Posted by zeugma on November 14, 2003, at 17:19:35
I started Klonopin last week for extreme anxiety (general and social) at 0.25 mg bid, and immediately experienced a return of hypnagogic and hypnapompic hallucinations and cataplexy. My neuropsych and I came to the conclusion that since Klonopin suppresses stage 3 and 4 sleep, it caused a return of my narcolepsy-like symptoms that had gone into remission with the NE reuptake inhibitors I take. Her advice was to increase the nortriptyline dosage (I'm currently at 75 mg) because nortriptyline has a beneficial effect in both reducing REM s;eep (linked to depression and narcolepsy) and increasing slow-wave sleep (probably through 5HT-2A antagonism). My anxiety is unbearable, but the narcoleptic-like symptoms are painful and can completely disrupt my sleep. Does it sound like a reasonable strategy to up the nortriptyline dosage in order to tolerate the clonazepam? Currently I take 0.25 mg klonopin in the am and it helps some with anxiety, but it wears off and I'm left with some unpleasant anxiety rebound. Also, I seem to be developing tolerance to such a low dose.
poster:zeugma
thread:279824
URL: http://www.dr-bob.org/babble/20031111/msgs/279824.html