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Mental Health (Expert Forum)
Effexor XR and Klonopin
Answered by
Roger Gould, M.D. - Mental Health, Wellness
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD), bipolar disorder, dementia, electroconvulsive therapy (ECT), learning disabilities, memory, obsessive compulsive disorder (OCD), panic, personality disorders, phobias, post-traumatic stress disorder (PTSD), schizophrenia, stress, transitions, and work problems.
Effexor XR and Klonopin
by Baby123, Mar 09, 2004 12:00AM
I was diagnosed in December with Generalized Anxiety Disorder. I also have Mitral Valve Prolapse which I was diagnosed with 11 years ago. Initially when I was diagnosed 11 years ago with MVP and having a lot of heart palpatations and anxiety I was put on Prozac (20 mg), Klonopin (.5 mg) and Tenormin (25 mg.). After being on the meds for 10 years and completely symptom free the whole time, I weaned myself off the Prozac very slowly with no withdrawals at all. Stayed on the other meds. Was doing fine for about 4 months and then started having extreme anxiety again. I went to a counselor who recommended a Dr. to prescribe medication for me. He upped my Klonopin to 1 mg. three times a day, my Tenormin to 50 mg. a day and put me on Paxil. I didn't do too well on Paxil, so 7 weeks ago he changed me to Effexor XR. Started at lowest dose for one week and now on 75 mg. a day. I started feeling a lot better but he now wants me to start weaning down off the Klonopin. I tried last week by cutting out 1/4 of my mid-day dose and after three days the anxiety started returning, not sleeping, etc so I started back on my full dose and feel fine again. Also, even before I tried to wean I still feel a little shakiness in my upper thighs when I lift my legs. I have also started relaxation exercises, deep breathing exercises, and listening to calming music at night to help fall asleep. My question is: am I not stable enough yet to cut out the Klonopin? Has the Effexor been in my system long enough to be giving me the full therapeutic effect? My psychologist seems to think (because I am VERY sensitive to changes in anything and I am 5 ft. and weigh 100 lbs) that cutting out 1/8 of the mid-day pill every other day for a few days and then cutting out 1/8 of the pill everyday and see how I feel. Wait a week and then do the same for the morning dose. And just slowly keep going from there. What are your thoughts on this? Would upping the dose of the Effexor while I wean off the Klonopin help and then go back down to 75 mg? I would like to stay on the lowest doses possible. It worked 11 years ago, so I can't imagine why it wouldn't work now. In fact that is the thing that is bothering me now is that 11 years ago, I pretty much instantly felt better and better and this time I feel like I have been more on a roller coaster. I want to come off the Klonopin but don't want to throw my body back into the anxiety state again and have to start all over. Also, will the muscle shaking eventually go away. It is very mild but me being such a worrier, I guess I want everything perfect. My psychiatrist is on vacation for 2 weeks and I am going to talk to him when he gets back but I wanted to have some ideas of what to expect and what may help.
Thanks again for your advice.
Thanks again for your advice.
Doctor's Answer
by Roger Gould, M.D., Mar 10, 2004 12:00AM
, Mar 10, 2004 12:00AM
The problem with combination of drugs is they often contradict each other. You should know that effexor can both treat anxiety and depression, and because it has a stimulating effect, also make your anxiety worse( especially if you are a self observant sensitive person), and therefore need more klonopin. I agree that you, with this knowledge, experiment to slowly lower your doses of all the drugs you can.
