New Drug, New Adventures

I had been treated for Anxiety, PTSD, and Panic Disorder with a healthy dose of Xanax throughout the day.  I am also treated  for depression with Wellbrutin. I also participated in a Transcranial Magnetic Stimulation program for depression several weeks ago. I had hoped that TMS would help anxiety too.

Post TMS (you can read my previous posts) I felt a boost in mood but no benefit to anxiety. Then one day, like the switching off of a light, that mood boost was gone.  The cause is unknown to me and my doctors; but they have told me I didn’t respond as well as they would have liked or as much as the average patient to TMS treatments.  My mood decline also coincided with the anniversary of the death of my former partner from suicide and his birthday, so multiple issues are involved.

For three weeks my anxiety increased and my world began to shrink again.  My mood also dipped; I was reliving trauma and grieving.  Neither was near my worst ever experiences.  However, I did feel as though each day I regressed further and further downward.  When you make progress it is a wonderful feeling, when you regress it simply adds to the anxiety and negative feelings.

At the same time I began to suspect Xanax wasn’t quite working as well as it had been for the many years I have been taking it. I’ve always kept myself at minimum dosage, only increasing (PRN with doctor’s permission)  during times of extreme panic or stress and I dosed throughout the day to maintain a minimum steady state level.  Suddenly it seemed, more and more I began to feel the ups and downs of the drugs short acting character.  My anxiety levels were high and I began having more frequent panic attacks.  Strangely, upon taking a dose of Xanax instead of feeling its quick calming effects, which I still somewhat felt,  I was instead acutely feeling its cognitive side effects.  Dizziness, and mind fog being the most prevalent.  Those two effects exacerbated my already high anxiety, temporarily negating the calming effects of the drug.  It wasn’t until those side effects subsided that I was able to feel the calming effects of the drug.  Then the drug acted as it is designed to; but being short acting the effects dissipated and the pattern repeated.

Although still somewhat effective, I began to feel that it was letting me down and creating too much of a constant state of rebound flux.  I don’t know how long this was truly happening since when my anxiety was lower these rebound states may have been less noticeable and easier to handle.

At my next doctors visit I discussed this matter and my desire to try something else.  I was interested in trying Xanax Extended Release.  I was once encouraged to try Klonopin so I was also open to considering that too.  My doctor recommended Klonopin over Xanax XR because he felt it would put me on a more even keel throughout the day.  I agreed to Klonopin 1mg twice a day. (the dose had to be slightly increased to add .25 to .5 midday)

It’s been two weeks now and I am still deliberating.  I have noticed some advantages and some disadvantages with side effects.  Although I was told they were very much the same with Klonoin just being longer acting, I found them to be quite different.  Different is the word I have most often used in my comparison.  At times I can’t even articulate exactly how they are different, they just are.

There is always more at play than just drug interactions.  I also got past the trauma anniversary dates at the same time I began trying Klonopin so what is attributed to what is hard to say.  I can say that I had no adverse reaction switching from one to the other.  No Xanax withdrawal.  I will also credit Klonopin for providing a more longer acting calm throughout the day.  I don’t experience the rebound flux I had been experiencing with Xanax.  Klonopin seems to keep my anxiety just below the surface.  Sometimes it rises and  I use my CBT methods to quench it. I have had only one full blown panic attack during this time.  Those are the good effects I’ve noticed and been able to verbalize so far.

On to the side effects;  of which Klonopin has its own set of unique side effects.  Again,  different from Xanax.  So far it’s the most descriptive way I can say what I am feeling and experiencing.  First and foremost it has sexual side effects I did not anticipate, especially after being told it is in the same class and essentially a longer acting Xanax.  I never had any sexual side effects on Xanax.  I don’t feel as interested in sex and when I do its more difficult to maintain and nearly impossible to, without getting to graphic, reach completion.  This has been extremely difficult for me to manage.  I’m a very sexual person so this is obviously at the top of list of concerns.  I’m hoping it will improve, if not to my previous level of function, then at least to a livable level.  The other side effects are cognitive in nature.  Not as dizzy like Xanax, but more of a lightheadedness. A lack of focus and concentration, and a general spaciness.  Also, transient fatigue, which I find puzzling.  Some days I feel more energy and others less.

Some of these side effects have slightly improved over the two weeks.  Some I feel are more manageable than the constant rebound flux of Xanax. That is why I have not yet made the decision to either remain on Klonopin or request to try the extended release Xanax.  A part of me thinks I owe it to myself to at least try Xanax XR but I really hate changing medications. Therefore I am giving Klonopin more time.  My main concern is the sexual side effects.  Again without getting to graphic or personal, I was able to function twice.  I think both were at a time when one dose was wearing off and it was time for the next dose.  It’s something I am continuing to experiment with and monitor in order to help me make the decision on this medication.

I tried not to read too much on the internet because its full of horror stories and I know everyone reacts to drugs differently.  I also know that I have a proven track record of being extra sensitive to medications and can not take most of what is offered to me.  The fact that I can tolerate Klonopin at all is a plus.

I would be interested in hearing from anyone with any experiences with Klonopin or Xanax XR and welcome any questions since I know I’ve had a difficult time putting into words my experiences.