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)
Showing posts with label scalloping. Show all posts
Showing posts with label scalloping. Show all posts
Sunday, July 4, 2010
Thursday, April 29, 2010
Chapter 11: My Brain Scans; Outside Surface View
Getting off the drug clonazepam is brutal! Clonazepam is the generic name for Klonopin, and is in the benzodiazepine family of drugs. They are sometimes called benzos for short. The last time I lowered the dose it brought me down to .03125 of my original dose of .50 at night. This time the withdrawal symptoms did not subside in 2-3 days, they persisted.
After having a headache, slight nausea, a strange dizzy feeling, and increased anxiety for a week, I increased the dosage of Neurontin. I am now taking 300 mg of Neurontin three times a day and 600 mg before bed. The main side effect of Neurontin (for me) is a dizzy feeling; so I am just more dizzy now. Increasing the dose of Neurontin has decreased the anxiety, and the other withdrawal symptoms as well.
The supplements recommended by the doctor at the Amen Clinic are also helping. (Refer to Chapter 10 for more details) I take Restful Sleep and Neuro PS at night and they have helped me continue to sleep well. Adding the extra Neurontin capsule at night also helps me sleep. Taking Brain Vitale in the morning seems to help with anxiety. Luvox, Neurontin, and the supplements are making the withdrawal tolerable. I would hate to do it without them!
I am hoping in the next two weeks the side effects of Neurontin will be over, and the clonazepam withdrawal symptoms will have stopped. If this happens, I am going to stop taking clonazepam. I am anticipating a spike in anxiety when I do this. If this happens I can increase the dosage of Neurontin again.
Being addicted to clonazepam gives me more compassion for anyone addicted to anything! I want to get off clonazepam because it is causing scalloping on my brain. This scalloping shows I am not getting the blood flow I need in those areas. It is hard to remember the reasons to quit when I feel sick day after day and know if I took a little clonazepam I would begin to feel better. It is a hard place to be.
Here are SPECT scan photos of the outside of a healthy brain. These are scans of the top down surface and the underside surface of the outside of the brain. These are 3D Surface renderings, looking at the top 45% of brain perfusion. (Perfusion means injection of fluid into an artery in order to reach tissues.) A normal scan shows full, even, symmetrical perfusion.
These are my SPECT brain scans of the outside of the brain during concentration. The scalloping is circled in white. The scalloping on my brain is mild and should heal after I am off clonazepam. The scalloping holes mean cerebral blood flow and metabolism are poor in these areas. It does not mean my brain is missing in these scalloping holes. After the scalloping heals my brain will have better functioning capabilities.
These are my SPECT brain scans of the outside of the brain during rest. The scalloping is circled in white again and you will notice an object has been put in one of holes to show how deep it is. I think it looks like I put a Mentos candy in my ear and it went to my brain. :)
After having a headache, slight nausea, a strange dizzy feeling, and increased anxiety for a week, I increased the dosage of Neurontin. I am now taking 300 mg of Neurontin three times a day and 600 mg before bed. The main side effect of Neurontin (for me) is a dizzy feeling; so I am just more dizzy now. Increasing the dose of Neurontin has decreased the anxiety, and the other withdrawal symptoms as well.
The supplements recommended by the doctor at the Amen Clinic are also helping. (Refer to Chapter 10 for more details) I take Restful Sleep and Neuro PS at night and they have helped me continue to sleep well. Adding the extra Neurontin capsule at night also helps me sleep. Taking Brain Vitale in the morning seems to help with anxiety. Luvox, Neurontin, and the supplements are making the withdrawal tolerable. I would hate to do it without them!
I am hoping in the next two weeks the side effects of Neurontin will be over, and the clonazepam withdrawal symptoms will have stopped. If this happens, I am going to stop taking clonazepam. I am anticipating a spike in anxiety when I do this. If this happens I can increase the dosage of Neurontin again.
Being addicted to clonazepam gives me more compassion for anyone addicted to anything! I want to get off clonazepam because it is causing scalloping on my brain. This scalloping shows I am not getting the blood flow I need in those areas. It is hard to remember the reasons to quit when I feel sick day after day and know if I took a little clonazepam I would begin to feel better. It is a hard place to be.
Here are SPECT scan photos of the outside of a healthy brain. These are scans of the top down surface and the underside surface of the outside of the brain. These are 3D Surface renderings, looking at the top 45% of brain perfusion. (Perfusion means injection of fluid into an artery in order to reach tissues.) A normal scan shows full, even, symmetrical perfusion.
These are my SPECT brain scans of the outside of the brain during concentration. The scalloping is circled in white. The scalloping on my brain is mild and should heal after I am off clonazepam. The scalloping holes mean cerebral blood flow and metabolism are poor in these areas. It does not mean my brain is missing in these scalloping holes. After the scalloping heals my brain will have better functioning capabilities.
These are my SPECT brain scans of the outside of the brain during rest. The scalloping is circled in white again and you will notice an object has been put in one of holes to show how deep it is. I think it looks like I put a Mentos candy in my ear and it went to my brain. :)
Below are three examples of more severe scalloping and the causes. These scans are taken from a poster made by Dr. Daniel G. Amen. They show a 3-D surface view of the brain, acquired by SPECT imaging, looking at cerebral blood flow and metabolism. I think these scans are fascinating and intriguing!
Friday, April 16, 2010
Chapter 9: Three Days At The Amen Clinic
Wednesday morning I had my first SPECT brain scan. The IV was inserted with ease and I had no bruising later. The concentration scan is done first and I did an activity to get my brain focused. The radioactive isotope was put into my IV during the activity. I did not have any sensation in my body when it was injected. After the activity I laid down on my back on the scanning machine. I needed to hold still, but the the time went quickly; it took about 15-20 minutes. A band was wrapped around my forehead to help me keep my head still. The scanning machine made a noise, but it wasn't irritating. Part of the machine went around my head, but I did not feel claustrophobic like I have during an MRI.
Wednesday afternoon I had an appointment with one of the historians. She had read my intake questionnaire and asked me questions to clarify, or give her more details on my answers. This was a calm, deliberate process. She gave me plenty of time to add any information to what was included in the questionnaire. She compiled a well written history for the psychiatrist I had an appointment with later in the week.
Thursday morning I had my second SPECT brain scan. After the IV was in place I was taken to a dim lit room to prepare for the resting scan. I was asked to let my mind wander or daydream, but not to think about any specific subject, meditate, or fall asleep. A short time into my resting the isotope was injected. There was an interesting rug in the room with geometric shapes on it. I wanted to see how the pattern repeated itself, but I didn't, I kept resting. There was also a picture of Dr. Amen with information about his work in brain imaging I wanted to look at. I didn't, I kept resting. After 15-20 minutes, I laid down on the scanning machine for my second scan.
On Thursday afternoon, my husband and I had a delectable seafood lunch at a restaurant called Rusty Pelican. It is on 2735 West Coast Highway, Newport Beach, CA 92663-4798, (949) 642-3431. http://www.rustypelican.com/
On Friday afternoon I met with a psychiatrist. He showed me my brain scans and went over what was found on them. It was awesome to see the scans! He showed me rippling, called scalloping, on the surface of my brain. For me, it is probably caused by taking the drug clonazepam. I have not abused or been exposed to drugs, alcohol, or environmental toxins. I have used this drug for approximately 8-10 years and the Amen Clinic uses it only for short periods of time for severe cases of anxiety. I am in the process of coming off clonazepam so the scalloping on my brain can heal!
Other Findings:
Wednesday afternoon I had an appointment with one of the historians. She had read my intake questionnaire and asked me questions to clarify, or give her more details on my answers. This was a calm, deliberate process. She gave me plenty of time to add any information to what was included in the questionnaire. She compiled a well written history for the psychiatrist I had an appointment with later in the week.
Thursday morning I had my second SPECT brain scan. After the IV was in place I was taken to a dim lit room to prepare for the resting scan. I was asked to let my mind wander or daydream, but not to think about any specific subject, meditate, or fall asleep. A short time into my resting the isotope was injected. There was an interesting rug in the room with geometric shapes on it. I wanted to see how the pattern repeated itself, but I didn't, I kept resting. There was also a picture of Dr. Amen with information about his work in brain imaging I wanted to look at. I didn't, I kept resting. After 15-20 minutes, I laid down on the scanning machine for my second scan.
On Thursday afternoon, my husband and I had a delectable seafood lunch at a restaurant called Rusty Pelican. It is on 2735 West Coast Highway, Newport Beach, CA 92663-4798, (949) 642-3431. http://www.rustypelican.com/
On Friday afternoon I met with a psychiatrist. He showed me my brain scans and went over what was found on them. It was awesome to see the scans! He showed me rippling, called scalloping, on the surface of my brain. For me, it is probably caused by taking the drug clonazepam. I have not abused or been exposed to drugs, alcohol, or environmental toxins. I have used this drug for approximately 8-10 years and the Amen Clinic uses it only for short periods of time for severe cases of anxiety. I am in the process of coming off clonazepam so the scalloping on my brain can heal!
Other Findings:
- Luvox has been helping calm the activity in my deep limbic system; where depression originates.
- There is too much activity in my basal ganglia; causing anxiety.
- I have an atypical depression needing to be treated in layers. This is why I haven't achieved a more complete remission of symptoms in the last year and a half. The basal ganglia (anxiety) must be calmed down first.
- My prefrontal cortex is not functioning effectively. After the anxiety is calmed down I will need to take a drug to stimulate the prefrontal cortex. If I take this drug too soon, it will over stimulate the basal ganglia and cause too much anxiety.
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