SSRI Medication

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Dr. Gould-

I have previously asked you a question in this forum about tapering off of Clonazepam (Klonopin), and combined your advice with my family internist and Psychiatrist, and have weaned down to .25mg of klonopin every other day.  I'm ready to go off.  I was diagnosed mildly depressed by my psychiatrist, after two visits, and he put me on the klonopin about a month ago for some anxiety...which I think stemmed from everyday stressors.  I do not have a panic disorder.  I have a couple of questions for you.  1) Could the klonopin be making the depression worse?  2)  How do you recommend I proceed with stopping, since I'm down to .25mg every other day at lunch.  3)Could the klonopin be causing gastro problems and nausea?  I'm a male, age 32, and have lost about 22 lbs since I started the klonopin.

Also, two months back I had a very extreme reaction to Zoloft, which was originally given to me for anxiety...before the klonopin.  Recently, when I visited my family internist, through some questions he thought I would be a candidate for Effexor XR.  After the first dose, I had the exact same reaction as when I had the zoloft before...agitated, unable to sleep, worse nausea, uncontrollable shaking (especially foot) and unable to stay warm...this is what happened on the zoloft, as well.  He told me to pull the starter pill apart (37.5mg) then take out half the powder, skip a day, and try it.  I had the same thing happen again...even at 1/2 the starter dose.

My mother has always been very sensitive to medications, but my dad is taking Wellbutrin SR to quit smoking right now.  He said other than a few extra rolls in the bed at night, and trouble sleeping a little bit, he has had no other problems.  Would this be another type of medication I should suggest to my Dr.?  Am I correct that I could just be REALLY sensitive to the SSRI medications?  I NEVER want to feel like I did after the last dose, again...it's much worse than the mild depression!  I just don't think that the SSRI's or SSNI's are for me.  Any other suggestions?

Thank You.

[Roger Gould, M.D.]

Yes, klonopin can increase depression. Yes you are very sensitive to ssri's and should stay away from them. Yes, Wellbutrin is a very good choice for depression and anxiety. Another one is Buspar. I don't think klonopin can cause that much gastric distress or weight loss.  It is probably the underlying anxiety.

You could probably safely stop the Klonopin but if you want to be extra cautious either go to twice a week and then stop or stop only you have been on Wellbutrin.

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Do you know how long the "fuzzy hungover" feeling from the Effexor XR will last, or is this from the klonopin?  The 1/4 dose of Effexor XR was on Saturday...and this morning, while I did not have the "shakes", even after a walk I feel like my head is "fuzzy." (some dizziness when I get up, as well).  What I feel like is that I have been overstimulated, and now my body is "zoned out".