Kickas.org Forums Treatments, Drugs and Alternatives AS Pharmacy Effective sleep med for pain/depression

Terry Lea

Thanks. I hope pain is controlled today. May I ask what dosages work for you, with these two. Doc started me on 50 mgs Traz @ bed, but left me on the Ami.

Could you also tell me all about thequalities you've found with these two , or PM me ,if you like. I think, with KICK AS's help, I almost have my answer.
Thanks, Terry Lea

Yours in the Battle
Brian in Vanc

Hey Brian,

Always happy to help out when ever I can. I was on Neurontin for about a year and it seemed to stop working, but so far I have gotten a lot better results with the Klonopin. Here is some info on it for you. There is also an herb called Kava that is claimed to have some of the properties as Klonopin.

Brent

http://www.psyweb.com/Drughtm/klonopin.html

Clonazepam ( Klonopin ) is an anticonvulsant primarily used in the treatment of seizure disorders. Clonazepam ( Klonopin ) is a member of a class of drug known as benzodiazepines. This drug may also be used as an antianxiety, for the short-term relief of mild to moderate anxiety. Clonazepam ( Klonopin ) may also be used to treat movement disorders ( e.g., Touette's Syndrome), panic disorder, drug-induced mania, to help resistant depression, nocturnal myoclonus, relieve trigeminal neuralgia, bipolar affective disorder, and to help control certain types of petit mal, atypical, akinetic, myoclonic, or absence seizures.

Symptoms or Effects

Common: Anxiety, behavior problems, insomnia, irritability, drowsiness, or problems with coordination.

Rare: Abdominal cramps, blurred vision, chest congestion, coated tongue, confusion, convulsions, depression, diarrhea, double vision, dry mouth, fever, fluid retention, hair loss, hallucinations, headache, involuntary eye movement, loss of voice, memory loss, racing heartbeat / palpitations, shaking / slurred speech, sore gums, staggering / trembling, trouble breathing, unusual bleeding / bruising, or urination problems.

See physician always: Abdominal cramps, blurred vision, chest congestion, coated tongue, confusion, convulsions, depression, diarrhea, double vision, dry mouth, fever, fluid retention, hair loss, hallucinations, headache, involuntary eye movement, loss of voice, memory loss, racing heartbeat / palpitations, shaking / slurred speech, sore gums, staggering / trembling, trouble breathing, unusual bleeding / bruising, or urination problems.

http://www.immunesupport.com/library/showarticle.cfm/id/3154

Many CFIDS specialists prescribe the drug Klonopin. In the October 1999 issue of The Fibromyalgia Network, nine CFS/FM specialists summarized their most effective treatments, and six included Klonopin. Interestingly, the three who did not are primarily FM specialists.

Dr. Cheney prescribes Klonopin to address a condition associated with CFIDS called "excitatory neurotoxicity." To explain this condition to patients, he draws a line with "seizure" on the far left and "coma" on the far right. A big dot in the middle represents where healthy people are when awake. A dot somewhat to the right of the middle indicates where healthy people are when asleep – slightly shifted toward coma. He highlights in red the left portion of the line, from seizure to the middle, and labels it "Neurotoxic State" (damaging to the brain). He highlights in blue the right portion of the line, from coma to the middle, and labels it "Healing State."

In CFIDS, an ongoing injury to the brain shifts patients toward seizure. A dot to the left of the middle, marked "injury," represents the position of CFIDS patients. This puts us in the red "Neurotoxic" zone. When we shift toward seizure, we often experience "sensory overload." It’s as if our brain’s "radar" is too sensitive. Our neurons (nerve cells) are sensing stimuli and firing when they should not. This causes amplification of sensory input. Light, noise, motion and pain are all magnified. At the beginning of their illness, many patients report feeling exhausted, yet also strangely "wired." The "wired" feeling is the slight shift towards seizure that occurs as a result of the excitatory neurotoxicity.

Cheney frequently uses the term "threshold potential" when discussing excitatory neurotoxicity. (Think of the threshold - bottom - of a doorway. The lower it is, the more accessible it is. When it is at floor level, everything can enter. When it is raised, access is restricted to taller people. If it is too high, no one can enter.) Threshold potential refers to how much stimulus it takes to make neurons fire. If the threshold potential is too low, even slight stimulation is "allowed to enter" and is detected by the neurons. This causes the neurons to fire, resulting in sensory overload. If the threshold is dropped to nothing, all stimuli get through and the neurons fire continuously, resulting in a seizure. If the threshold is raised, only stronger stimuli can make neurons fire. A healthy person’s threshold potential naturally rises at bedtime, promoting sleep. If the threshold potential is too high, you feel drugged or drowsy. If the threshold potential is raised extremely high, coma results.

Two receptors in the brain, NMDA and GABA, determine the threshold potential. During the waking hours of a healthy person, NMDA and GABA should be equally active. This balances the person in the middle of the seizure/coma continuum. NMDA stimulates, and GABA inhibits. If NMDA increases, one moves toward seizure. If GABA increases, one moves toward coma.

In CFIDS, NMDA is more activated than GABA, lowering the threshold potential. This causes neurons to fire with very little stimulation, resulting in sensory overload. This condition of excitatory neurotoxicity is dangerous. Dr. Cheney emphasizes that in an attempt to protect itself, the body will eventually kill neurons that fire excessively. He states that brain cell loss can result if this condition isn’t addressed.

How can the brain be protected against excitatory neurotoxicity? Klonopin. This long acting benzodiazepine has been Dr. Cheney’s most effective drug for CFIDS over the years. He believes that Klonopin and the supplement magnesium may be two of the most important treatments for CFIDS patients because of their neuroprotective qualities. He recommends two or more 0.5 mg tablets of Klonopin at night. Paradoxically, very small doses (usually a quarter to a half a tablet) in the morning and mid-afternoon improve cognitive function and energy. If the daytime dose is low enough, you’ll experience greater clarity and think better. If the daytime dose is too high, you’ll become drowsy. Adjust your dose for maximum benefit, taking as much as possible without drowsiness. Adjust the morning dose first, then take the same amount mid-afternoon if needed, then take three to four times the morning dose at bedtime. Dr. Cheney recommends doubling the dose during severe relapses.

Dr. Cheney most frequently prescribes the combination of Klonopin and Doxepin, along with the supplement "Magnesium Glycinate Forte." Magnesium Glycinate alone is a good choice for the more budget minded(www.ImmuneSupport.com sells it as "Magnesium Plus".) A common dosage of magnesium is 200 mgs at bedtime. Too much magnesium can cause diarrhea, though glycinate is usually the best tolerated form.

Cheney prescribes Doxepin in the form of a commercial elixir (10mg/ml). At low doses, this tricyclic antidepressant acts as a very potent antihistamine and immune modulator. Doxepin acts synergistically with Klonopin to assist sleep, and may improve pain. Patients tend to be very sensitive to Doxepin, which can cause morning fog and fatigue if the dose is too high (5 to 10 mg or higher). He recommends starting at two drops a night and gradually increasing the dose until "morning fog" becomes a problem. Most patients can’t tolerate more than half a cc.

On a handout entitled "Neuroprotection via Threshold Potentials," Cheney lists six substances that can protect the brain. Under the category "NMDA Blockers" Cheney lists:

1. Parenteral magnesium and taurine (intramuscular injections of magnesium and taurine, usually given with procaine) 2. Histamine blockers (Doxepin Elixir) Under the category "GABA Agonists" (increases GABA) Cheney lists: 3. Klonopin 4. Neurontin 5. Kava Kava 6. Valerian Root

Klonopin is taken "day and night"; Neurontin "night, or day and night"; kava kava “daytime only”; and valerian “nighttime only.” The first four are by prescription, the last two are herbs. In my limited experience, only certain patients are put on magnesium/taurine injections, and then only for a limited period before switching to oral supplements.

aloha Brian,

I read the other post first, but in answer to your quest.

I've been takin Klonopin for two years...almost every night/ 20min before going to bed.
One doctor refered to the 'pins'n needles, muscle cramps and spasms in the legs while sleeping'
as night atraxia...dosage .5mg is very mild...this one has worked wonders for me...it's the only
good thing rheumy#3 came up with( he told me to take 4 tums a day for an ulcer)...

Now what I really like about it is this- NO HANGOVER, even on the nights when i wake at
3/4am with back pain and can't get back to sleep. the cool thing is getting 5-7 hours of
restful sleep on a fairly regular basis...nothing else i tried was as kind and gentle.

not like pushin' pills or nothing
aloha Ben

Hi Brian,
I am on 100mg of trazadone and 1 blue zopiclone. They seem to work well together. I take them about 1030pm and am asleep by 11. I still wake occasionally at night. No druggy effect in the morning though. Nice to see you live in Van. I live in N. Van.
Anyways take care,


~If there is something you cannot change, then change the way you react to it

Hi Terry Lea-

Cool! me too! Med ? Must you stay on both continuously like Anti-D's, or can you use when + as needed?? How is your back , and what limitation of AS, if any? Who's your Rheumy? ( Please Pm if preferred.)
Yours Brian

Yours in the Battle
Brian in Vanc

Hi Ben- Thanks and no sweat- just seeking the healthiest option for pre- existing conditions.. I keep trying the NSD,, but alas , I've not the money , nor perhaps, the discipline to stick all the way through it, even when the pain gets hightened. Yours Brian

Yours in the Battle
Brian in Vanc

Thx so much , Brent. I havent been able to read all the way through yet, but I will soon, and reply. Yours- Brian

Yours in the Battle
Brian in Vanc

I stay on both every night. I also take morphine for the bad pain. My rhummy is Dr. Chatlin in N.V. Who's yours? I also when first diagnosed went to G.F. Strongs in Van. Was very helpful!!!!


~If there is something you cannot change, then change the way you react to it

Do you live in N. Van????


~If there is something you cannot change, then change the way you react to it

Hi Terry Lea



Yes, you have a fellow KICKAS'er on the shore. I live in Lynn Valley, in kind of subsidized accomadation. It really helps a lot, and allows me to have somewhat of a life , although because I look fairly normal (vitamins,excercise etc), the old folks can gossip a bit.


My AS- SI joints definately show,although for some weird reason, they don't like to admit it- I guess its because AS is so harsh a diagnosis, it warrants incapacity ,without question. I have bone spurs and vertabral "cupping' throughout lumbar + thoracic, 2 protruding discs,that I try to ignore, little lordosis of spine,natural fusion at T4-5,the list goes on. My anti-enflam is Flurbiprofen,Dmard is Sulphasalazine, bed med is Amitryptyline + now trazadone- pain med- Oxycodone. Wow, I sound like a frickin'' drugstore. Fortunately, I always use the absolute minimum of all, to get by on.


I spent about a year and 1/2 volunteering on the Arthritis Answers line, at the Mary Pack Arthritis Centre, and my Rheumy, Dr Klinkhoff, practices there. Is Dr. chatlin a female? I think they tried to get me in to see her, but she was full or something. How do you find her/him? I beleive GS Strong is the place with the warm water pool etc- What else is there?

Well, I'm just starting some typing excercises, and boy are my hands sore. Hopefully I'll learn the correct method soon. Can you tell me more about your other sleep med( not Traz ). Thx Terry Lea I hope your back is tolerable today!!!

Yours in the Battle
Brian in Vanc