To klonopin or not to klonopin?

I started feeling increasingly anxious and depressed as the day wore on today- despite being busy and productive at work. And I had a bunch of errands to do this evening as I am going away this weekend.

I went in to Panera bread for some soup and a sandwich, hoping to relax and feel better. I didn't. I decided to take a quarter of a milligram of klonopin. It helped.

I don't know. Should I just fight the anxiety? Try to push through on days like this? Just be miserable, and hope that in the long run it will make me a better person? Is taking the klonopin on days like this only giving me more days like this? I never know.

I think that if I take it too frequently, and give in too easily, it becomes a problem- it will actually start to affect my mood. Then again, my mood is not so good if I am taking it a lot, so I don't know which came first. But I also know that not taking it does not keep these days away, and that taking a tiny bit can be the difference between getting things done vs going home to be miserable.

And I did get a haircut, go shopping for presents for my niece, and do some grocery shopping. Not too bad for a work night for me. The only think I haven't managed to do is clean. I'm not that good. I'm going to get up early and see if I can clean a little before I leave. I get to see my niece this weekend!

Getting off of klonopin

During a manic period I was  once prescribed 10mg of Klonopin a day. I rebelled, eventually, because between that and 500mg of Seroquel I was sleeping 20 hours a day, and during the 4 hours a day I was awake I couldn't speak in complete sentences. I cut it in half, and then for a number of years was taking about 4mg a day. Then another psychiatrist told me that klonopin causes depression, and that I should try to get off of it- but he wrote me whatever I asked for. So I tried to get off of it, at my own pace- if it causes depression, it is the last thing I want to be taking! I got down to about half a milligram. And I have really taken half a milligram a day, on and off, for the last few years- occasionally more during PMS, etc. 

Any time a doctor gave me a hard about giving me a script for Klonopin, I would get angry and a little scared. I'd feel the lack of power I had. I'd get mad. I'd decide I needed it all the more. The times I have cut down was when I was under no pressure to do so. I'm sure if a doctor had given me a tapering schedule, etc., I would have rebelled. And it would have felt too threatening.

So when I was in the hospital, I told them my meds, which included half a milligram of klonopin 1-2x/day prn- but I had been taking it pretty much daily for the past few weeks. And the psychiatrist wrote the order for that. I could take it if I wanted to. But once I decided to go back on the Ambien (the lesser of 2 evils), I decided enough is enough. I am done with klonopin. Forever. 

Again- if there had been any external pressure not to take it- I think I would not have made the decision. I would have argued to keep taking it, tried to get the psychiatrist to prescribe it.

I keep thinking that it really wasn't that hard stopping the klonopin- but there were two nights I could hardly sleep because of cramps in my legs. I wonder if that was a withdrawal effect. I was attributing it to all of the pacing I was doing, after spending so my of my life recently in bed. 

I was also able to stop the stimulants without much trouble- I was just a little tired and hungry for a week. But miss a dose of Effexor, and I go into a very miserable withdrawal. And as for Zyprexa- forget it. I have given up, for the moment, trying to get off of that. I think that the wrong medicines are controlled substances!

The couple of times that I did feel like taking klonopin recently it wasn't due to anxiety. It was due to agitation. And because of how out of control I was when I was manic- even though it was many years ago- my agitation still scares me. If I am anxious, okay I'll just suffer. But mostly I haven't felt like taking it.

I know I haven't really been tested. When I next have my period (every 3 months the way I take the BC pill). If I get hypomanic in the spring. Or my next serious depression when I am trying to still function. We'll see how easy it is to forget about klonopin then. But for the moment, it is a non-issue. 

No More Benzo's!

Over the weeks preceding my hospitalization, I had started taking klonopin on a daily basis. Not a lot, maybe half a milligram a day most days, but that is a lot for me. Part of the reason was I stopped the Ambien due to morning fogginess- and the Lunesta that my doctor gave me in it's place was even worse (so I took klonopin- makes no sense). And part of it was the growing anxiety I had- which was really secondary to the depression. I was too depressed to do what I needed to do- so I was anxious about things. I wasn't happy I was taking it, but it seemed to get me through the moment.

I took my last klonopin my first night in the hospital- at 1am because I couldn't sleep. The next day I had switched back to ambien. And I no longer had to function- if I felt anxious, I could just pace (which I did). And as the lithium has been raised, I think that it has also had an anti-anxiety effect.

So I decided while in the hospital, no more benzo's. Ever. They make me depressed in the long run, they have cognitive side effects, they have rebound effects. So no more. So far, it really hasn't been much of an issue- I haven't really wanted to take any klonopin- but I know that I haven't been tested. Also, I am taking Ambien, so I am sleeping really well.

I also came off the Wellbutrin. I told my doctor in the hospital that I am on so many drugs that if I am going on one drug (lithium), I have to get off of something else, and I wasn't sure if the wellbutrin was doing anything anyway.

Still too many drugs. If I had more courage, I would use this time away from work to try to get off of my Zyprexa. Or at least to reduce it. I don't think I will. I just got off of benzo's, I can't get off of two "downer's" at once!

But we are trying to reduce my Effexor, and I don't know if I am out of my mind for doing this or not. I was just hospitalized for depression, why try to reduce my antidepressant? Because I take an incredibly high dose. And less meds sounds good to me- and I am not working, so now seems like the time to try it.

What I really need to decide about is the ambien. I tried taking 7.5mg a couple of nights ago, but my body wasn't having it. I didn't fall asleep until I gave in and took another 5mg pill. Perhaps I gave in too soon. Perhaps I just need to have a few sleepless nights and then ambien will work great at 5mg. But my other plan is to try Sonata, which has an extremely short half-life, and is much less likely to make me fuzzy the next morning.

Other meds- I will probably stay on for the moment. Just the effexor and the ambien I will try to reduce for now. And the lithium- I am not sure about my dose. My doctor at the program raised my dose from 750mg to 900mg because my level was so low. I said sure, because I figured having a therapeutic lithium level would put me in a better position to someday get off of the Zyprexa and not get manic. But since the increase my stomach has not felt good- and I don't know if is the reason. I don't think I need 900mg of lithium for antidepressant augmentation purposes, and if I am going to have side effects- and I'm not trying to get off of the Zyprexa right now anyway- then it is just not worth it to be this high.

So I put in a request to see the psychiatrist today at the program, but I was not seen.