Zoloft and Klonopin

I've been taking a 25mg dose of Zoloft for 12 days now and don't think I've seen any improvement yet.  Now after speaking with a counselor the other day she thinks my anxiety is stuck on high right now and I need something to bring it down before us talking would really help.  She doesn't think they're much she can do for me at the moment given where my anxiety is.  I couldn't even focus on what she was saying because my mind was racing.  Now my doctor prescribed Klonopin (Clonaxepam) but he only presribed a .25 mg dose.  To anyone else taking these medications, is such a low dosage of Klonoplin even going to help.  I took it for the first time today and don't feel different at all.  Also, isn't 50 mg the usually starting dosage for Zoloft?  I just want to get to the point where I feel better and am thinking my doctor is being too conserative on the dosing.

[greenlydia]

The "normal" starting dose of Zoloft is 50mg. In my humble and non-medical opinion, she should have increased your dose after a week at the .25mg level. I would definitely discuss her dosage choice.
If your anxiety is "stuck on high," again in my humble opinion, your dovtor is not doing much to help you as he has started you on the next to lowest dose of the Klonopin. Normally for panic disorder, Klonopin is perscribed at the 1-2mg level and is taken in divided doses at least twice a day. It can also take a few weeks for the Klonopin to reach a therapeutic level as it needs to accumulate in your system. Again, I think a dosage discussion is called for.
I agree that both doctors are being a bit too conservative in their dosing.
But please remember that I'm not a doctor and they may reasons I know nothing about for dosing you at these levels. Only they can give you their reasons.
I wish you the very best.
Hang in there.
Peace
Greenlydia    

[WorriedOne84]

Thanks for your response.  Right now I just feel so lost and confused over this whole mess.  I don't want to be on any medication at all but I don't know what else to do.  Last Thursday was my first ever appointment with the counselor.  She said she can tell I'm struggling right now which is why she called my doctor to see if he would prescribed something short-term in addition to the Zoloft.  When I was talking to her my mind was racing and I was really shaky.  I don't think the Zoloft is helping and I don't know about the Klonopin yet.  I hate to go back to the doctor and talk about his with him.  You think he would've realized how bad the situation is when the counselor called his nurse and was explaining what was going on.  Like I said, she didn't see how we could make any progress talking until we get my anxiety off the high level it is now.  What do you think I should do?  Thanks.

[greenlydia]

I would hang in with the Zoloft, but would definitely talk to whomever perscribed it for you about bumping the dose up. Even if you had started at the normal 50mg dose, after 12 days it would be somewhat unlikely that you'd notice any change in your mood. Some people do begin to notice a very slight lifting of the depression after only a week, but for most people, any real noticeable change takes a few weeks. It is very hard when you are new to AD's to learn that patience is an absolute must. You HAVE to give them time to work.  

Don't hesitate to call your doctor and tell him the Klonopin just isn't cutting it! Your therapist asked him to perscribe something "short term" just to get you calmed down, Klonopin is normally perscribed for "long term" use.
Personally I would ask for Xanax. BUT...........you must be very careful with this med. It is intended for short term use ONLY, as in 4 months or less if used on a daily basis. Tolerance builds rapidly to this med and you do not want to go down that road. Trust me! If you use the Xanax only on a "prn" basis, (AS NEEDED) you can stay on it pretty much indefinitely. It is very potent and very fast acting and will help with your anxiety almost immediately. It can be very sedating, so you need to be careful about that. If you begin to use it more than a couple times a week, then you need to consider some other options. One would be diazepam (Valium) or you could rethink the Klonopin.
Once the Zoloft really kicks in, it also has properties to deal with anxiety/panic as well as depression.
I understand your feelings about not wanting to be on any meds at all........none of do, but sometimes we just have to accept that we can't do it on our own. And there is no shame in that. Also, if you stick with your therapy, it's very likely you can get off the meds much sooner.
If you don't feel comfortable confronting your doctor, call your therapist and tell HER that the Klonopin is doing nothing for you and tell her you need something stronger and faster acting like Xanax or Ativan. SHE was the one who saw you in crisis mode and I'm sure she would be willing to get you on something so you two can begin therapy.
I know that you feel lost and confused, that is so normal in this situation, but it will pass........I promise you that.
You'll be fine!
Peace
Greenlydia    

[WorriedOne84]

Thank you so much for taking time to respond.  You actually made me calm down a bit as I was totally freaking out.  My doctor only wrote a 30 day prescription on the Zoloft so I guess I could just wait and go back or call when it's about time for it to run out.  The problem is I'm not a patient person and I want results now, haha!  

My counsleor was concerned as I was having trouble focusing, I don't remember much of what she said I was so anxious.  I was also shaking a bit towards the end of the session and shared with her that I've really lost interest in things I enjoyed doing because I'm worrying all the time.  That's when she decided to call.  Little does she know I freaked out even worse after leaving her office.  I started thinking about some of the really personal stuff I had shared with her and then started wondering about what she thought of me.  I kind of felt panicky.  

I'm scheduled to have another session with her on Thursday so I guess I could ask her then what she thinks about the medication situation.  It's frustrating that she thinks I need something, in addition to Zoloft, to get the anxiety down before she thinks she can help me.  My doctor however still didn't prescribe something that would do just that.  He seems to be very conservative on the medication which is not exactly what I need right now.  The counselor actually told me that she doesn't know how I've made it this long without help.  

Since I had gallbladder sugery in December I've been obsessing over my health because I still don't think things are the way they should be.  Actually I'm having chest discomfort from time to time that is either from acid reflux, which an endoscopy showed I have, or anxiety is causing it.  The reflux causes me to think something is seriously wrong with me.  I have had trouble sleeping, strange dreams, irritability, trouble concentrating, and many other things.  

For years I've had lots of issues with anxiety though but never as bad as it is currently.  I've been good at staying in my comfort zone and never venturing out of it.  This has lead me to be 26 years old, living at home, same job as I had in high school, and I've seriously never even been on a date.  I've been asked, I just won't go...too stressful.  Anyway, I'm just now to the point where I've recognize how much this has controled my life and how unhappy I am.  Which is why I finally talked to my doctor and now to a professional counselor.  I'm just hoping to someday be happy or at least have the opportunity to do so.  I've been stuck in a rut for years now and I'm tired of it.  I want to live!

Just felt like I needed to get all of that out.  Again, thank you so much for your response!

[Kel5]

Is it your medical doctor or a psychiatrist that is prescribing the meds? Medical doctor on the most part are very conservative with psych drugs especially the anxiety meds like xanex, klonopin, valium, etc. My doctor stopped prescribing me them and made me go see a psychiatrist for medication monitoring. that might be a possibility for you if you doctor will not prescribe higher doses. Psychiatrist are more comfortable with and understand the psych meds better. good luck. give the meds some time. klonopin takes a while to reach a theraputic level and the right theraputic level is different for everyone.

[WorriedOne84]

It's my primary care physician prescribing the meds.  For right now, I guess I just need to wait and see how this goes.  Maybe I'll discuss this with my counselor on Thursday and see what she thinks.  She's the one that thinks I need to be on something to bring the anxiety down now.  If I could just relax and not be freaking out over it I'm sure I would feel better.  Right now I just keep thinking nothing is going to work and I'm going to be stuck like this indefinitely.  I'm lacking in the patience department currently.  Thanks for your input!

[29sillygirl]

You do need to see a psychiatrist.  I second that.  After reading this thread and excellent response from Greenlydia, I am so glad Kel5 thought to ask who was prescribing.

Now I understand more.  Primary care physicians typically will not get into head meds except for very commonly used SSRIs like Zoloft.  Mine did the same with me years back:).

The low dosage of Klonopin is as G said, really an ineffective dose for tackling your extreme anxiety.  Frankly I have never read of a doctor prescribing this dose..LOL.

Xanax may be what a psychiatrist would try at first for short while. Best drug ever for panic.  

Keep posting here or in Agoraphobia Forum.  We want you to get out and back into life!

[WorriedOne84]

Honestly I'm overwhelmed by all of this right now.  I feel like I have so many issues going on and they are driving me crazy.  It's not that I actually have that much that should be upsetting me, yet it is.  I haven't had any experience in dealing with doctors in general and especially not with anxiety issues.  Talking to the counselor about my problems is weird for me.  Now it seems as though I should be going to a psychiatrist.

Also I've got a couple issues at work that I don't want to have to deal with.  We just hired a 17 year male old employee and I have major issues with talking to someone around my own age.  I'm telling you, I'm going to feel like the same insecure pathetic person I was back in high school.  I've always had difficult associating with my peers even girls but especially guys.  The thought of having to work a 10 hour shift alone with him is stressing me out.  What can I possibly talk about with him?  He is not going to know anything about the job and I'm the person in charge.  What if some major issue comes up and I don't know how to handle it.  I do not want to have to work with him for so many reasons.  

Also, the one person I go to, who is my best friend, whenever I need some good advice just had a baby Friday.  While I should be happy for her, and I am, I'm also feeling sorry for myself as she has everything I want but right now looks as though I'll never have.  This is totally going to change our friendship as how is she going to have time for me when she is taking care of a newborn?  Why can't I just be happy?

[greenlydia]

I'm sort of starting in the middle here, but you said there were a "couple" of issues at work that you don't want to deal with. I only saw the one that had to do with your concern of working with this 17 year old kid. And that is what he is! You are a 26 year old adult! There is almost a 10 year age difference.............so while you are both "young" in MY book, that 10 years makes a hell of a difference. He is not in the same league as you at all. You are going to be HIS boss and it's not YOUR responsibility, nor YOUR obligation to make idle chit-chat with him. Teach him what he needs to know, answer his questions and beyond that, don't worry and stress about what you're going to talk to him about! You are stressing about working a 10 hour shift alone with him and I can understand your concern. The best I can tell you is to just be yourself and do your job as you've always done it. Give the situation some time and eventually a working relationship will be formed. It may be one where the two of talk only when you have to or you find that it's easier to talk to him than you thought. You may find that even with the age difference you have things in common. Just remember that you are no longer the same person you (thought) you were back in high school. I sincerly doubt you have gained the position you have by being an insecure, pathetic person! Try to relax and remember who the boss is!

I can also understand your concern about your best friend who just had a baby. And there is no doubt that your relationship will change, but that does not mean that it's going to change in a negative way. She WILL be very busy and stressed and exhausted for a couple of months until she gets the "mom" thing worked out, but she is going to need YOU perhaps more than before. Staying at home with a new baby can be terribly isolating and lonely. One begins to feel out of the loop as their friends continue their busy lifestyles and there you are, stuck at home, changing diapers, wearing pajamas all day and always smelling like "Eau de Spit-Up."
One of the nicest things a friend did for me when I had my first baby and was feeling very lonely and abondoned by my "non-mom" friends.............she would bring a sort of picnic lunch over and amongst the chaos and clutter we'd spread out this mini feast and talk and laugh just like old times. If the baby woke up, we'd pass him back and forth and just continue our conversation. She didn't have kids yet, so she got to see up and close and personal what it was really like, and I got caught up on all the local gossip and goings on. Win-Win! When she would go home, even though I hadn't stepped a foot outside the door, I felt like I'd been back in the world again.
New moms ARE very busy and they don't have as much time for old friends, but just because she has a baby now, she hasn't tossed you out as her best friend! Keep in touch with her, ask if there is anything you can do for her, talk about when she might feel ready for a visit and don't assume she is going to abandon your friendship, just as  I hope you don't abandon her!

Finally, getting back to the beginning of this post, it's natural you're feeling overwhelmed right now. You have a lot on your plate, much of it new to you and that is anxiety provoking all by itself. But instead of letting all of these issues storm around in your mind like a tornado, take that old stand-by...........the deep breath and look at each issue by itself. Deal with each thing as a seperate entity, which it is.
Like going to a therapist for the first time. It's hard. To sit in front of a total stranger and tell them your innermost and private thoughts and fears. You can't help but wonder if they're thinking your some of freakish loser or a really messed up person, but trust me, there is virtually nothing you can tell them that they haven't heard before, you're not going to shock them. They are professionals and their main goal is to help YOU. You will find after a couple of visits that you're actually looking forward to the session. You will discover that it feels wonderful to finally be able to tell someone exactly how you're feeling without having to worry about shocking them or hurting their feelings. It's quite liberating. You will soon get over any embarrassement, if you had any, as you begin to form a bond with your therapist. Which you will. This person will not judge you. Think of them as your guide up a mountain you've never climbed before.

Your last question...................."Why can't I just be happy?"
The answer.................You CAN be and you WILL be and you'll have those things you want, you just have some work to do first to allow yourself to own the happiness you deserve.

Peace
Greenlydia  

[WorriedOne84]

There are a couple other issues at work as well but I don't really want to get in to it.  One of my concerns is working with the 17 year old.  At the place I work, there are only 3 employees now including myself, well 4 if you count the new guy.  The other 2 people I work with are women, one is mid-40s and the other is 60.  We've worked together for several years and they are easy to talk to.  This job can be boring and sometimes the only thing that can get you through the day is having the other person to talk to.  For me, right now, I just feel like this is going to make me feel like I'm back in high school.  Also, I don't like being the boss.  I'd much rather someone tell me what to do than the other way around.  I'll have to handle all the big stuff because he won't know anything yet. What if some situation comes up and I don't know how to handle it?  This is totally stressing me out and I do not want to work with him.

Maybe you are right about the baby being a positive not a negative.  I spent some time at the hospital today visiting and holding him.  He is such a blessing and having him in my life can't be a bad thing at all.  Who knows it may just make my friend and I even closer.  She has always been there for me and I'm sure that will still be the case.  I'll do anything to help her out as well and am excited about getting to babysit.

I'm having so many mixed emotions about everything right now and it's driving me crazy.  I wish I could just have the mentality that I could take on the challenges one by one, like you said, and not get overwhelmed.  Right now, I just can't do that for some reason.  I guess I need to try harder.  I'm still feeling exhausted after talking to the counselor the other day.  Right after I left her office I had all these thoughts racing through my head...Wonder what she thought about me?...What if she can't even help me?...She obviously thought I needed additional medication...Does this mean I'm crazy?  Then I started thinking about what medication the doctor would prescribe and started worrying about that.  I was even paranoid walking in to her office as I was afraid that people driving by would know me and wonder why I was going there.  

You mentioned having to work at getting to a point where I can be happy - well, what if I'm not really ready to do the work it will involve?  Maybe I think I'm ready to change but in reality, being in my comfort zone, while I'm not really happy there, is safe and I want to stay?  You know what, I think I'm having anxiety about having anxiety.  Is that possible?

Thanks for taking time to respond!