![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 14 to 38 of 38. Go back in thread:
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
Posted by Peter on August 18, 2003, at 13:30:54
In reply to Re: thank you » Peter , posted by Jasmine Neroli on August 17, 2003, at 22:57:28
I'll try to keep this brief. Second half of the day I haven't been feeling so hot.
The first 10mg adderall dose that I took upon awakening seemed to pep me up a bit and give me a bit more social boldness.
The second 10mg dose, which I took at 6p.m here, didn't fare so well. As the dose kicked in, I got some new creative energy, and was able to play and enjoy the piano for about 20 minutes. I then noticed increased social boldness as I conversed with someone.
But then, all of a sudden, it's like the bad side-effects all hit me at once - armpits sweating constantly, I noticed my RHR was up at @105bpm (my raised RHR was something that concerned my pdoc when I was taking higher doses of adderall in the recent past).
Also, I am noticing a certain type of anxiety that is hard to pinpoint - it's like a spaciness and general feeling of being ill at ease, which hits me in waves.
I realize now that I was living in this state for almost a year, taking adderall 35mg a day, without realizing that it might have been heightening my anxiety and general malaise.
Now, I have no idea if I should give it more time and take the 20mg a few more days, or if, in doing so, I would ultimately just be getting my brain once again adjusted to a med that I'd probably end up coming off of in the long-run anyway.
It has it's benefits (listed above), but I just feel a bit uneasy about it-and stopping after just one day would probably not produce any withdrawal symptoms, as I haven't given my body enough time to accimate to it.
But then what? If I back up and decide to stopand not after all resume the adderall, I'll be taking 3.5-4mg of klonopin daily and will probably be quite tired and moody.
Damn, this sucks that of all times, my pdoc has got to be on vacation now! I know I sound selfish, but I'm confused again )o:
Peter
Posted by Peter on August 18, 2003, at 20:16:07
In reply to Re: AGH! This is too much!! » wingedcat, posted by Jasmine Neroli on August 17, 2003, at 17:06:13
Ok. Here's the situation. One day of adderall 20mg, and, even after calming down for 4 days on 3.75mg klonopin, I experienced extreme mood lability and the obsessional worrying seems to have increased. The adderall had it's beneficial points (drive, focus, mood-lift, calm), but I would say the resultant mopiness, comatose spaciness, and exacerbation of obsessional thinking far outweighed the benefits.
I realize this is only after ONE day of the adderall, but I am quite familiar with the drug, as I've taken it on and off for 1-2 years, and, if I were to be brutally honest with myself, I can say that each time I fell into a callous, detached, hyperfocused haze that I was too sucked into to notice and too afraid to change even if I to some degree did notice. But, having been off it for a few weeks and having started it up again today, I can perceive more clearly the detrimental effects, and I believe I do not want to get deeper into that mess by continuing the adderall. I just don't understand why my pdoc suggested that i resume it rather than start an AD.
It is OBVIOUS to me, and evident in my posts (as some of you have noted), that my main difficulty now that is destroying me is my obsessional anxiety and resultant depression.
I have tried all SSRI's in the past. They all worked well in this particular area, though they might have exacerbated other areas of my diagnosis. My pdoc has concurred with me that I've reaped benefits for my anxiety from SSRI's, but he is more of the 'cutting edge,' 'experimental type' (great at first, but I've since come to desire a doc that sticks by more 'tride and true' methodology), and would probably in the end want to try out strattera or Welbutrin again on me (both of which agitated me first time around), believing somehow that a large part of my comorbid disorder stems from low dopamine levels. I'm not mocking him; I highly respect his genius, truly. But I get tired of being the gineau pig.
Here's the question: He won't be back until Sept.2, and not available for a session until Sept.9. He answered 'no, not the right time' on that last phone call when I asked if I could start up an SSRI. But With this much klonopin, I would think that whatever pre-therapeutic acute side-effects an SSRI would cause would be at least lessened.
So, I can either:
a) continue the adderall with the possibility (improbable, says my 'gut') that it will be different this time and I'll feel better after multiple days on it.
b) switch to adderall XR (I found a two year old unopened script from when I used to take XR, but we decided, as it doesn't have a steady pulse mechanism like strattera, that it really doesn't offer much improvement in terms of 'smoothness.'). Then again, that was then, this is now. The XR, from what I remember, does seem to pack less of a punch, which might be a benefit for me at this point (that is, if it;s not too old a script to be effective).
b) STOP the adderall; do not continue it for a second day, and just stick with the higher-than-usual klonopin dose and nothing else; this will undoubtedly render me extremely tired and probably depressed, but is a simpler regime to take until doc returns.
c) Take out my 10mg prozac stash, and just start taking 5mg every other day, and deal with the difficult side-effects for a few weeks before it starts to work, knowing that when it does start to work, it will most probably be the best solution now with the widest therapeutic range for various anxieties and depression. In addition, any anxiety side-effects, etc. could be helped by my current high-dose klonopin. Of course, though, there is a chance that this in fact would not be a right move for reasons that I, not a doctor, cannot understand.
As for my doc's long-term plans with strattera or wellbutrin, or any new drug on the block, he's a great guy (REALLY great), but as many of u have said, albeit in different words, this is MY body/mind, not his; and I'm in no mood for further experimentation. It's time to function in life, and if the SSRI's have proved conducive to those ends in the past, i can deal with possible overactivaion/alcohol cravings if and when it comes to that as it did a few times in the past after a few months of SSRI therapy.
I'm sorry for going on like this - honestly, I've never had such an intense streak of obsessional anxiety. As for why such a high dose of klonopin isn't helping, I don't know - I guess it isn't efficacious for OBSESSIONAL type of anxiety?
Anyway, I really took to heart what some of you said that sometimes we just need to take matters into our own hands in emergency situations, but I don't know if that is wise in this specific situation with the prozac, especially with it's extra long half-life (if it begins to really agitate me, it'll take a while to get out of my system). But who knows - at this point I'm talking out of my ___, and it's 3a.m here.
But I'd really appreciate your thoughts given this new info and the 3 possible steps I can take.
Thank you so much again,
Peter
Posted by Jasmine Neroli on August 19, 2003, at 1:06:55
In reply to Re: thank you, posted by Peter on August 18, 2003, at 13:30:54
Hey Peter: Oh how frustrating for you! Maybe the second dose of Adderall just was a little too much to handle, you may be especially sensitized to it now, after withdrawing for a little while.
Maybe just keep the morning dose only?
The sweating/increased HR sounds like an adrenalin response to me. Anxiety or withdrawal??
The spaciness feeling maybe a response to the Klonipin, instead of the Adderall. Did you feel like that yesterday,or the last few days before you took Adderall again? I have just started Klonipin, cuz my anxieties have started on a mild level again (and I wanted to "catch" them before they got worse) and I felt quite spacey for about 2 hours, about 1.5 hours after taking it. Since I'm taking nothing else right now, I KNOW it's the Klonipin...unlike you, who have so many factors to try and figure out. However, once the kinda sedated spacey feeling died down, I felt very relaxed and calm. But I didn't have a lot energy or "brightness", so I can see how you would want to get that back. It maybe that, for people like us, we can either lose the anxiety and be relaxed, but not be very lively and creative OR have the "bouncy" side and all the anxieties/worries too! What we are looking for, is a "balance", isn't it???
For me, right now, I'm happy to be calmed down again :). I wish that for you too, right now!
Can you let go of your need to be creative and "alive", for a few weeks. So you can rest your nerves?
And no, you are not selfish, you got such a lot to wade through, and need a sounding-board, to help sort it out.
Take care.
Posted by Jasmine Neroli on August 19, 2003, at 2:10:27
In reply to REALLY need advice just once more, posted by Peter on August 18, 2003, at 20:16:07
Hello there. 3 am and you're not sleeping...aagh! I remember those nights.Wake up already thinking a whole bunch of stupid thoughts, as tho' they kept on going on whilst you were asleep! So sorry that you're suffering still.
Coupla thoughts: (1)Nicotine gives you an immediate norepinephrine kick from the adrenal cortex (you said you were smoking and craving it, right?). Then it stimulates glucose release into your blood stream and you become energetic as your blood sugar rises.The stimulation suddenly ends (after cigarette ends), followed by depression and tiredness. This may be part of that cycle you are talking about, and the HR/sweating thing. Also, if you stop smoking for 24 hours (apparently)it takes longer for any emotional equilibrium to return, once disturbed. (No wonder it's SO hard to quit!). Can the smoking be part of the cycling equation you are experiencing? (2) Adderall has about a 6 hour effect and can cause lethargy on initial dosages. So maybe you're reacting like you just started it and were never on it before? In my answer to your previous post I suggested taking only the morning dose. I wonder if you can handle that amount better (i.e. adjust to it more easily).(3) I think you are EXTREMELY sensitive to any chemical that has a direct affect on neurotransmitters, including alcohol, THC, nicotine & probably caffeine. Your brain has been over-primed and probably "re-wired" by all the different drugs and life experiences you've been exposed to over the years. It's almost impossible to know how to advise you, cuz your brain is not a "blank canvas" or virgin territory.
HOWEVER, IMHO...if you feel that the Adderall effects are so noticeable and negative compared to how you've felt recently, then YES, stop it until you are in NY. Make sure, it's not the nicotine though! If you wanna take a chance on the XR having a less pronounced effect, you could try that, but it maybe best to just stop it altogether.
At the very worst, the Klonipin helps you stay calm, doesn't it? I think your goal should be as relaxed as you can. I kinda feel that Klonipin is the most important one right now.
DON'T take the Prozac yet!! Too many drugs substituting for too many other drugs.....confusion, meltdown, HEEELP! (That's your brain talking, hehe).
If your obsessional thinking/worrying is now specifically about the medications. Tell yourself something like the following, everytime the thoughts come up :"I'm on vacation and resting my brain/mind/emotions from all other drugs. On September 3 I will do informed research about available medications, evaluate my emotional state and prepare to visit my doctor. End of discussion"
And Peter, I'm gonna give you an assignment!! Next time you post, tell us which part of France you are in, and describe something you've seen in great detail. Change of focus.
Retrain your observations to "outside" of you, if you can. Your sensitivity is also a HUGE asset.
Be kind to yourself :)
Jasmine
Posted by Peter on August 19, 2003, at 5:53:44
In reply to Re: REALLY need advice just once more, posted by Jasmine Neroli on August 19, 2003, at 2:10:27
> Hello there. 3 am and you're not sleeping...aagh! I remember those nights.Wake up already thinking a whole bunch of stupid thoughts, as tho' they kept on going on whilst you were asleep! So sorry that you're suffering still.
> Coupla thoughts: (1)Nicotine gives you an immediate norepinephrine kick from the adrenal cortex (you said you were smoking and craving it, right?). Then it stimulates glucose release into your blood stream and you become energetic as your blood sugar rises.The stimulation suddenly ends (after cigarette ends), followed by depression and tiredness.
>>yes, that's what it has always felt like to me.
This may be part of that cycle you are talking about, and the HR/sweating thing. Also, if you stop smoking for 24 hours (apparently)it takes longer for any emotional equilibrium to return, once disturbed. (No wonder it's SO hard to quit!). Can the smoking be part of the cycling equation you are experiencing?
>>I'm not sure; I haven't really been considering my return to smoking as even a factor in all of this. I do notice, however, that each cig during the day stimulates me initially and then makes me feel depressed, like I wanna go to bed. That's why I really only smoke at night while reading in bed (and that, I guess, is what's been contributing to my poor-quality sleep. I definitely plan on stopping smoking again; I did quit after years of use - and didn't smoke for 3 years! Then I started it up 'cause of my high stress levels in NY this past Spring. It's a bummer, and I hope I'll be able to quit again.
(2) Adderall has about a 6 hour effect and can cause lethargy on initial dosages. So maybe you're reacting like you just started it and were never on it before?
>>I also considered this; even though I got so used to the med, I haven't taken it in a while, and my body might have to get used to it all over again.
In my answer to your previous post I suggested taking only the morning dose. I wonder if you can handle that amount better (i.e. adjust to it more easily).
>>The problem with just taking the a.m dose for me, is that I become like a zombie after it wears off in the afternoon; I think that, while it raises NE/DP, it does it very sharply and quickly, and the resulting crash might leave the NE/DP at a SUB-NORMAL level? When I used to take it, the inert, zombie-like feeling hit me a few hours after each dose, and I always assumed it was a sign of the med wearing off. That's why I inevitably had to climb the dose up to 40mg at once point so that my whole day and evening until bed was 'covered' so my mood didn't suddenly drop mid-day or mid-evening. Maybe 20 mg isn't enough (but I certainly don't want to get caught up in higher doses again), or, 10mg bid is not a good way to spread it out; maybe 10+5+5? The only thing about that is that I'm sick of having to think so much each day about how many pills to take and when to take it. Then I'll start wondering when to take the tid klonopin in relation to when I take my adderall, etc.
(3) I think you are EXTREMELY sensitive to any chemical that has a direct affect on neurotransmitters, including alcohol, THC, nicotine & probably caffeine. Your brain has been over-primed and probably "re-wired" by all the different drugs and life experiences you've been exposed to over the years. It's almost impossible to know how to advise you, cuz your brain is not a "blank canvas" or virgin territory.
>>tell me about it(-: my brain is a med factory.
> HOWEVER, IMHO...if you feel that the Adderall effects are so noticeable and negative compared to how you've felt recently, then YES, stop it until you are in NY. Make sure, it's not the nicotine though! If you wanna take a chance on the XR having a less pronounced effect, you could try that, but it maybe best to just stop it altogether.
>>Well, the discard date on the XR bottle is 1/23/03 (I thought it was older) - u think it would still have full potency?
> At the very worst, the Klonipin helps you stay calm, doesn't it? I think your goal should be as relaxed as you can. I kinda feel that Klonipin is the most important one right now.
>>>True; but I'm just concerned that making me calm is not the worst the klonopin could do; I'm thinking it could make me depressed; after all, within the 1st 2 days of the higher dose I had some pretty intense, random crying spells.
> DON'T take the Prozac yet!! Too many drugs substituting for too many other drugs.....confusion, meltdown, HEEELP! (That's your brain talking, hehe).
>>>Ok. GOOD - at least I've got that off my back and don't have to worry about it anymore. But I really just meant stopping the adderall, staying on the klonopin, and starting the prozac - that's only 2 drugs (prozac + klonopin); but you're right. It's also probably best to hold off on a med that takes a while to work and that, in the interim, has a lot of acute side-effects, until my pdoc is back and can monitor my response
> If your obsessional thinking/worrying is now specifically about the medications. Tell yourself something like the following, everytime the thoughts come up :"I'm on vacation and resting my brain/mind/emotions from all other drugs. On September 3 I will do informed research about available medications, evaluate my emotional state and prepare to visit my doctor. End of discussion"
>>>And that's why I need to resume therapy when I get back to NY; perhaps CBT this time. Thanks, that's a good thing to tell myself.
> And Peter, I'm gonna give you an assignment!! Next time you post, tell us which part of France you are in, and describe something you've seen in great detail. Change of focus.
>>>awesome idea.
> Retrain your observations to "outside" of you, if you can. Your sensitivity is also a HUGE asset.
> Be kind to yourself :)
> Jasmine
> >(o:
>
Posted by Jasmine Neroli on August 19, 2003, at 15:13:00
In reply to Re: REALLY need advice just once more » Jasmine Neroli, posted by Peter on August 19, 2003, at 5:53:44
Peter, I think you're sounding better!!!! Not so desparate.
Yeah, I agree with you about the NE/Dopa levels suddenly dropping, that would explain a lot. Maybe breaking up the 20mg Adderall into 4 doeses would even you out, but as you say...wow what a pain!!! Especially when you have to factor in Klonipin too. Makes me feel like you should just forget Adderall again. BTW re the expiry on the XR, my doctor once told me that shelf life on drugs lasts several months after the "best before" date, but she couldn't "officially" tell me it was ok to take it! So it may well be ok.As to the intense crying spells etc....that maybe a sign of your extreme anxiety. I do exactly that ( and I'm not a "crier" usually)...it's like a complete frustration expression welling up and overflowing, coupled with anger at myself/situation. It may not be a side-effect of Klonipin per se.Just a sign of how deep your anxiety is and how much it troubles you. I dunno, I'm only just on Klonipin now and a low dose. I find no depression, just not much "pep". Apparently tho', you do adjust after 2 weeks. How long's it been on the higher Klonipin? Keep at it Peter. and yeah where are the travelogues???
BTW, I'm actually going away for 4 days now too, myself, but I will try to check this board in about 2 days. I'll be thinking about ya..even if I'm not actively responding. Others are hear to encourage too!
a bientot!
Jas
Posted by Peter on August 20, 2003, at 7:08:30
In reply to Re: REALLY need advice just once more, posted by Jasmine Neroli on August 19, 2003, at 15:13:00
> Peter, I think you're sounding better!!!! Not so desparate.
Yeah, I agree with you about the NE/Dopa levels suddenly dropping, that would explain a lot. Maybe breaking up the 20mg Adderall into 4 doeses would even you out, but as you say...wow what a pain!!! Especially when you have to factor in Klonipin too. Makes me feel like you should just forget Adderall again. BTW re the expiry on the XR, my doctor once told me that shelf life on drugs lasts several months after the "best before" date, but she couldn't "officially" tell me it was ok to take it! So it may well be ok.
>>> Hey Jasmine. Not sure about the XR. It says 'Discard after 1/23/03.' And I remember my pdoc and I decided it's not smoother than the IR adderall, since it just releases 2 full doses 4 hours apart (it doesn't have that cool pulse-release mechanism that Concerta does - u know, a little bit at a time evenly throughout the day). And with the unsureness about the date, I might just stick w/IR.
I am doing better in terms of my extreme anxiety levels having been lowered. But the battle about the adderall is still going on in my head. On the one hand, while the klonopin alone has calmed my hysteria, it's also pushed my mood down overall - the fatigue and spaciness make me irritable and, though I feel less inhibited socially, I don't have the drive or clarity to act on that disinhibition. I also feel very understimulated and I've been resorting to drinking 2 beers and sometimes a glass of wine with dinner; I used to be a BIG drinker, but the adderall seemed to curb my alchol/drug cravings (another positive effect of it). Now, with just klonopin, I feel a need to somehow 'pep' myself up, and the alcohol is probably not a good idea while on this fairly high-dose klonopin; I noticed that even the first beer gave me a pretty big buzz, but by 9 or 10p.m I felt even more listless and down.
Back to the adderall argument. Conversely, I had actually made some pretty solid arguments for my NOT taking the adderall; I remember when I used to take 35mg daily for months, I got into an unhealthy state of social avoidance and isolation, and I think it did, to a degree, exacerbate my obsessive and anticipatory anxieties. But again, that was a higher dose with HALF the amount of klonopin I take now and the additional synergistic reactions of the 3 or 4 other meds I took simultaneously.
But I am afraid of the possbility of my getting trapped again into that self-absorbed, isolated, avoidant state. Because even though in hindsight I see how it was an unhealthy state to be in, at the time I was in a kind of denial and refused to reduce the adderall because I liked the feeling of avoiding life. On a positive note, I guess now that I'm aware of the adderall having placed me in that state, I can be more on the lookout, if I resume taking it, to make sure that it doesn't again happen.
Then there's the issue that I really felt that I accomplished a lot by tapering off the adderall once and for all, because we had tried before, but my brain had gotten so accustomed to it that I felt like I couldn't function everytime we tried to taper it and ended up always raising the dose back up. My pdoc seemed quite happy also when I finally tapered off it completely, because I believe he thought that it was doing me harm as well as good, and wasn't ideal for me. Maybe that's why he said during that last phone call that I should be very careful in assessing whether I should start up the adderall again, because I had accomplished a lot by getting off of it.
But he did also say that if I'm not 80% better that I should take the stimulant. The one day I tried it, as I told you, was good during the daytime but made me sort of inert and zombie-like 1 or 2 hours after the second 10mg dose. Like you said, though, it might be my body/mind seeing it as my taking it for the first time and my having to adjust to it. I don't know, it was nice to have that whole adderall monkey off my back, but I'm growing tired of waking up every day feeling like a drank a 5th of scotch the night before because of my 3.5-3.75mg daily klonopin , and I would like to be able to continue composing and practicing during this time, two things that require some energy. Also, though my pdoc returns Sept 2, my session with him isn't for another 10 days after that, and then if he prescribes me an AD, it'll be multiple weeks after that point until I start feeling more functional. That fact speaks more toward my taking the adderall now, n'est-ce pas? I just have to be careful I don't start increasing the dose to try to make it 'cover' me for the entire day, 'cause then I'll be up to a high dose and will then at some point have to again go through the sucky withdrawal from it. I'm pretty sure I'll get to a point, thoug, of wanting to manipulate the dose (raise it) so I don't 'crash' mid-evening; that is, after all, why I had climbed up to 35mg in the past (15mg + 20mg seemed to each last longer than single 10mg doses), but my pdoc said on the phone to take 10mg bid if i resume it. All this contradictory stuff said, yesterday I held to the first point of view and decided, with resolve, to NOT take the adderall. BUT, Today I woke up and stuck to the second standpoint and decided I SHOULD just take it for a few days - let's say 4 days, and then stop it if it still is creating all the moodiness it did that one day that I took it. So I took 10mg when I woke up today. BTW, Would I be able to stop it 'cold' after 4 days or will my body have adjusted enough to necessitate a taper?
All this back and forth reasoning is really annoying (I'm sure for you too!) - I can debate any side of this topic, and it's fairly frustrating.
> As to the intense crying spells etc....that maybe a sign of your extreme anxiety. I do exactly that ( and I'm not a "crier" usually)...it's like a complete frustration expression welling up and overflowing, coupled with anger at myself/situation. It may not be a side-effect of Klonipin per se.Just a sign of how deep your anxiety is and how much it troubles you.
>>>I totally relate. I really never just break out crying for no apparent reason like I was doing, and I do think it was just a manifestation of my being so overwhelmed by my anxiety and frustrated/angry at myself that I'm in such a nice place yet not enjoying it.
>I dunno, I'm only just on Klonipin now and a low dose. I find no depression, just not much "pep". Apparently tho', you do adjust after 2 weeks. How long's it been on the higher Klonipin?
>>>Now it's 6 days. True that it helps my anxiety, but man I am not looking forward to the time when i'm gonna have to taper such a massive dose! Oh, and about adjusting after 2 weeks - hmm..I didn't think about that. I guess, though, that, while my fatigue might go away, I still would lack the pep&drive.
>Keep at it Peter. and yeah where are the travelogues???
>>>I think I still gotta work on what you said-thinking OUTSIDE of myself; but I'll give you something: I'm in the South. It's really beautiful; you can feel how clean and pollution-free the air is each time you breathe in. It's been a major heatwave, but is cooling down now. A nice break from NYC hecticness.
> BTW, I'm actually going away for 4 days now too, myself, but I will try to check this board in about 2 days. I'll be thinking about ya..even if I'm not actively responding. Others are hear to encourage too!
> a bientot!
>>>merci, Jasmine. A bientot!
> Jas
Posted by Peter on August 20, 2003, at 14:43:19
In reply to Re: REALLY need advice just once more, posted by Jasmine Neroli on August 19, 2003, at 15:13:00
Well, today I took my 10mg adderall bid along with my klonopin. For each dose, I took 0.75mg klonopin+10mg adderall. After the first dose, I felt a bit more clear-headed, did some exercise, relaxed, felt fairly even-mooded and ok for hours. It was very subtle-just gave me a bit more overall pep to compensate for the high-dose klonopin fatigue.
BUT, again, the problems arose from the second adderall dose, and I just cannot figure out why. I took it about 6-7 hours after the first. After I took it, when it started kicking in, everything was ok, and I felt fine. In fact, my creative juices started flowing and I composed some music; I did feel more energy than after the first dose, but maybe that's because my early-day exercise might have made the energy from the 1st dose less noticeable than the energy from the second.
But I felt active and my mood was pleasantly lifted. However, beginning 2 hours after I took the second dose, I felt a VERY SHARP SHIFT in my mood. I suddenly became very inert, my mood and energy shot way down, and I just began to feel a spacy, depressive, detached kind of feeling. How could there have been such a big mood change only 2 hours after the dose? Was it the klonopin 0.75mg kicking in and strongly counteracting the adderall? (even though, I took them both simultaneously, I know the klonopin takes longer to kick in). But if that were the case, wouldn't I have experienced a similar phenomenon 2 hours after the first dose of both meds?
It sucks, because I was active and talkative and in pretty good spirits throughout the early evening. Guests have visited and I felt social and well until the end of dinner, when I had to excuse myself 'cause my mood dropped so fast. Is it too high a dose of adderall? But if that were the case, why would it feel fine during the first 2 hours of the dose and then feel like a stimulant 'crash?' Is it not enough of a dose (but I used to take up to 40mg daily- 20mg bid)? I don't want to increase it without my doctor's consent (I did that once before and it got a bit messy).
What really sucks is that it's 9pm and this is when I'd usually play piano for the guests and socialize, etc. But I feel almost comatose I'm so spaced-out and low. Maybe it is what I had considered before - that when I take stimulants, my DP/NE levels are pushed up rapidly and then quickly fall to BELOW normal levels. That's good reasoning, if it is true, for me to take a stimulating AD like wellburtin or strattera - I guess they would raise the neurotransmitter levels gradually over time so the result is more stable and consistent. But, again, my pdoc is away and I won't be able to talk to him until sept. 10th.
I don't know if I should keep taking the 10mg adderall bid for a few days and see if things smooth over, divide the dose differently, switch to taking two 10mg adderall XR caps (which are 7 months past their 'discard date,' and which I believe my pdoc and I didn't conclude were any smoother-acting than the IR tabs anyway), or just AGAIN stop the adderall before going further with it and try to cope on 3.5mg daily klonopin alone with all the lethargy and emotional-dulling that comes with it. The positive thing about the last option is that at least the klonopin will be the ONLY med I'm taking so that my pdoc wouldn't have to factor in any other meds when assessing what to start me up on when he gets back.
I guess it thus comes down to what is most logical-sounding versus which way I'd FEEL better until he returns. I guess staying on just the klonopin ('less is more') is most logical, but adding and staying on the adderall might make me feel better ON THE WHOLE. I just don't know. If only the adderall didn't have these wierd moody effects on me, it wouldn't be so much of an issue; I'd just continue to take it without question.
AGH! HERE I GO AGAIN!ANY RECOMMENDATIONS?
Peter
Posted by blondegirl47 on August 21, 2003, at 12:14:28
In reply to adderall problem - question, posted by Peter on August 20, 2003, at 14:43:19
I take short acting adderall too. I think you are waiting too long to take your second dose. It only lasts about 4.5 hours for me. The crash from adderall seems to be pretty harsh. Also if you ate before or after you take it, it will lower the kick in effect. I have found that as soon as I have a reg size meal, my medication pretty much goes away. Sometime to my iritation it will come back when the food is gone and I am left stairing at the ceiling instead of sleeping :)
For my long acting medication I have just started generic dexedrine sr...2 15 mg capsules. It takes a long time to come on, but it last longer than XR.
Are you drinking any high acid stuff or caffiene with your medication, this will also lower your absorption.
Hope this helps some :)
Blondegirl
Posted by Peter on August 21, 2003, at 13:13:19
In reply to Re: adderall problem - question » Peter , posted by blondegirl47 on August 21, 2003, at 12:14:28
> I take short acting adderall too. I think you are waiting too long to take your second dose. It only lasts about 4.5 hours for me.
>>>That's what I always thought; but the only way I could split up this 20mg total dose is 10mg bid, because if I split the dose up further and took like 10mg+5+5mg, I wouldn't feel any effect from the 5mg doses - too small. I seem to build up a tolerance pretty quick. I was taking 20mg + 10mg +10mg a while back, and I couldn't even feel the effect of the 10mg doses, so that's why I everntually decided upon twice -a-day dosing (20mg+20mg). If I hadn't, I would have had to continue to raise the dose yet again to something way too high.
I stopped the adderall IR for a few weeks, and now my tolerance seems to have lowered, but I'm having the wierd fx I mentioned. since my doc told me to start up this time ar 20mg, I'd only feel the effect of each dose, if at all, if I did 10mgx2. But it's difficult, because you have to somehow strategically spread the doses so they cover the whole day/early evening, but you don't want each dose so small that it has no effect.
The crash from adderall seems to be pretty harsh. Also if you ate before or after you take it, it will lower the kick in effect.
>>how long before or after? I did notice my downward mood shift during dinner.
I have found that as soon as I have a reg size meal, my medication pretty much goes away. Sometime to my iritation it will come back when the food is gone and I am left stairing at the ceiling instead of sleeping :)
> that's annoying!
> For my long acting medication I have just started generic dexedrine sr...2 15 mg capsules. It takes a long time to come on, but it last longer than XR.
> interesting; I'll ask my doc about that
> Are you drinking any high acid stuff or caffiene with your medication, this will also lower your absorption.
>>Yes. When I tapered off of adderall, I was a mess for a few weeks - always exhausted, etc. so I started drinking coffee again, and I still am. Perhaps if I resume the adderall, I should stop it?
> Hope this helps some :)
>>It did-thanks. I still gotta figure out, though if I'm going to resume a stimulant at all or wait for my pdoc to return from vacation and see what grander scheme he has planned for me this time around (-;
>>BTW, do you know how long a stim stays in your system? Because I took my 20mg dose yesterday and afterwards, because of my moodiness last night, I decided to not take it today and see how I'd do on just the klonopin. I was exhausted, of course, but I also felt an annoying, underlying restlesness. Could this have been some residual 'salts' still in my system from the yesterday's adderall or something?
Peter
Posted by blondegirl47 on August 21, 2003, at 13:37:19
In reply to Re: adderall problem - question, posted by Peter on August 21, 2003, at 13:13:19
I would stop drinking coffee with your adderall...the coffee will make your urine more acidic, thus eliminating your medication faster. That underlying restlessness could be the caffiene. I am not sure how long it stays in your system. Caffiene will stay in your system 12 to 14 hours.
Blondegirl
Posted by Jasmine Neroli on August 25, 2003, at 1:13:13
In reply to UPDATE, posted by Peter on August 20, 2003, at 7:08:30
Aagh! I wrote a really long post and somehow lost it! I'm trying to re-write it now .Sorry.
Well Salut Peter! I'm finally back in cyber-psych space. How are you doing? The South of France sounds like a lovely place to be.
I have posted some thoughts about my "newbie" Klonipin experiences to another thread addressed to you and Ames, today. In it you will see that today I am very tired and low for the first time since off my AD. I, like you, have isolated myself and withdrawn, and I'm now wondering if this is a KLonipin affect. But I was not feeling this way before, on it ??? Do you think your "up's and downs" may have more to do with Klonipin, than to Adderall rebound? It's all so confusing.
I read your Update and your Adderall query posts. Did you end up doing the 4 day Adderall trial? It sounded like a good idea to me... a kinda "middle of the road" approach, whilst you observed what happened. I don't think it would be too difficult to taper off, after such a relatively short time.
I don't know much about Adderall and would leave that advice for others that have used it. But I do know that CNS stimulants in general are notorious for the suddenly "dropping off" effect. So maintaining a consistent dosage is so crucial, and ANYTHING interferes....lack of sleep, other stimulants, food, energy exertion. Adderall sounds the same. I wish you could do without it,Peter, your love/hate relationship with it is such a draining force, isn't it?
You mentioned having a few beers to help you feel "up". Well, I just realized now, upon reading that, that I have drank a LOT OF STRONG ESPRESSO in the past coupla days...maybe that's me looking for a stimulant whilst on the Klonipin??!! Anyway, since alcohol is a CNS depressant, wouldn't you feel more "low" afterwards? O the tail-chasing syndrome of drugs...haha!
BTW, when I saw my doc for the Klonipin, he suggested I consider Effexor to help with my mild obsessional/ritualistic behaviour..which returned with my anxiety 2 weeks ago. Did you ever try Effexor? I seem to remember you saying you had tried a lot of AD's.
Actually, since my anxieties have been controlled by the Klonipin, I no longer have the obsessions again. So maybe it's not even an issue.
Well, you have one more week in France, and I have one more week before I am back at work (at a Middle School!). Hope we BOTH have a good time!
Jas
Posted by Peter on August 25, 2003, at 12:04:43
In reply to Re: UPDATE » Peter , posted by Jasmine Neroli on August 25, 2003, at 1:13:13
> Aagh! I wrote a really long post and somehow lost it! I'm trying to re-write it now .Sorry.
> Well Salut Peter! I'm finally back in cyber-psych space. How are you doing? The South of France sounds like a lovely place to be.
> I have posted some thoughts about my "newbie" Klonipin experiences to another thread addressed to you and Ames, today. In it you will see that today I am very tired and low for the first time since off my AD. I, like you, have isolated myself and withdrawn, and I'm now wondering if this is a KLonipin affect. But I was not feeling this way before, on it ??? Do you think your "up's and downs" may have more to do with Klonipin, than to Adderall rebound?
>>Hi Jasmine. I think the ups and downs for me are probably a combination of both meds working on me. When taking only klonopin, I definitely experience a mood that is more toward the depressive side, so I'm more prone to isolation and social withdrawal. Even though klonopin lowers my overall anxiety and helps me feel a bit less self-conscious in public (thus the anti social-anxiety effects), I still tend to have difficulties in social situations or even, for that matter, in getting involved in constructive things when I am alone, because the klonopin tends to lower my overall mood and leave me bereft of 'pep' and energy.
It's all so confusing.
>>that it is(-: How much klonopin are you taking now? I noticed you said you didn't feel these undesirable effects in the past when taking klonopin? Is the dose you are taking now different than then? Were you taking it along with any other meds, like an AD, in the past?
> I read your Update and your Adderall query posts. Did you end up doing the 4 day Adderall trial? It sounded like a good idea to me... a kinda "middle of the road" approach, whilst you observed what happened. I don't think it would be too difficult to taper off, after such a relatively short time.
>>Well, what happened was I kept going back and forth throughout the week. It was infuriating. One day I'd say to myself: 'all right. I'm fed up with feeling low and dull on the klonopin. Tomorrow I'm starting up the adderall; end of subject!' But then the next day, when I took the adderall, I felt the beneficial energy and alertness, but it also gave me some undesirable side-effects to which I seemed much more senstizied than when I'd taken it in th past; these included waves of anticipatory anxiety, triggering of more obsessional-type anxiety, and the 'crash,' when I would feel completely inert, braindead, and zombie-like. That ended up making me just as socially-avoidant as the klonopin, albeit in a differnt way! So then I'd say: 'these feelings outweigh the adderall's benefits, so tomorrow I'm just going to go back to the 3.25mg daily klonopin dose without adderall.' This is how it was going, until I finally decided to call my pdoc's substitute; I explained what I could to him, and he said I should avoid the adderall during the week-end, stay on the 3.25mg klonopin, and try to 'take a vacation from med managing,' and distract myself, etc. It was good advice-like the advice you gave me in a recent post regarding my trying to direct my thoughts outside of myself. So I tried throughout the weekend to keep myself busy, even though I was overall pretty low and tired; I made myself exercise each day, which helped a bit. But when I tried reading a book, practicing piano, or composing, it all felt like a series of chores that I wanted to just get over with! My anxiety levels had decreased, but nothing interested or stimulated me, and I couldn't keep myself involved in anything. I also feel even now an inner restlesness. This all sounds like ADHD peaking thru the klonopin, but who knows. It's quite frustrating.
> I don't know much about Adderall and would leave that advice for others that have used it. But I do know that CNS stimulants in general are notorious for the suddenly "dropping off" effect. So maintaining a consistent dosage is so crucial, and ANYTHING interferes....lack of sleep, other stimulants, food, energy exertion. Adderall sounds the same. I wish you could do without it,Peter, your love/hate relationship with it is such a draining force, isn't it?
>>It is. That's why I'd probably fare better on a dopaminergic AD-type med like wellbutrin or strattera. The annoying thing is that I've already given both of these adequate trials and they proved ineffective - but I only tried them combines with multiple other meds, so who knows what was synergy and what were the individual meds' innate actions?
> You mentioned having a few beers to help you feel "up". Well, I just realized now, upon reading that, that I have drank a LOT OF STRONG ESPRESSO in the past coupla days...maybe that's me looking for a stimulant whilst on the Klonipin??!! Anyway, since alcohol is a CNS depressant, wouldn't you feel more "low" afterwards? O the tail-chasing syndrome of drugs...haha!
>>Well, if I had one too many beers, I'd begin to feel low; but my initial reaction seems to stimulate me; maybe it just helps me feel less 'dull,' but not less tired. In fact, last night I had a few glasses of wine at a restaurant and I ended up hours later feeling very restless and my RHR was up to 120bpm! And I thought alcohol + klonopin would increase CNS depression! It's all complex and difficult to figure out.
>>Believe it or not, this is very contrary to my past posts, but the only thing that now helps me feel interested and stimulated is a few puffs of pot! I know I had told you of that bad experience that one night, but I think that was really before the klonopin had a chance to decrease my overall anxiety. Now it seems to somewhat help me; I'm only smoking a bit with my brother late-night, but I surely don't think this is the right solution! And I definitely don't want to become a 24/7 stoner again like I was in High-School and University!
> BTW, when I saw my doc for the Klonipin, he suggested I consider Effexor to help with my mild obsessional/ritualistic behaviour..which returned with my anxiety 2 weeks ago. Did you ever try Effexor? I seem to remember you saying you had tried a lot of AD's.
>>Yep. I tried effexor years ago, but it was not a fair trial, because, firstly, I was taking a lot of other meds, and, secondly, I was abusing drugs and alcohol before I even started the effexor and through the few weeks that I was using it. Those were darker days. I'd be interested to see how it would affect me now.
> Actually, since my anxieties have been controlled by the Klonipin, I no longer have the obsessions again. So maybe it's not even an issue.
>>Well it might help some of your other symptoms of anxiety, isolation, etc..and it can keep the obsessions at bay, maybe?
> Well, you have one more week in France, and I have one more week before I am back at work (at a Middle School!). Hope we BOTH have a good time!
>>Me too!
>> Peter
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.