Chapter 15: Clonazepam The Beast, Effexor XR

During the past month since I posted on my blog I have been trying to eliminate the withdrawal symptoms from clonazepam (generic for Klonopin).  I have not made much progress!  The main symptom being extreme anxiety. Starting Wellbutrin also increased anxiety.  On the fourth day the anxiety was so extreme I did not take anymore.  I took regular Wellbutrin, instead of SR or XL which was what my psychiatrist at the Amen Clinic recommended.  I think that was a mistake!  I was disappointed, but I didn't want to try Wellbutrin again!  The anxiety makes my body feel like it is going to explode from the inside.  This feeling is a new one to me, very uncomfortable, and I am weary!

I was first prescribed clonazepam for the anxiety caused by the antidepressant Zoloft.  I did not feel anxious until I started on the medication, and the anxiety was mild.  There was evidence at this time of clonazepam causing scalloping on the brain and of it being highly addictive.  There was also evidence the anticonvulsive class of drugs helped with anxiety.  My psychiatrist at the time didn't know this information about clonazepam (or maybe he didn't agree with it), but he helped me recover from a major depression more than once.  Now I want to come back to the "present" and not spend any more time in the past.

One bright spot in the past month was talking to my psychiatrist at the Amen Clinic by phone on June 16.  He was happy to hear I had been off clonazepam for over 5 weeks.  He was positive and supportive and boosted my spirits.  He reminded me what an accomplishment it is to be off this drug!  He said I had been on clonazepam for so long it could be causing depression!  He recommended I wait until my body had been free of the drug for 8 weeks before we decide to change or add medications to my treatment.  I did add 5-HTP, also known as oxitriptan (INN), a naturally-occurring amino acid, chemical precursor and a metabolic intermediate in the biosynthesis of the neurotransmitters serotonin and melatonin from tryptophan.  I will talk to my psychiatrist again on July 7 after being off the beast (clonazepam) for over 8 weeks.

I have not noticed any difference in how I feel after adding 5-HTP, except maybe a little nausea.  I am ready to take the next step in my treatment plan, adding Effexor XR.  This is what my treatment plan from the Amen Clinic says about Effexor XR:  "At low dosages, Effexor XR will help anxiety, depression and obsessive thinking, and at high dosages will help ADHD symptoms.  An antidepressant with action at multiple receptor sites, Effexor XR will enhance prefrontal cortex function and decrease anterior cingulate and limbic hyperactivity.  Effexor XR has a starting dosage of 37.5 mg daily, increasing by one every 7 days as tolerated, to the therapeutic target dose of 75 mg to 350 mg.  It should be taken with food to avoid upset stomach.  Effexor should not be stopped abruptly because it has been associated with a discontinuation syndrome in some patients.  At higher dosages, blood pressure should be monitored.  If Effexor XR causes more irritability, I would increase the anticonvulsant to stabilize the temporal lobes, enhance mood stability, and decrease anxiety or irritability."

I was on Effexor (not Effexor XR) about 10 years ago.  The nausea it caused didn't stop, so I changed to Zoloft.  The problem with nausea could have been caused by going on the medication too quickly.  This time I will increase the dosage more slowly.  I experienced the discontinuation syndrome mentioned above when coming off Effexor.  At this point, I expect to be on an antidepressant for the rest of my life so I am not concerned about discontinuing the drug.  I will need to lower the dose of Luvox as I add Effexor XR.  I have a positive attitude and will discuss the treatment plan with my psychiatrist next week.

I am ready to have a normal day not based on surviving!  "Normal day, let me be aware of the treasure you are." (by Mary Jean Iron)