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adeline said:

Hi, my pdoc sent me home with a list of benzodiazepines and ADs to research: xanax, ativan, clonozepine, and prozac, paxil and zoloft. I'm mostly interested in the clonozepine, since I've tried Xanax (completely useless) and respond badly to ADs.

Some background info: I'm bipolar, adhd, and recovering bulimic, and stopped all meds ~3 weeks ago.

Besides Lamictal, no meds have ever really helped me. Benzodiazepines (xanax and vistiril) make me feel extremely useless and depressed. Which is the same way I feel when I can't control my anxiety anyhow.

Is there anything that won't make me lethargic? The only thing that works for my anxiety is alcohol, which is probably a bad idea.

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Hi adeline!

I haven't had time to read all of the other posts in response to your initial post - so I apologize if anything I post had already been said.

Benzodiazapines like Xanax, Klonopin (clonazapam), Ativan all work pretty much the same, however, I've known people to respond one way to one benzo and the exact opposite to another benzo. Xanax has a very short half-life, then comes Ativan and then Klonopin. Doctors like to use Klonopin because it has a very long half-life so you aren't as likely to experience ups & downs or lapses in coverage for your anxiety symptoms as you would with shorter-acting benzos like Xanax (although there is a new extended-release form of Xanax available called Xanax XR). Sometimes you'll hear doctors refer to benzo meds as "alcohol in a pill" however, this statement is false because the way benzos act in the brain and the way alcohol acts in the brain are not the same.

Clozaril (clozapine) is an atypical anti-psychotic. Research has shown that these meds are useful in treating other disorders as well including bipolar disorder.

Vistaril (Hydroxyzine) is actually a novel antihistamine - unrelated to benzodiazapines (Xanax, etc). It's novel because it has anti-nausea, anti-anxiety and sedative/hypnotic properties (among others).

Selective Serotonin Reuptake Inhibitors (SSRIs) are meds like Prozac, Paxil, Zoloft, Luvox, Celexa, and Lexapro. They work by blocking reuptake of serotonin in the brain and are mostly prescribed for major depression and anxiety. Other antidepressants like Effexor and Cymbalta work on serotonin and norepinephrine. Wellbutrin mostly works on norepinephrine and a little on dopamine. Remeron is more of a serotonin "enhancer" and at higher dosages enhances norepinephrine as well.

Lamictal was originally developed as an anti-convulsant, but has been found to help with mood stabilization, depression, and anxiety.

Some people who are bipolar find that SSRIs don't help much and can cause hypomania. However, I have heard of those who are bipolar who do well on a combination of an SSRI + Lamictal or Lithium. Wellbutrin can be helpful for bipolar and ADHD but it can also aggravate anxiety and cause insomnia. SSRIs are very helpful for eating disorders like bulimia.

I hope this helps some. Please don't hesitate to ask more questions!

Jerry