Posted by Keith Talent on June 4, 2004, at 10:01:01
In reply to Stimulant/Benzo combo - Chemist or anyone?, posted by psychosage on June 1, 2004, at 0:55:14
> I am wondering what is the rationale for a stim/benzo combo like Dexedrine/Klonopin
The stimulant makes one more sociable (such as in Social Phobia), can fix the anergic (lack of drive) component of Major Depressive Disorder and improves focussing ability (whether it was a symptom of a disorder or not). The benzodiazepine reduces the anxiety ideally to zero or fairly close to it. The anxiety can occur in many patterns, in many disorders. The benzos used in this context are not taken to cause sleep - the aim is for a steady concentration in the brain. This is why clonazepam is the gold standard - it has a half-life in the blood of about 40 hours. If taken twice daily, the concentration in the brain and blood will stay within a nice, narrow, therapeutic range. The stimulants and the benzodiazepines are not, as you might at first think, opposites. I used to think of it this way before reading about the combination at places like this one. You may have seen how often this topic of discussion arises, especially in the context of Social Phobia. The drug companies aren't interested in promoting any drug that is off-patent, so good and useful drugs are often never introduced to young physicians and psychiatrists, leading patients to suffer. I'm not saying that some of the new drugs aren't great, just that some of the oldies are goodies.
> I am BP with depression/some anxiety.
Do you mean Borderline Personality Disorder or one of the Bipolar Disorders? If the latter, there is some longstanding research that amphetamines, when given to patients with manic episodes in hospital, help to control the mania rather than cause/make it worse. If the former, drugs with even a moderate abuse/dependence potential like these would probably be denied to you (because borderlines abuse substances).
> Do non ADHD people take this?
All the time.
> If yes, do any of you take a mood stabilizer and/or antidepressant too?
I take sertraline (Zoloft) as well as clonazepam and dextroamphetamine, but there are plenty of people who are on mood stabilisers with a stim and a benzo. Stimulants were the first drugs used to treat depression. Now, if they're used for this, it's usually in combination with another antidepressant. Some people develop enormous tolerance to stimulants, which is a problem for treating a lifelong condition like MDD. Others stay on the same, low and effective dose for decades.
> I am more curious about Klonopin than the stim part because of past history I should stay away from amphetamines/ritalin. I do take provigil though.
Have you asked yourself why you started taking stimulants? Were there any particular symptoms that you were trying to self-medicate away? Studies have now established that, for example, people with ADHD who never get treated have a much, much greater risk of becoming stimulant abusers than the general population. People with treated ADHD, on the other hand, have a lower risk of abuse. I've never taken modafinil (Provigil), but it sounds from discussions here like glorified coffee. I wouldn't deny yourself a potentially life-transforming treatment just because you tried to treat yourself as a youngster, rather than get professional help.
Hope all works out well for you,
Keith.
poster:Keith Talent
thread:352602
URL: http://www.dr-bob.org/babble/20040602/msgs/353707.html