry you are feeling this way.
I felt a lot like this in January when I tried to stop taking my medications. The obsessive chatter in my head was really frightening me.
4 mg is a big dose for Klonopin. On 1 mg I am having memory problems and so I'm trying to taper off of it.
Have you tried Wellbutrin? Adderall is a good medication but it IS an amphetamine, and withdrawal from amphetamines can be hell. Wellbutrin has a similar effect as amphetamines but without the emotional ups and downs that Adderall can have. Adderall tended to make me a lot more paranoid too and I think that's common with amphetamines.
Wellbutrin + Klonopin was a really good combination to get me out of the hole.
I'm sorry you're feeling this way, it will pass. You aren't going insane.
I'm glad that you are in a beautiful place on vacation. Are you vacationing with a friend? Go see things! :) I hope you feel better soon.
Posted by Peter on August 16, 2003, at 6:20:57
In reply to Re: I'm scared-am I going insane?, posted by stjames on August 15, 2003, at 23:48:30
> You are not going insane. Far from it. Actually, I hate the word. It seems it is the obsessive thoughts
> that are the major issue, and consern you the most, correct ? Do you have any compulsive behaviors or rituals that you get caught up in or cannot stop ?
>>> No-that's why I eliminated the idea of it being OCD.
> I think treating the anxiety is a good place to start, till you can consult face to face with your doc. Then consider some meds that are more specific
> for obsessive thinking
>>>Well, I've taken every SSRI there is out there over the last 10 years.
But I could never go above a very low therapeutic level, due to emotional numbness and or/switches into hypomania-like states.
Is this really 'obsessional' thinking? I mean, what about the actual quality of the thoughts? The twisting around of things in my head until I manage to make mountains of every mohehill and I get completely overwhelmed and horrified.
Is there even another anti-obsessional drug aside from high doses of SSRI's like luvox?
thanks,
Peter
Posted by Peter on August 16, 2003, at 6:25:08
In reply to Re: I'm scared-am I going insane?, posted by kara lynne on August 16, 2003, at 1:41:17
> -Not a day goes by when there isn't constant, obsessive, chatter in my head about all these morbid, shocking things; the inevitable death of my parents, since they're growing old; questions of my own sanity, sudden flashes of haunting memories - constant worry, self-criticizing; can't talk to people, 'cause the self-deprecating voice just keeps questioning me and making me always feel like a 'loser' who can't survive in this world, and will never be able to, no matter what new meds I continue to try.-
>
> Wow. Can I relate to this one. I'm sorry if I'm stating the obvious, but Peter, I would definitely be staying away from the pot at these times. It is notorious for facilitating 'enhanced' states of paranoia-- something I don't need, thank you very much. It sounds to me like that may be responisible for some of your intense feelings this evening.
>>I think you're absolutely right.
> Drink some tea and do something calming for yourself to get through the night. Start again tomorrow and try not to throw something so potentially disturbing into the mix, especially while you're going through such a precarious time.
>> Definitely. I agree - it can only exacerbate things at this point. Thank you so much, Kara.
Posted by Peter on August 16, 2003, at 6:40:25
In reply to Re: I'm scared-am I going insane?, posted by McPac on August 15, 2003, at 23:30:07
> "Not a day goes by when there isn't constant, obsessive, chatter in my head about all these morbid, shocking things; the inevitable death of my parents, since they're growing old; questions of my own sanity, sudden flashes of haunting memories - constant worry, self-criticizing;"
>
> >>>>>>>>>>>>>> Sounds like obsessive thinking (OCD), taking an anti-obsessional could help GREATLY! Taking a stimulant could easily make you obsess even more; I'd stay away from the stimulants. Your own words echo this, "(unless i took higher doses - like I think the 35mg might have been too high a dose, since it caused me to hyperfocua on singular tasks and made me isolate". Get that obsessional thinking under control with an anti-obsessional and you'll likely feel MUCH better. Klonopin for the anxiety sounds very good (Klonopin is a good med to take along w/ an anti-ocd med, the combo works well for many. Take care Peter!!!!!!!!!
>>>Definitely a possible solution. But what counts as a n anti-obsessional drug other than moderate-to-high-doses of the SSRI"s?
I've tried every SSRI there is. Some have helped me for a short time with my anxiety, but, just about in every case, they ended up either : a) making me emotionally numb and more prone to drinking a lot; b) causing a mood switch toward hypomania-like behaviour.
So I never got passed the lowest possible therapuetic doses of SSRI's - I don't think high enough for OCD. Also, though, I don't have any ritualistic, compulsive behaviour that accompanies the obsessive thinking. Would that still count as a form of OCD?
As for the stimulant, what I was saying is that, yes, at higher doses it made me even more hyperfocused and obssesed with tasks, etc., but at lower doses it actually put a damper on my obsessionalism by calming me and helping me focus constructively on one or two things. It gave me an ability to be patient, and cross each bridge when I got to it. That's why maybe resuming the stimulant at the lower dose that my pdoc proposed might be beneficial; also, it lowered my impulsivity and, when taking it, I never craved excessive stimulation - I never felt the need for any alcohol or drugs.
I was actually asking to be put on an SSRI again this past week, but my pdoc said that it could activate me even more, and that's why he said it's not a good idea at this time, and that we should get my anxiety down now.
I'm really gonna try to not smoke any more pot in the meantime; it's just that when the klonopin make me so withdrawn and spaced-out, I feel like I need stimulation and thus the pot smoking. That's why maybe some of the adderall in a few days, after being further calmed, would also help the tiring side-effects of the klonopin.
Maybe when I get back to NY and my pdoc gets back from vacation, we could discuss resuming an SSRI or another antiobsessional, if another one exists.
thanks,
Peter
Posted by Peter on August 16, 2003, at 8:07:21
In reply to Re: I'm scared-am I going insane?, posted by Jasmine Neroli on August 16, 2003, at 1:48:17
> Hi Peter:
> You're not insane, you're desperate for a way out of the pain of continual anxiety. Stick with your Klonopin for now, I've just been learning on this board, about how useful it is for so many people. It seems like you have an extreme case of Generalized Anxiety Disorder, since most of your anxieties are anticipatory in nature, continual worries about "what if" or "what might happen". Do you go over dangerous or tragic scenarios in your head? Trying to figure out how you would react, or what would happen if they really occurred? Then do you feel like you mightn't be able to cope,if they did happen?
>>>Definitely. 24/7.That's a GAD type of thinking. Your mind can't shut off those thoughts, especially at night. (I used to be like that and found Celexa really helped).There might be an obsessional aspect to it as well. I wonder if adding an SSRI for GAD/OCPD would help??.
>>>Even though my pdoc of 7 years has never diagnosed me with GAD (he has, however with social anxiety, and mixed mood states superimposed on some ADHD symptomology-at least that was the latest diagnosis; other docs I've been to for consultations have said there's no evidence of bipolar, but instead a lot of evidencie for 'depressive anxiety.' Another doc said no ADHD, but 'bipolar otherwise unspecified.' My steady pdoc seems to think it's a bit of everything!
He has prescirbed me every SSRI at different points over the years, and they did seem to help more than anything else with my core anxieties; but they always ended up switching me to what my pdoc called hypomanic-like behaviour or emotionally-numbing me and causing me to crave a lot of alcohol.
> Sounds to me like you need to stay away from the stimulants for now....if your mind has this constant agitated thinking going on all the time. Why do you think you crave them so? Did they give you social confidence? Or is it just that the new Klonipin dose makes you dozy?
>>Well, the adderall did put a stopper on a lot of my anxiety-filled thinking by narrowing my thought processes(sp?) down. In that sense, it calmed me in a certain way. But it also seemed to help with social anxiety where the klonopin didn't - that is, in terms of my energy and confidence. But, I really think an SSRI or something along those lines would be best for me, maybe in combination (though I've tried that too and we just ended up changing everything again because of increased anxiety. My doc said I definitely should not start up an SSRI again now, because he said it would probably increase my anxiety at the beginning (that's true - I've experienced a worsening of anxiety from the immediate, acute side-effects of SSRI's, and I guess he thinks I'm right now too anxious now to go through those acute, pre-therapeutic side-effects that SSRI's have always produced in me.
> I'm sorry that I've just given you a bunch more questions to add to your own, and little concrete info!! I was just hoping to help you evaluate your situation and give you encouragement to hang in there! I hope you are able to talk to you doc real soon. Let us know how you are doing and take care!
> Thank you
Posted by Peter on August 16, 2003, at 8:15:55
In reply to Re: I'm scared-am I going insane? » Peter , posted by wingedcat on August 16, 2003, at 4:43:01
> Have you tried Wellbutrin?
>>Yes, I did once but only for a few weeks. At the time, it made me very physically uncomfortable and more anxious. But then again, who knows what med 'cocktail' I was on at the time and how much of these undesirable effects were due to synergy between meds as opposed to direct effects of the wellbutrin.
>>Wellbutrin seems to make sense to me because of the nature of its dopaminergic activity. I believe, as opposed to a stimulant which, one way or the other, promotes isolated releases of dopamine and then wears off, wellbutrin gradually raises your natural dopamine levels, and my pdoc has told me that a lot of my problems are due to a dopamine deficiency.
But I don't know - he's on vacation now, and he didn't mention wellbutrin. I assume it has the potential in the short-term of riling me up more even if it could help in the long-term-just like an SSRI would if I were to begin it now (according to him).
Thanks
Posted by Peter on August 16, 2003, at 8:18:40
In reply to Re: I'm scared-am I going insane? » Peter , posted by Janmar on August 16, 2003, at 2:30:13
> Hi Peter. I just read your post while looking for some kind of hope on here myself. It does suck when there seems to be no one to confide in. Well, I'm off to a positive start here...
>
> It sounds like you just have a need to explain so someone can truly understand you and maybe help.
>
> There are so many things I could comment on in your post, but it's way late, and my brain is getting dopier, so just take this as a "word of encouragement". Even though you think you're not being succinct, this really explained things very well. I think psychotic is a break from reality, and the crap of it is, you're totally in reality. You are tired of feeling the way you do, but you're right there in it. And you're making it through each day even though you feel this way. You're posting in here for help.
>
> You ARE going to make it out of this pit!> That is encouraging - thank you. I have a lot of trouble seeing the positive things like this, and often need people to help me take a step back and look at the glass as half full. Thanks a lot for this encouragement.
>
>
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>
>
>
>
Posted by Rainee on August 16, 2003, at 11:31:17
In reply to Re: I'm scared-am I going insane? » wingedcat, posted by Peter on August 16, 2003, at 8:15:55
No your not! I know that fear so well .. just knowing that others have the same struggles helps me.. always needed validation that I was still together... anxiety sucks.
Rainee
Posted by stjames on August 16, 2003, at 12:26:25
In reply to Re: I'm scared-am I going insane? » stjames, posted by Peter on August 16, 2003, at 6:20:57
I think you need to find a doc who can propperly treat you. Till then take whatever works, evern if it is not an idea treatment
Posted by Peter on August 16, 2003, at 17:24:16
In reply to Re: I'm scared-am I going insane?, posted by stjames on August 16, 2003, at 12:26:25
> I think you need to find a doc who can propperly treat you. Till then take whatever works, evern if it is not an idea treatment
>
> Well, my steady pdoc went on vacation and will be returning to his office Sept. 2.
In the meantime, I can either make myself more of a basketcase by second-guessing his choice to NOT (at least during these upcoming weeks) put me on another SSRI, since I do believe I have every symptom that SSRI's are meant to treat, though they haven't been ideally succesfully on me in the past.
Or I can trust in his professionalism and do what he says until he gets back; that is, double my daily klonopin from 2mg to 4mg, and resume 20mg adderall if I don't feel at least 80% better within 4 days.
I've been questioning this and confusing myself about it all day; why start up the adderall again if I just 'accomplished' getting it all out of my system? Why even resume the adderall if I'm now noticing that a lot of my anxiety is obsessional, which can be exacerbated by a stimulant?
But I can really drive myself mad constantly asking these questions. He has a legit reason for my not starting up an SSRI, even though it seems like it would be best for me now. He's been treating me since 1996, and I gotta believe him when he says the acute side-effects caused by SSRI commencement can really heighten my anxiety at a time right now when it's high enough (even though I have prozac 10mg tabs with me here(o:
Instead, I'll trust he knows what he's talking about regarding the adderall and that maybe the 20mg adderall does atypically help my obsessionalism in that the obsessionalism might be stemming from adult ADHD symptomology. So a low dose might affect me positively, and if not, it's immediate acting, so I'll stop it.
The klonopin/adderall combo is probably in fact the safest bet for me until he comes back, and it's not going against anything he said.
I'm just really trying to stop my constant 'chatter' and accept things as they are.
I know this is probably the wrong thing to say, but 1 beer before dinner is helping me relax a bit too(-:
(More than that, with all the klonopin I'm taking during this period, would put me right to sleep).
Ahh - and avoid the pot. It could be fun, but during this time it could be Paranoid Central.
Well, my mood will keep changing, and I might have another acute episode, but I'll cross that bridge if/when I get to it. I certainly wouldn't have been able to cross the last one without all of your help, everyone! Thanks again.
Just gotta press on.
Peter
Posted by Dave1 on August 16, 2003, at 20:52:53
In reply to I'm scared-am I going insane?, posted by Peter on August 15, 2003, at 21:05:42
I went through the same fear several months ago, and based on your message and its coherent content and the fact that the voices are coming from inside your head and not outside, I would say you are not going insane.
I took 20 mg lexapro for 3 months for OCD and it made my fears of going insane go away. It be worth a try for you.
dave
Posted by gabbix2 on August 16, 2003, at 23:36:40
In reply to Re: I'm scared-am I going insane?, posted by Dave1 on August 16, 2003, at 20:52:53
I don't know what your previous experiences with pot have been Peter, but I definitely agree with Kara Lynne. I stay so far away from Pot, I thought it would help my anxiety, but it sends me into mind bending anxiety.
I have almost exactly the same fears and anxieties you mentioned, they are always on my mind, and pot while helping other people focus on how "pretty" things are just helps me focus on my terrors.
Incidentally Klonopin was a very bad drug for me
I know it helps a lot of people, but it was overall a depressent for me, which seemed also to exacerbate my anxieties. Valium helps me much more.
That can be so confusing though as we're all so different.I don't think you are insane though, it sounds very much like you are suffering from anxiety and depression. Depression manifests itself in so many more ways than "sad"
Posted by Peter on August 17, 2003, at 13:15:52
In reply to Re: I'm scared-am I going insane?, posted by gabbix2 on August 16, 2003, at 23:36:40
That's annoying; I just wrote up a huge post and it got erased!
Anyway, I'm sorry to go on and on again like this, but my constant worry has gotten pretty bad tonight.
Firstly, remember I said that right before my doc went away for vacation he said I should double my daily 2mg klonopin to 4mg?
Well, he was just leaving that same day and I had for weeks been sending him like 4 emails a day, so I understand his reasoning for getting my anxiety down.
But, until a few weeks ago, I had been taking lamictal, prozac, strattera, adderall, klonopin, temazepam, ambien, and trazadone daily for months, and a few weeks ago I completed my taper of everything and ended up on only klonopin!
Isn't it possible that my acute anxiety might still be due to my body/mind undergoing a process of reaching a state of equilibrium after having gone through so many biochemical shifts from so many multiple med tapers?
If so, is it worth my ramping my klonopin dose all the way up to 4mg, if my anxiety might naturally lessen anyway over time?
I've been taking klonopin at differing doses for 6 years, but never over 2mg daily. And now, all of a sudden, in a voice that didn't sound much like he was very sure of what he was saying anyway, my doc tells me to ramp it all the way up to 4mg.
I've heard that klonopin is 1 of the hardest meds to come off of. How on earth will I be able to taper from 4mg if we get to a point (and I'm sure we will) when I will have to reduce back down?
Is it really worth my raising it up until my body gets adjusted to the new 4mg dose. That will only make it all the more difficult to reduce (I was already concerned about this with my former max 2mg dose).
Don't get me wrong - I know from experience that everytime you startup, resume, or increase a med, the factor is introduced of you possibly having to undergo withdrawal if you need at some point in the future to reeduce or come off it again.
But I'm just wondering if such a severe move up to 4mg is worth the trouble it might cause reducing it in the future. Also, I already thought my memory was fried from years of up to 2mg klonopin, how much all the more will I have difficulty finishing sentences, and remembering words and events with 4mg klonopin? (even though my pdoc said he doesn't think benzo-induced memory problems are cumulative - so, if my memory probs are cause by the klonopin, I would have felt it years ago, earlier in my klonopin therapy).
Anyway, this obsessive worrying does really show that I have a definite obsessive element to my anxiety, right? In fact, my disorder touches upon multiple areas of anxiety - social anxiety, OCD and GAD (though my doctor never specifically diagnosed me with these last two), anxiety stemming from probable adult ADHD (mind spinning, worry, etc.) and/or recurring mixed-mood bipolar episodes.
Another thing wbout the klonopin; I'm in France now, so I had to get Rivotril 2mg pills (the only dose the pharmacy had). It's very hard to break up the rivotrils, so is it ok that I'm taking 2mg worth of normal 0.5mg orange klonopin pills spread throughout the day but a 2mg rivotril at bedtime? Is it the exact same med composition or am I introducing a whole new mess by mixing the two?
So:
1) is it worth ramping up the klonopin to a whopping 4mg? 2) Is it ok to mix klonopin and 'rivotril?' same exact med?
Here's my THIRD MAJOR WORRY:
I also said in a former post that my pdoc said if the higher 4mg dose of klonopin doesn't make me feel at least 80% 'better' by 4 days, I should resume 10mg adderall bid.
But I just finally got off of all that medication, and adderall was the hardest one to taper! Now he said, again with a sense of unsureness evident in his voice (unless that was my paranoia), that I should resume the adderall if I'm less than 80% 'better' - how the hell am I supposed to gage whether I'm greater or less than 80% better than 4 days ago? And in what respect 'better'?
So here's more stress - deciding whether to start up the adderall again - now it is true, however, that if I do start it up, it would be at a lower dose and not in combination with 5 other meds (I used to take 35mg adderall +lamictal, prozac, etc..).
Then I though that, while the 35mg adderall I was taking for months helped me focus, gave me drive, and seemed to put a bit of a damper on my wild, wandering worries and thoughts, it still in the end caused me to become quite callous toward others, made me a bit apathetic, and caused me to isolate, hyperfocus, and be socially avoidant.
Than again, that was a higher dose, and it was also combined with many other meds and could have been the result of some sort of synergy.
This way, it would just be a lower dose adderall with one other drug - klonopin, and a high 4mg dose of it, at that.
But still, I can't stop obsessing about how to decide if I'm 80% better tomorrow, and whether I should resume the adderall or not. It seems like a shame after all that trouble tapering off of it; but, it might really help me in ways that the klonopin is not - like it might, (especially at this lower dose), take the edge of my ADHD-related worrying, and target that area of my anxiety that the klonopin cannot.
However, if this is all stemming from an OCD disorder that, after all these years, my 'top-of-the-line' pdoc has overlooked, maybe the adderall will just get me into that zone of social avoidance and obsessive hyperfocus, which, BTW, took me along time to admit was a problem, because I liked the feeling of it! But objectively, and how it affected others, it was sort of a 'trap.' What if I get caught in that trap again? Then again, the adderall, as I said, might really help.
I'm so confused, and I'm really working myself up again. I've done everything my doc said. And now, since that night of pot terror, I'm completely avoiding pot. I also do exercise daily, which I know helps the mind a lot, and TRYING to keep a healthy sleep schedule.
But it's already almost the 4th day on 4mg klonopin, when I must decide, and I'm stressed out!
I can't reach my pdoc, obviously; he's left #'s on his machine for docs that are substituting for him while he's away, but I am so not ready to call up a new doc and tell him my whole history; in fact, I don't even know what I'd be calling to ask him.
And also, my doc said we definitely should NOT start me up again on an SSRI now, since I'm so worked up and the temporary acute side-effects could exacerbate my anxiety even further, obviously something he thinks the adderall would not do.
So should I just not listen to my 'inner chatter,' stay on the new 4mg klonopin dose and, if still feeling not so good tomorrow (which I guess is 'less than 80% better'), should I just take the damn lower-dose adderall and not think about it?
Or should I not take the adderall tomorrow since this might be an overlooked OCD element that the adderall could exacerbate?
Or should I not take it just because, maybe at the current time, after having succesfully tapered off so many meds, 'less is more.'
I'm so sorry; I just can't stop my brain, and I'm getting stressed about what to decide and do tomorrow. Maybe the first adderall dose will miraculously get right at the target of all this - maybe all the worrying is ADHD-induced. Or maybe it would help by just giving me a little mood lift and confidence and energy that the higher klonopin has taken away. Is that enough of a 'justification' to resume it after all the hard work of coming off of it?
There are so many variables, it's so hard to figure out, I'm sick and tried of second-guessing everything - did my pdoc know what he was saying this last time or was his mind on other things, like getting his family ready to leave for the airport (it was the same day, anyway).
Agh! This is pure foolishness. Maddening!
sorry,
Peter
Posted by Peter on August 17, 2003, at 13:21:06
In reply to AGH! This is too much!!, posted by Peter on August 17, 2003, at 13:15:52
Sorry, but something else I constantly forget to ask my pdoc:
Through the last few years of changing med combos, etc., one thing I've been taking EVERY night without ever taking a break is a 3mg melatonin pill.
I started taking it to help get my carcadian rhythms in order years ago, and my doc ever touches upon whether I should remain taking it or not.
Is it dangerous to take it for so many years?
Is it possible to just stop it cold turkey or would it 'rock the boat' a bit too much at this time?
Just some of my hypochondriasis coming out,
Peter
Posted by wingedcat on August 17, 2003, at 16:28:53
In reply to AGH! This is too much!!, posted by Peter on August 17, 2003, at 13:15:52
GO with your gut. If you feel that 4mg is too much, than don't go there, especially if you've never taken that much before. That's a pretty high dose, if I tried to take that much I would be so out of it and tired and confused.
I ran out of Wellbutrin (stimulating antidepressant) a few days ago and so I was on the Klonopin alone for a while. I felt so funky, memory loss, so tired, confused, sleeping all the time. I felt better since I started the Wellbutrin, I think Klonopin alone is just too sedating, for me at least.
I think adding the Adderall might help, maybe not as a long term thing but until you can see your doctor it's the fastest "upper" you can get, as something like Wellbutrin would take a long time to work. And if you felt like I did when I ran out of WB, you probably need an "upper" to snap you out of this. When people are very depressed they sometimes prescribe Cytomel, Ritalin, or Adderall to give you an immediate response.
Rivotril is indeed the same med. If you're used to taking doses at spaced intervals you should at least try cutting the pill into approximate halves. I know of some people who take the whole dose at night, but you should probably do what you're used to, especially since your body is physically dependent on it and tampering with that may trigger withdrawal symptoms.
You are on vacation, I say take some Adderall and go sightseeing with your friends, you're in France for heaven's sake!!! Get away from the computer and go play!!! You'll be ok!
Posted by Jasmine Neroli on August 17, 2003, at 17:06:13
In reply to Re: AGH! This is too much!! » Peter , posted by wingedcat on August 17, 2003, at 16:28:53
Hey Peter!
Jasmine again. I just wanted to echo what has already been said "follow your instincts". Sometimes we forget that we know ourselves best. Your doc can only guess at how you were feeling when you called. The constant worrying you have, stops you from trusting your own feelings..or it clouds them. I know, cuz I've been there with GAD last year. I waited until I had some pretty severe anxiety/hysteria attacks before I followed what my feelings were telling me! The problem with ignoring it (and not medicating yourself adequately as a result) is that you can fall headlong into a very BLACK hole of depression too.
IMHO, I think you might be stressing/confusing yourself over the meds issue to the point that you might just go there too. You sound like you're leaning toward taking the 4mg Klonipin (maybe do it in 2 sep. doses, if you can) and then adding the Adderall tomorrow (unless feeling VERY much better). I'm pretty sure that's what you WANT to do. If so, go with it!!!!!
Then, once you've made a decision (and it's based upon the best researched info you can get!! and your own gut) I think you will feel better, more settled.
Also, I wonder if you find being in France stressful??? As a traveller myself, I always found it stressful, but didn't realize until ATERWARDS! Like you feel out of control cuz you don't have access to the the familiar..like your doc.
Do what you feel is right, accept it as the most informed decision you can make. Relax and look around you. You WILL be OK.
All the best, Peter!
Posted by Peter on August 17, 2003, at 18:33:11
In reply to Re: AGH! This is too much!! » wingedcat, posted by Jasmine Neroli on August 17, 2003, at 17:06:13
> Hey Peter!
> Jasmine again. I just wanted to echo what has already been said "follow your instincts". Sometimes we forget that we know ourselves best. Your doc can only guess at how you were feeling when you called. The constant worrying you have, stops you from trusting your own feelings..or it clouds them. I know, cuz I've been there with GAD last year. I waited until I had some pretty severe anxiety/hysteria attacks before I followed what my feelings were telling me! The problem with ignoring it (and not medicating yourself adequately as a result) is that you can fall headlong into a very BLACK hole of depression too.
>>>oh yes, this is true.
> IMHO, I think you might be stressing/confusing yourself over the meds issue to the point that you might just go there too. You sound like you're leaning toward taking the 4mg Klonipin (maybe do it in 2 sep. doses, if you can) and then adding the Adderall tomorrow (unless feeling VERY much better). I'm pretty sure that's what you WANT to do. If so, go with it!!!!!
>>>You're right. I'm gonna do it!
> Then, once you've made a decision (and it's based upon the best researched info you can get!! and your own gut) I think you will feel better, more settled.
> Also, I wonder if you find being in France stressful??? As a traveller myself, I always found it stressful, but didn't realize until ATERWARDS! Like you feel out of control cuz you don't have access to the the familiar..like your doc.
>>>It's beautiful here, but traveling in general definitely does have its stressors. And this particular trip does too; it's like a family reunion thing, and it could get pretty hectic.
> Do what you feel is right, accept it as the most informed decision you can make. Relax and look around you. You WILL be OK.
> All the best, Peter!
>>>>YOU GUYS ARE ABSOLUTELY THE BEST!! THANK YOU SO MUCH!! I will chill, take the adderall 20mg, keep the klonopin at @3.5-4mg, and aim to have fun until I go back home and, see my pdoc, get settled and back into the swing of things again. You guys have helped me beyond what I can express. Thank you!
Posted by Jasmine Neroli on August 17, 2003, at 22:57:28
In reply to thank you, posted by Peter on August 17, 2003, at 18:33:11
You're welcome!
All of a sudden, I need to know how you are getting on :). So keep in touch with this board and let us know how it goes! Have a great trip.
Jas
Posted by Peter on August 18, 2003, at 5:35:02
In reply to Re: thank you » Peter , posted by Jasmine Neroli on August 17, 2003, at 22:57:28
> You're welcome!
> All of a sudden, I need to know how you are getting on :). So keep in touch with this board and let us know how it goes! Have a great trip.
> Jas
>>>As soon as I awoke today, I took 10mg adderall and .75mg klonopin (I've decided to take 3.5mg total rather than 4mg, and I'm dividing it as .75mg+.75mg during the day + my routine 2mg RIVITROL at bedtime). My doc has had me stick with the 2mg dose at bedtime, along with my 15mg temazepam, which I will cut down to 7.5mg restoril as soon as the script gets here, and then stop taking entirely after @2 weeks.
Late afternoon today I'll take my second .75mg klonopin + my second 10mg adderall.
>>>Didn't really sleep well last night-kept on waking up throughout the night, so my mood is a bit low anyway today. But I'm gonna try to stick to the exercise routine I built up since I last tapered off the adderall. Interestingly, it used to be very hard for me to do any exercise when taking adderall, because I had no incentive to (I guess my DP/NE levels were already up there, in a sense), and I usually stayed indoors working. I'll try to stop that trap before I fall into it, and keep up the exercise, even if the adderall increases my heartrate-I'll just be careful doing it.
Another interesting thing: before leaving NY, I was really stressed out and began smoking cigarettes again after almost 3 years of having quit smoking. I'm noticing that I tend to not smoke much during the day at all. But after I take my bedtime 2mg klonopin, I smoke like a chimney in bed before going to sleep! I wonder why that is? Gaba Galor but no dopamine stimulation?
Anyway, that's just what I considered an interesting aside. Time to exercise, then see if I can compose some music (I've had writer's block for ages) and then keep going!
So far so good, but then again I just woke up!
I'd love to know how all of you are doing, as well. I'd love to help in any way I can. I really support this board; what an incredible way for people to help each other out! I'd like to contribute on that side; in other words, not only always being the one who is getting helped out(-:
So what's up Jasmine, everyone? Jasmine - I saw your SAD treatment algorythm and found it extremely informative and lucid - much moreso than a lot of ones I've seen in medical journals. Also I saw a post you had commented on regarding tobacco/nicotine and it's MAOI-B enhancing properties (sorry if that's not correct terminology). What do you think about that upcoming selegeline transdermal patch? Seems pretty cool - would it really surpass the dietary restrictions of other irreversible MAOI's because it is administered directly to the bloodstream. And how is selegeline as compared to the big 2 - parnate and Nardil? Are they totally different in that they work on MAO-A inhibition, while selegeline is an MAO-B inhibitor (is that right?). My doc has considered MAOI's for me in the past, but my anxieties about the diet got in the way.
I'm blabbering on. Time to check out France! I'll check back later (I'm on a laptop).
Peter
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