[Gene53]

Hi,

After being "overly nervous and anxious" most of my life, I was finally diagnosed with Generalized Anxiety Disorder, Panic Disorder, PTSD and other CNS disorders 12 years ago and after trying all kinds of meds, my ex-physician and I concluded that Rivotril (Klonopin, clonazepam, 1mg twice/day) was the most successful one at keeping me on an even keel.

Due to some events which have been happening for the past few years, I slowly sunk into depression and for the past year, severe depression.

I've finally coaxed myself to see a psychologist and he suggested I also get a prescription for an antidepressant (plus psychotherapy) but I'm quite aware that clonazepam doesn't jive too well with other meds.

Any advice on compatible meds (SSRI/SNRI) would be appreciated.

[iamtwilight]

Lexapro (SSRI) is a good one if the side effects don't bother you. I didn't get any, but some people do get rather terrible side effects and have to switch. I was also diagnosed with GAD and panic disorder and depression when I started it.

Also I have heard that Effexor (or the newer version of it, Pristiq) is a good one. It is an SNRI.

Hmm... Klonopin by itself isn't a very good med because you need it more and more if you take it regularly (tho you probably know this by now). Antidepressants, however, take a long time before they start working, and maybe you could keep taking Klonopin occasionally until you notice an improvement in your mood.

Good luck!

[splitimage]

I take both Effexor and Celexa with clonazapam with no ill effects. And I haven't had any problem with developing to tolerance to clonazapam in the Year+ that I've been on, but I take it exactly as prescribed.

Don't be discourage if it takes you and your Dr. a few tries to find an antidepressant that works. It often takes a few times, to find th one that's right for a person.

Good luck.

--splitimage

[Gene53]

Thanks for the great advice everyone, I'm seeing the Pdoc tomorrow morning and I would like to be prepared, knowledge is power.

Darn thing is with clonazepam, it needs the CYP-450 liver enzyme to metabolize and it's better to avoid other meds that need the very same enzyme so they won't interfere with each other's absorption and half-life.

Thanks again,
Gene

[iamtwilight]

I found a Finnish study (made by FInnish psychiatrist Sami Anttila) on interactions.

Venlafaxine (Effexor) metabolizes mainly through CYP2D6.
Using citalopram (or sertraline, fluoxetine or paroxetine) with it may block the reuptake of noradrenaline.

From what I saw in this study, most antidepressants don't need the CYP-450 enzyme to metabolize. A lot of people use clonazepam or some other tranquilizer especially when starting an antidepressant and maybe even after it and it's ok. Your pdoc won't have a problem choosing an antidepressant for you

Here's the study for proof though it won't make any sense if you don't know FInnish. but anywhoozle.
http://www.samianttila.net/interakti...kkeiden_yhtei/

Let us know how your meeting with pdoc went.

[Gene53]

Hi folks,

I finally went to see the PDoc this morning as I had heard, he was an older gentleman and really looked old school but I figured "what the hey, nothing to lose". He asked me a truckload of questions about my family history, the effects that clonazepam had on me, my depression, sleeping patterns, PTSD, OCD and phobias. Anyways, the interview (or third degree, LOL!) lasted for 45 minutes then he prescribed Celexa (once a day, at bedtime) and Trazodone (at bedtime, but I think I might hold off on that one till I'm sure the Celexa is not interfering with the Clonazepam). According to drug interactions sites, there's a minor drug-drug interaction between Celexa and Clonazepam whereas Celexa and Trazodone have a MAJOR drug-drug interaction.

He also adjusted my Clonazepam by dividing the 2mg/day into 4 dosages of .5mg every 4 hours or so, the way I was taking it wasn't working well anymore (1mg/twice daily) for it would peak and then die off (half-life is 4 hours) so this way, it'll have a continued effect and I shouldn't feel it's ups and downs so badly.

Cheers,
Gene