Update! My Endocrinologist Can't Believe a Psychiatrist Put Me on Klonopin.

I had my yearly checkup with my wonderful Endo, where we got caught up on how things have been the past year. She wanted to know about the Hypomagnesemia, and did I get the drug I was seeking from the UK. I was happy to report that I did receive a 44 day supply of the Investigational New Drug Netazepide after 8 months of legal and logistical wrangling with the FDA and US Customs and the UK's MHRA and Customs. I was now free of Proton Pump Inhibitor dependency, and no more Pantoprazole. (More about that in link in my sig).

 

We discussed some other issues and I mentioned that I had been prescribed Klonopin for GAD (which I don't and never did gave), and was switched to Valium by my current provider to taper. Knowing that the anxiety I had was caused by the Hypomagnesemia, she wondered why I was ever put on Klonopin, one of the most potent benzos out there. The subject of Menmantine (Alzheimers drug) came up. She understands what happens when you stop benzos, and how Memantine works. Theoretically, it should address the issue with the glutamate.

 

She sees no issue with my two endocrine issues being affected. She has concerns about my having used Zyprexa to help with sleep and stomach pain on and off, because it can raise cholesterol levels (mine are slightly elevated, but not a big concern for her) and could send me back to being diabetic again. She thinks Memantine would be safer, and would do what the Zyprexa did for me without the troubling side effects.

 

She asked who the psychiatrist was who I was seeing, I told her that one left the practice and they assigned me to a resident for medication management. One I was off the Proton Pump Inhibitor and the Hypomagnesemia resolved itself, my anxiety went away. So my Psych provider just told me to skip my afternoon dose, then the morning one two weeks later and I ended up in d/d's. I did tell her I switched practices and am going to a Benzo wise provider. She couldn't believe a doctor told me to stop my benzos like that, and said I could talk to the new one about adding Memantine. There are doctors prescribing this off label to help with benzo w/d's.

 

That my Endo is more Benzo wise then the PCP's and Psych's that prescribe this is no surprise. She has taken me off numerous meds over our 10 year relationship, and has said the prescribing doctor can call her if they have a problem with her discontinuing meds she felt I didn't need. I've done my homework on Memantine, so if I get it I'll start a new thread detailing my experience with this.

Having tried memantine I have some experiences with it, and will share them. First things first, it's a very hard drug to start up, it has to be slowly titrated up (but anecdotal reports say that dose of 30 mg / day allow one to cold-turkey benzos with no withdrawals, however at that point I think it would be a bigger problem of how to get off memantine). Anticholinergic side-effects are intense and dissociation is stimulating rather than relaxing. If you want to experiment, go low, and go slow.

I am going on the 5 mg dose, that's what the Endo and I discussed. I'm not planning on titrating it up, it's just to help me along with the taper, which is a concern to my Endo because I have an adrenal disorder, and the benzo taper is a source of stress. I had adrenal stress at one time, and was going into adrenal shock another time (was fortunate I was already in the ER for another issue and a doctor caught it in time). She and I don't want to reinstate the Dexamethasone, my adrenals looked good after last years lab work, so she took me off daily use, and it's only to be used in situations where I need cortisol because my body may not produce enough of it fast enough.

 

I've read threads on various websites about using Memantine, and most used the 5 mg pills, some found dividing the pills and using as little as 2 mg was sufficient. They take it at bedtime as it helps with sleep. But first I gotta get Psych provider on board. 

 

I think if my Endo had known some Psych doc was going to put me on Klonopin, she would have intervened. She was just incredulous.    Endos know that if one process is off, because of a drug or medical condition, it's likely to mess up others. I have no doubt that pituitary and adrenal function are affected by benzo w/d's, hence the people using melatonin as an attempt to sleep, and the ones reporting unpleasant cortisol surges. My Endo completely knew what happens when you stop benzos, and how Memantine could mitigate those effects. She sure knows more that the 3 Psych doctors at the old practice I went to, and thought their treatment was wrong for me.

 

Here's a few older threads I found on here about Memantine.

 

[urlhttp://www.benzobuddies.org/forum/index.php?topic=200797.msg2608249#msg2608249][/url]

 

http://www.benzobuddies.org/forum/index.php?topic=25442.0

 

I'm currently diving in Reddit, some interesting stuff from Memantine users there.

I found 5 mg to be absolutely intolerable (I was doing fine with 2 mg). On 5 mg I didn't feel hunger or that my stomach existed, pictures wanted to jump out of the screen, I had ballance issues and I couldn't sleep at all until it wore off. Once it wore off, I slept really, really well. But I don't have tolerance to NDMA antagonism. When I tried xenon treatment, the dose that was supposed to be low and anxiolytic proved anxiogenic for me.

Your experience seems to back up what many others are doing, splitting pills and using only 2mg. I'm going to start with 2mg and see how I feel. I expect some mild side effects initially (Nausea and dizziness seeem to be common), but if it eases w/d symptoms like it has for others, and reduces overall stress on me, I'll stick with it.

I'm getting the Memantine prescription! Psych provider agreed with Endo that I should try it.   

How large of a Zyprexa dose were you taking?

 

Zyprexa is one of my favorite medications for sleep. I can take 1/2 the lowest dose and be knocked out.

 

The weight gain is a significant problem. It can be managed by watching your eating and simply not over eating.

 

Weight gain is physics. It's not magic. You don't magically create calories because you're taking Zyprexa. You end up

with those calories because you're overeating. If you control that, which can be difficult, the weight gain is managable.

 

Zyprexa sleep is great. It's made for people with much more severe psychiatric conditions but it hits the right spots in

the brain to slow you down and let you sleep when you're anxious. I had some psych prescribe a tiny dose off label to

me because it helps with depression and sleep. Better sleep is less anxiety.

I was originally given 2.5 mg in the hospital for sleep, but my new provider had me split the pills in half because studies show that as little as 1.25mg is as effective as the 2.5mg. My current Psych provider is not a fan of it or anti-Psychotics in general, and the Endo was not wanting me to use it at all because we had made so many strides forward in my health, and this was risking undoing the progress. I had lost a significant amoint of weight, my A1C went from 7 to 5.1, my cholesterol levels all dropped, my adrenal function improved, my blood pressue dropped. Hence Endo took me off all meds for diabetes, cholesteral and adrenal insufficiency and halved my blood pressue med dose. Since using Zyprea, my A1C went up, my cholesterol is now borderline, and I gained a few lbs.

 

Zyprexa does help with sleep, or it did, until it didn't. And it seems to cause acid reflux for me (a known, but not common, side effect). When it didn't help with sleep, I tried the trazadone first, then Vistaril. It took 4 50 mg Vistaril pills (200 mg) to get some sleep. My Psyc provider agrees with Heather Ashton (She read the Ashton Manual) that anti-Psychotics do little to help with benzo w/d's, and only prescribed it because I'd already been on it. Endo has major oncerns because of my congenital adrenal issue about me taking any anti-Psychotics of any kind. I trust her judgement completely and agree with her reasons. I don't want to be dealing with my weight, blood sugar, cholesterol - I worked so hard to normalize all that, and don't need/want some pill that could put all that in jeapordy, not to mention any effects it might have on my adrenals. If I don't need it, why take it?

 

I'm hoping the Memantine will help with sleep, because sleepyness is ironically one of its more common side effects. Endo recommended taking it at night for that reason, and Psych provider agrees. Plus Memantine isn't going to mask w/d symptoms (I was also given Zyprexa to stop w/d agitation, which it worked well for), Memantine is going to halt most of the w/d symptoms at the source, the NMDA receptor, by blocking the excess glutamate causing glutumate etoxicity. It's going to theoretically make the process virtually painless. The anecdotal reports from Reddit and BlueLight users who have done this, support this. And my Endo says the science of what happens when you w/d from benzos, and how Memantine works in the brain as an NDMA blocker is sound. Psych provider agrees.

 

I'm glad Zyprexa works well for you but no more for me.