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Mental Health (Expert Forum)
Development of Panic Disorder/ Too much 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.
Development of Panic Disorder/ Too much Klonopin?
by Deschutes, Oct 14, 2004 12:00AM
I have Panic Disorder which eventually resulted in Generalized Anxiety Disorder as well. It began when I was in Montana bartending and was excessively drinking everyday for about a year. Every couple of weeks I would go sober for a few days and I would experience tingling of my left arm and face, irregular heart beat, extreme shakiness, jerkiness, hot/cold flashes and the inability to sleep. After a couple of months of this,I decided to move home and hopefully move on with my life and get rid of what I attributed to as alcohol withdrawal symptoms.
I have been home for 2 years now and had been having the same symptoms on a daily basis, even when I hadn't been drinking for weeks. It was affecting my ability to work, to go shopping and other daily routines. I finally acknowledged the problem and went to see a wonderful psychiatrist who put me on Effexor XR 150mg. He started me with Effexor 75mg and Klonopin .5mg until the effexor kicked in. I tapered off the Klonopin and began experiencing the panic attack symptoms again. I gave it 3 weeks to make sure it wasn't just withdrawal from the Klonopin. Then I went to my GP and received a perscritption for Klonopin 1mg. I am currently taking Effexor XR 150mg and 2-3mg of Klonopin daily. (I don't know if this matters, but I am a 27 year old female weighing 110 lbs.) I feel fine. My questions are:
1) Do you think the excessive drinking caused some chemical change in my brain to make me have these attacks?
2) Do you think I didn't give the Effexor enough of a chance and the Klonopin could be masking the effects of the Effexor? Do you think I would be fine with just the Effexor?
3) I am seeing a therapist who thinks I am fine now since my meds are working, but eventually (especially with the Klonopin) aren't I going to have to up the doses to get the same reaction?
4) Is it true that after a year of being on something like Effexor it can swith the chemicals in your brain so you can function normally again?
I know that Klonpin is addictive, but it just feels amazing to be myself again. The addictiveness concerns me though, but not enough to stop taking it. Panic attacks are the scariest things in the world.
Thanks for your help.
I have been home for 2 years now and had been having the same symptoms on a daily basis, even when I hadn't been drinking for weeks. It was affecting my ability to work, to go shopping and other daily routines. I finally acknowledged the problem and went to see a wonderful psychiatrist who put me on Effexor XR 150mg. He started me with Effexor 75mg and Klonopin .5mg until the effexor kicked in. I tapered off the Klonopin and began experiencing the panic attack symptoms again. I gave it 3 weeks to make sure it wasn't just withdrawal from the Klonopin. Then I went to my GP and received a perscritption for Klonopin 1mg. I am currently taking Effexor XR 150mg and 2-3mg of Klonopin daily. (I don't know if this matters, but I am a 27 year old female weighing 110 lbs.) I feel fine. My questions are:
1) Do you think the excessive drinking caused some chemical change in my brain to make me have these attacks?
2) Do you think I didn't give the Effexor enough of a chance and the Klonopin could be masking the effects of the Effexor? Do you think I would be fine with just the Effexor?
3) I am seeing a therapist who thinks I am fine now since my meds are working, but eventually (especially with the Klonopin) aren't I going to have to up the doses to get the same reaction?
4) Is it true that after a year of being on something like Effexor it can swith the chemicals in your brain so you can function normally again?
I know that Klonpin is addictive, but it just feels amazing to be myself again. The addictiveness concerns me though, but not enough to stop taking it. Panic attacks are the scariest things in the world.
Thanks for your help.
Doctor's Answer
by Roger Gould, M.D., Oct 15, 2004 12:00AM
, Oct 15, 2004 12:00AM
There are so many factors to consider that it is hard to sort out piece by piece so let's see if I can address the core issue for you, and the confusion. The confusion is your reliance on and belief in the medications. They help, but if you have a constant stream of anxious thought bubbling up from within about your life and your fears, then the medications won't stop that, only slow it down. chances are you were drinking so much to mask that same anxiety you are trying to tame with medications. My advice is stick with what you have but use your therapy to dig into, rather than avoid, your anxiety, and then, as you master that, gradually reduce the dosage of your medication.
Hopefully what I say will help you in some way. I have been suffering on and off with generalized anxiety since about 1997.
After experience my first panic attack which I can only describe as being the most terrifying experience humanly possible (of which u cant explain what its to like to some one who has not experienced one), it messed me up for some time.
Initially I tried a few types of medication, some of which made me feel worse including sertraline.. I currently take a very small dose of Clomipramine which I have been taking for a few years now.. I only take one 25mg tablet every two days and most times feel like I dont need it.. Its just that after a few days of not taking it I get a kind of fuzzy sensation every now and again in my head.
I think the thing with medication is that some med works well for some people and not for others.. There is also a MASSIVE mind over matter issue with anxiety and medication, to a certain extent the placebo affect. It may have been that you started getting paniccy again because you were aware you were weening of your med.
I have also thought about the "chemical change in my brain" thing but I dont think thats true. I have before explained things like this regarding panic.
Image that in your brain there are many roads to many places of feelings and emotions etc etc. When you experience a panic attack you slip onto a road which most people would never go down. But the terrible experience of that road means its stock in your memory and so more likely that you go down it again..
Does that make sense to you?? I hope so! I'm writing all this as I've had a very rough week with anxiety, not panic attacks but just feeling kind of unreal all the time and not sleeping well. I've been here many times before and know that time and mind over matter is the best healer.. I may well wake up tomorrow and feel a hell of a lot better but we'll see!!
The MD who posted a reply for you is also right in that there is a lot going on here and it would be very difficult to break everything apart. The best way to do this is to find a point of stability on the meds and begin a very slow and proportionate taper of the klonopin.
For more information on the dangers of Klonopin, please visit www.benzo.org.uk I would suggest you read all of the Asthon Manual, which you'll find linked on the left side of the page.
By the way, there is also ample post mortem evidence of permanent brain changes due to long term high dose benzo use. Though no evidence of low dose brain damage exists, it is believed probable,
You really need to stabilize then taper responsibly. Good luck...
I originally started on .5 MG about a year ago and am now up to 2MG. I have only taken the 2MG for a month and am now back down to one. However, I am beginning to feel worse and it's scaring the hell out of me. All I read are horror stories about weening off this drug and I need to know how one does it right? My doctor said after a month, going back down to one MG shouldn't be an issue, but I think it is. Any thoughts? I eventually want off of this stuff.
pete