Posted by Rick on May 1, 2001, at 21:09:24
Before I give details, here's the general question I'm throwing out for discussion:
If doses are reduced in a med cocktail for anxiety and then quick but moderate declines are seen in theraputic value, does this necessarily mean that the higher doses are essential for maximum benefit? Or is such a conclusion premature? Could it be that the initial post-down-dosing declines are due to a temporary withdrawal/body adjustment phase... with full benefit possibly returning after awhile at the lower doses? (Overt physical discomfort hasn't been a factor in my case.)
If you'd like more detail behind my general question before offering up an opinion, read on.
The cocktail of Klonopin, Serzone, and Provigil is still working wonders for my severe non-depressive Social Phobia after 9 or 10 months. Prior to that I was taking Klonopin for a year solo or in other combos with great benefit. But the current cocktail is the one that has clicked big-time for me.
However, over the last month or so, I've noticed myself oversleeping more often and forgetting things --nothing major, but enough to be a little troubling, embarrassing, and inconvenient.
So I've tried tapering the Serzone (even down to zero), and have cut my Klonopin from 1.25 mg to 1.0, in various combinations. What I've found is that with every cut (especially of the Serzone, although Serzone likely potentiates Klonopin), the memory problems and oversleeping (as well as the every-morning dry-mouth) improve very rapidly...but the theraputic value notches down very quickly as well. Since the full benefits, and the side effects discussed, come back promptly when I re-up the dosage, I know it's not poop-out. I've never given a significantly lower dose more that a week before moving back up.
Right now I'm taking just a little less than originally, with Serzone cut from 450 mg to 375, and Klonopin cut from 1.25 to 1.0. The side effects have dissipated slightly at this level, but the theraputic value has come down a notch as well -- i.e., still doing great, but with a tad of anxiety creeping back at times. Since I'm "spoiled" by the previous-dose success, I don't like to see even minor deterioration.
Naturally there's another complicating factor, which is that I've been so busy that I have to work late often. (My morning-only 100 mg of Provigil does NOT help me stay up late...it has neither a wake-promoting nor a crashing effect in the evening.) I understand that getting insufficient sleep can impair memory as well. But how much memory effect is due to hours-of-sleep vs. the meds, I can't say.
So, do you have any thoughts as to whether the loss of theraputic value I see with moderate cuts in Serzone and/or Klonopin could be due to mild withdrawal symptoms manifested in temporarily increased susceptibility to anxiety...and that if I stuck with the lowered doses for awhile full benefits could return? Or can small med reductions indeed have have an extremely quick negative effect on benefits that took awhile to surface and build in the first place (at least for the Serzone)?
Thanks in advance for any thoughts.
Rick
poster:Rick
thread:61308
URL: http://www.dr-bob.org/babble/20010424/msgs/61308.html