I understand. Can you take a low dose of Diazepam + Gabapentin on the off days? Or even Pregabalin?
How often are you taking Clonazepam and what dose?
Was it you who had the meeting with Dr. Bance, who suggested Carbamazepine if the Gabapentin does not work?
I've been close to your thoughts time and time again, however so far resisted daily use. I also have a theory that based on the long half-life taking it first thing in the morning may be better. It may reduce interdose withdrawal as you don't need it when sleeping. I have meant to ask
@linearb why he doses in the morning, as it's often suggested to take at night.
So far I have tried to cycle things, so 3-10 days of 2-3 mg Diazepam with 300-600 mg of Gabapentin, then 2-3 days of Clonazepam, then 2-3 days of Deanxit etc.
Maybe I'm stupid, I'm no doctor, but I look at monthly doses as an indicator of dependence and would rather have very low dependence on several medications than high dependence on one.
I take 30 mg of Mirtazapine as a daily regular medication at night with 300 mg of ALA in the morning.
Looking through posts, people seem to rotate or have a regular 'stack'.
Yes, I saw Dr. Bance. He suggested, given I'd had some success with Clonazepam, to try a 3 month course of 0.5 mg a day. He quoted the fact many are on it all their life for epilepsy with no issues.
However, he advised his preferred routes of Gabapentin and Carbamazepine.
You may recall I have severe reactive electrical sensation tinnitus in the left ear, particularly aggravated by white noise. On top of that I have reactive morse code like beeps that ride on other sounds in both ears.
I gave the Gabapentin a go for a fortnight and felt it was making the left ear worse so I stopped - not sure if this was a long enough chance to give it, but it wasn't helping the slightest.
Next came the Carbamazepine, initially I thought it was helping the reactive morse element but the strangest thing happened, it started giving me the electrical reactive spasming in the right ear as well - it was definitely the Carbamazepine doing this as it ceased when I stopped taking it. I'm still not convinced there isn't a stapedial myoclonus element to one part of my problem based on this and the physical sensation I get.
Anyway, back to Clonazepam. That's quite a combo you have there, I'd imagine it's not a UK GP that's prescribed you both Diazepam and Clonazepam and you've had to source them elsewhere.
I take them for 1 or 2 days a week. They aren't as effective as initially when a single 0.5 mg tablet would knock out the left ear reactive electrical spasming, now I have to take say 0.5 mg Friday night, then Saturday morning and then maybe again Saturday afternoon to get the same effect. I sometimes take an extra 0.5 mg in the week on the odd day, which I know is stupid, but out of pure desperation as my symptoms are so distressing.
I've done a fair bit of research on Clonazepam lately and certain things stuck out. The first is the recent studies on how the bad reputation benzos have received doesn't stack up to the science and 50 years of study. It summarised that they're as effective for anxiety as SSRIs, have similar withdrawal issues and that their anxiolytic properties don't build tolerance contrary to popular belief.
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Benzodiazepines - It's Time to Return to the Evidence
Another report I read was from a long serving MD who discussed how they had positively changed many of his patients' lives after being put on them long term.
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Benzodiazepines - A Perspective
I'd also draw attention to Clonazepam's rating on the Drugs.com website, it is consistently in the 9s and most comments are from long-term users. The SSRI ratings pale in comparison.
I'm not for one second discounting that benzos are powerful drugs and that withdrawals can be immense, but my current situation is untenable. I'm almost 8 months in, struggling with work every day, and have pulled away from most social situations as it's unbearable. My only concern taking Clonazepam long-term is if it stops working as then I truly am in limbo land. If I could guarantee it would have the same effect the next 20 years, I'd be on it permanently tomorrow, even if it meant I was dead at 60 and could have 20 semi-decent years of life. I actually don't think a UK GP would even allow that, they've battened down the hatches on benzos in the UK outside of epilepsy and that ain't going to change.
One last question, slightly off topic, do you find the Mirtazapine has made any actual difference to your mood and struggles?